National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 368786

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 368786
VAERS Form:
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2009-11-10
Onset:2009-11-12
Submitted:2009-11-19
Entered:2009-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (INFLUENZA A (H1N1) 2009 MONOVALENT) / SANOFI PASTEUR UP001AA / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Ataxia, Back pain, Blood pressure increased, Computerised tomogram normal, Drug abuse, Electrocardiogram ambulatory normal, Fatigue, Gait disturbance, Headache, Hypoaesthesia, Hyporeflexia, Lumbar puncture, Malaise, Nerve conduction studies normal, Neuropathy peripheral, Paraesthesia, Vision blurred, Drug screen positive, Blood test normal, Post lumbar puncture syndrome

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.PMH: smoker
Allergies:
Diagnostic Lab Data: LP done 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.Diag/Labs: CT head WNL, bloodwork WNL, nerve conduction study WNL, holter monitor WNL, drug screen (+)cannabinoids.
CDC 'Split Type':

Write-up: tingling sensation at fingertips radiating down arms, ataxia, sluggish reflexes, increased BP, headache Tx''d with Neurontin and Percocet 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09. Seen in ER on 11/13. DX: parasthesias, HA. Pt. c/o numbness/tingling in hands/feet, HA, increased BP. Assessment: (+)parasthesias. Pt declined LP. On 11/14 Seen in ER for worsening sx. DX: peripheral neuropathy Presenting SX: c/o tingling, electrical feeling in hands and feet, generalized weakness x3 days ago. Pt. c/o HA, difficulty walking, fatigue/malaise, blurred vision, Pt states received H1N1 last week and gardasil vax this week. Pt admitted for neuro eval. 11/19/09 Pt seen in ER w/ c/o N/V, back pain. DX: post spinal HA. Pt tx for generalized HA and dc.


Changed on 1/5/2010

VAERS ID: 368786 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2009-11-10
Onset:2009-11-12
Submitted:2009-11-19
Entered:2009-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (INFLUENZA A (H1N1) 2009 MONOVALENT) / SANOFI PASTEUR UP001AA / 0 RA / IM

Administered by: Unknown Public      Purchased by: Unknown Public
Symptoms: Asthenia, Ataxia, Back pain, Blood pressure increased, Computerised tomogram normal, Drug abuse, Electrocardiogram ambulatory normal, Fatigue, Gait disturbance, Headache, Hypoaesthesia, Hyporeflexia, Lumbar puncture, Malaise, Nerve conduction studies normal, Neuropathy peripheral, Paraesthesia, Vision blurred, Drug screen positive, Blood test normal, Post lumbar puncture syndrome

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.PMH: smoker 12/23/09 PMH: Tonsillectomy
Allergies:
Diagnostic Lab Data: LP done 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.Diag/Labs: CT head WNL, bloodwork WNL, nerve conduction study WNL, holter monitor WNL, drug screen (+)cannabinoids. 12/10/09 LABS and DIAGNOSTICS: LP- WN
CDC 'Split Type':

Write-up: tingling sensation at fingertips radiating down arms, ataxia, sluggish reflexes, increased BP, headache Tx''d with Neurontin and Percocet 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09. Seen in ER on 11/13. DX: parasthesias, HA. Pt. c/o numbness/tingling in hands/feet, HA, increased BP. Assessment: (+)parasthesias. Pt declined LP. On 11/14 Seen in ER for worsening sx. DX: peripheral neuropathy Presenting SX: c/o tingling, electrical feeling in hands and feet, generalized weakness x3 days ago. Pt. c/o HA, difficulty walking, fatigue/malaise, blurred vision, Pt states received H1N1 last week and gardasil vax this week. Pt admitted for neuro eval. 11/19/09 Pt seen in ER w/ c/o N/V, back pain. DX: post spinal HA. Pt tx for generalized HA and dc. 12/10/09 Hospital neurology consult, progress notes and tests received for DOS 11/14/09-11/17/09 Dx: Prob AIDP, microcytic anemia, back pain Complaint of tingling and numbness progressively worsening. Headache X3 days. Back pain and blurred vision. TX with percocet and ferrous sulfate. 12/11/09 Duplicate ER record for 11/14/09 received and ER record received for DOS 11/19/09 DX: Post spinal headache Patient presented with c/o nausea & vomiting, back pain and abdominal pain. Assess causes-ABD pain from vomiting, nausea caused by headache after lumbar puncture X2 (past week). Treated with Reglan, Morphine and IV fluids. Discharged home. 12/23/09 Hospital discharge summary received for DOS 11/14/09-11/17/09 DX: Possible Guillain-Barre Syndrome. Patient received HPV vaccination and H1N1 flu shot in the same week. Twelve hours after receiving H1N1, the patient experienced tingling and numbness of fingers and toes, which progressed to wrists and feet. The patient then experienced headache, blurred vision, back pain and since morning of admission, experienced generalized weakness. Lumbar puncture and nerve conduction study performed. Discharged home in stable condition.


Changed on 6/2/2010

VAERS ID: 368786 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2009-11-10
Onset:2009-11-12
Submitted:2009-11-19
Entered:2009-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (INFLUENZA A (H1N1) 2009 MONOVALENT) INFLUENZA (H1N1) (H1N1 (MONOVALENT) SANOFI) / SANOFI PASTEUR UP001AA / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Ataxia, Blood pressure increased, Headache, Hyporeflexia, Lumbar puncture, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.PMH: smoker 12/23/09 PMH: Tonsillectomy
Allergies:
Diagnostic Lab Data: LP done 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.Diag/Labs: CT head WNL, bloodwork WNL, nerve conduction study WNL, holter monitor WNL, drug screen (+)cannabinoids. 12/10/09 LABS and DIAGNOSTICS: LP- WN
CDC 'Split Type':

Write-up: tingling sensation at fingertips radiating down arms, ataxia, sluggish reflexes, increased BP, headache Tx''d with Neurontin and Percocet 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09. Seen in ER on 11/13. DX: parasthesias, HA. Pt. c/o numbness/tingling in hands/feet, HA, increased BP. Assessment: (+)parasthesias. Pt declined LP. On 11/14 Seen in ER for worsening sx. DX: peripheral neuropathy Presenting SX: c/o tingling, electrical feeling in hands and feet, generalized weakness x3 days ago. Pt. c/o HA, difficulty walking, fatigue/malaise, blurred vision, Pt states received H1N1 last week and gardasil vax this week. Pt admitted for neuro eval. 11/19/09 Pt seen in ER w/ c/o N/V, back pain. DX: post spinal HA. Pt tx for generalized HA and dc. 12/10/09 Hospital neurology consult, progress notes and tests received for DOS 11/14/09-11/17/09 Dx: Prob AIDP, microcytic anemia, back pain Complaint of tingling and numbness progressively worsening. Headache X3 days. Back pain and blurred vision. TX with percocet and ferrous sulfate. 12/11/09 Duplicate ER record for 11/14/09 received and ER record received for DOS 11/19/09 DX: Post spinal headache Patient presented with c/o nausea & vomiting, back pain and abdominal pain. Assess causes-ABD pain from vomiting, nausea caused by headache after lumbar puncture X2 (past week). Treated with Reglan, Morphine and IV fluids. Discharged home. 12/23/09 Hospital discharge summary received for DOS 11/14/09-11/17/09 DX: Possible Guillain-Barre Syndrome. Patient received HPV vaccination and H1N1 flu shot in the same week. Twelve hours after receiving H1N1, the patient experienced tingling and numbness of fingers and toes, which progressed to wrists and feet. The patient then experienced headache, blurred vision, back pain and since morning of admission, experienced generalized weakness. Lumbar puncture and nerve conduction study performed. Discharged home in stable condition.


Changed on 7/31/2010

VAERS ID: 368786 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2009-11-10
Onset:2009-11-12
Submitted:2009-11-19
Entered:2009-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) SANOFI) / SANOFI PASTEUR UP001AA / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Abdominal pain, Ataxia, Blood pressure increased, Headache, Hypoaesthesia, Hyporeflexia, Lumbar puncture, Lumbar puncture normal, Microcytic anaemia, Muscular weakness, Nausea, Paraesthesia, Vomiting, Demyelinating polyneuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.PMH: smoker 12/23/09 PMH: Tonsillectomy
Allergies:
Diagnostic Lab Data: LP done 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.Diag/Labs: CT head WNL, bloodwork WNL, nerve conduction study WNL, holter monitor WNL, drug screen (+)cannabinoids. 12/10/09 LABS and DIAGNOSTICS: LP- WN
CDC 'Split Type':

Write-up: tingling sensation at fingertips radiating down arms, ataxia, sluggish reflexes, increased BP, headache Tx''d with Neurontin and Percocet 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09. Seen in ER on 11/13. DX: parasthesias, HA. Pt. c/o numbness/tingling in hands/feet, HA, increased BP. Assessment: (+)parasthesias. Pt declined LP. On 11/14 Seen in ER for worsening sx. DX: peripheral neuropathy Presenting SX: c/o tingling, electrical feeling in hands and feet, generalized weakness x3 days ago. Pt. c/o HA, difficulty walking, fatigue/malaise, blurred vision, Pt states received H1N1 last week and gardasil vax this week. Pt admitted for neuro eval. 11/19/09 Pt seen in ER w/ c/o N/V, back pain. DX: post spinal HA. Pt tx for generalized HA and dc. 12/10/09 Hospital neurology consult, progress notes and tests received for DOS 11/14/09-11/17/09 Dx: Prob AIDP, microcytic anemia, back pain Complaint of tingling and numbness progressively worsening. Headache X3 days. Back pain and blurred vision. TX with percocet and ferrous sulfate. 12/11/09 Duplicate ER record for 11/14/09 received and ER record received for DOS 11/19/09 DX: Post spinal headache Patient presented with c/o nausea & vomiting, back pain and abdominal pain. Assess causes-ABD pain from vomiting, nausea caused by headache after lumbar puncture X2 (past week). Treated with Reglan, Morphine and IV fluids. Discharged home. 12/23/09 Hospital discharge summary received for DOS 11/14/09-11/17/09 DX: Possible Guillain-Barre Syndrome. Patient received HPV vaccination and H1N1 flu shot in the same week. Twelve hours after receiving H1N1, the patient experienced tingling and numbness of fingers and toes, which progressed to wrists and feet. The patient then experienced headache, blurred vision, back pain and since morning of admission, experienced generalized weakness. Lumbar puncture and nerve conduction study performed. Discharged home in stable condition.


Changed on 8/31/2010

VAERS ID: 368786 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2009-11-10
Onset:2009-11-12
Submitted:2009-11-19
Entered:2009-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) SANOFI) / SANOFI PASTEUR UP001AA / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Abdominal pain, Ataxia, Blood pressure increased, Coordination abnormal, Headache, Hypoaesthesia, Hyporeflexia, Lumbar puncture, Lumbar puncture normal, Microcytic anaemia, Muscular weakness, Nausea, Paraesthesia, Vomiting, Demyelinating polyneuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.PMH: smoker 12/23/09 PMH: Tonsillectomy
Allergies:
Diagnostic Lab Data: LP done 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.Diag/Labs: CT head WNL, bloodwork WNL, nerve conduction study WNL, holter monitor WNL, drug screen (+)cannabinoids. 12/10/09 LABS and DIAGNOSTICS: LP- WN
CDC 'Split Type':

Write-up: tingling sensation at fingertips radiating down arms, ataxia, sluggish reflexes, increased BP, headache Tx''d with Neurontin and Percocet 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09. Seen in ER on 11/13. DX: parasthesias, HA. Pt. c/o numbness/tingling in hands/feet, HA, increased BP. Assessment: (+)parasthesias. Pt declined LP. On 11/14 Seen in ER for worsening sx. DX: peripheral neuropathy Presenting SX: c/o tingling, electrical feeling in hands and feet, generalized weakness x3 days ago. Pt. c/o HA, difficulty walking, fatigue/malaise, blurred vision, Pt states received H1N1 last week and gardasil vax this week. Pt admitted for neuro eval. 11/19/09 Pt seen in ER w/ c/o N/V, back pain. DX: post spinal HA. Pt tx for generalized HA and dc. 12/10/09 Hospital neurology consult, progress notes and tests received for DOS 11/14/09-11/17/09 Dx: Prob AIDP, microcytic anemia, back pain Complaint of tingling and numbness progressively worsening. Headache X3 days. Back pain and blurred vision. TX with percocet and ferrous sulfate. 12/11/09 Duplicate ER record for 11/14/09 received and ER record received for DOS 11/19/09 DX: Post spinal headache Patient presented with c/o nausea & vomiting, back pain and abdominal pain. Assess causes-ABD pain from vomiting, nausea caused by headache after lumbar puncture X2 (past week). Treated with Reglan, Morphine and IV fluids. Discharged home. 12/23/09 Hospital discharge summary received for DOS 11/14/09-11/17/09 DX: Possible Guillain-Barre Syndrome. Patient received HPV vaccination and H1N1 flu shot in the same week. Twelve hours after receiving H1N1, the patient experienced tingling and numbness of fingers and toes, which progressed to wrists and feet. The patient then experienced headache, blurred vision, back pain and since morning of admission, experienced generalized weakness. Lumbar puncture and nerve conduction study performed. Discharged home in stable condition.


Changed on 1/4/2011

VAERS ID: 368786 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2009-11-10
Onset:2009-11-12
Submitted:2009-11-19
Entered:2009-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) SANOFI) / SANOFI PASTEUR UP001AA / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Abdominal pain, Ataxia, Blood pressure increased, Coordination abnormal, Headache, Hypoaesthesia, Hyporeflexia, Lumbar puncture, Lumbar puncture normal, Microcytic anaemia, Muscular weakness, Nausea, Paraesthesia, Vomiting, Demyelinating polyneuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.PMH: smoker 12/23/09 PMH: Tonsillectomy
Allergies:
Diagnostic Lab Data: LP done 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.Diag/Labs: CT head WNL, bloodwork WNL, nerve conduction study WNL, holter monitor WNL, drug screen (+)cannabinoids. 12/10/09 LABS and DIAGNOSTICS: LP- WN WNL, Nerve conduction study-WNL 12/23/09 LABS and DIAGNOSTICS: Head CT-normal, Nerve conduction study-normal.
CDC 'Split Type':

Write-up: tingling sensation at fingertips radiating down arms, ataxia, sluggish reflexes, increased BP, headache Tx''d with Neurontin and Percocet 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09. Seen in ER on 11/13. DX: parasthesias, HA. Pt. c/o numbness/tingling in hands/feet, HA, increased BP. Assessment: (+)parasthesias. Pt declined LP. On 11/14 Seen in ER for worsening sx. DX: peripheral neuropathy Presenting SX: c/o tingling, electrical feeling in hands and feet, generalized weakness x3 days ago. Pt. c/o HA, difficulty walking, fatigue/malaise, blurred vision, Pt states received H1N1 last week and gardasil vax this week. Pt admitted for neuro eval. 11/19/09 Pt seen in ER w/ c/o N/V, back pain. DX: post spinal HA. Pt tx for generalized HA and dc. 12/10/09 Hospital neurology consult, progress notes and tests received for DOS 11/14/09-11/17/09 Dx: Prob AIDP, microcytic anemia, back pain Complaint of tingling and numbness progressively worsening. Headache X3 days. Back pain and blurred vision. TX with percocet and ferrous sulfate. 12/11/09 Duplicate ER record for 11/14/09 received and ER record received for DOS 11/19/09 DX: Post spinal headache Patient presented with c/o nausea & vomiting, back pain and abdominal pain. Assess causes-ABD pain from vomiting, nausea caused by headache after lumbar puncture X2 (past week). Treated with Reglan, Morphine and IV fluids. Discharged home. 12/23/09 Hospital discharge summary received for DOS 11/14/09-11/17/09 DX: Possible Guillain-Barre Syndrome. Patient received HPV vaccination and H1N1 flu shot in the same week. Twelve hours after receiving H1N1, the patient experienced tingling and numbness of fingers and toes, which progressed to wrists and feet. The patient then experienced headache, blurred vision, back pain and since morning of admission, experienced generalized weakness. Lumbar puncture and nerve conduction study performed. Discharged home in stable condition.


Changed on 4/13/2011

VAERS ID: 368786 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2009-11-10
Onset:2009-11-12
Submitted:2009-11-19
Entered:2009-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) SANOFI) / SANOFI PASTEUR UP001AA / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Abdominal pain, Asthenia, Ataxia, Back pain, Blood pressure increased, Computerised tomogram normal, Drug abuse, Electrocardiogram ambulatory normal, Fatigue, Gait disturbance, Headache, Hypoaesthesia, Hyporeflexia, Lumbar puncture, Lumbar puncture normal, Malaise, Microcytic anaemia, Muscular weakness, Nausea, Nerve conduction studies normal, Neuropathy peripheral, Paraesthesia, Vision blurred, Vomiting, Drug screen positive, Blood test normal, Post lumbar puncture syndrome, Demyelinating polyneuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.PMH: smoker 12/23/09 PMH: Tonsillectomy
Allergies:
Diagnostic Lab Data: LP done 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.Diag/Labs: CT head WNL, bloodwork WNL, nerve conduction study WNL, holter monitor WNL, drug screen (+)cannabinoids. 12/10/09 LABS and DIAGNOSTICS: LP- WNL, Nerve conduction study-WNL 12/23/09 LABS and DIAGNOSTICS: Head CT-normal, Nerve conduction study-normal.
CDC 'Split Type':

Write-up: tingling sensation at fingertips radiating down arms, ataxia, sluggish reflexes, increased BP, headache Tx''d with Neurontin and Percocet 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09. Seen in ER on 11/13. DX: parasthesias, HA. Pt. c/o numbness/tingling in hands/feet, HA, increased BP. Assessment: (+)parasthesias. Pt declined LP. On 11/14 Seen in ER for worsening sx. DX: peripheral neuropathy Presenting SX: c/o tingling, electrical feeling in hands and feet, generalized weakness x3 days ago. Pt. c/o HA, difficulty walking, fatigue/malaise, blurred vision, Pt states received H1N1 last week and gardasil vax this week. Pt admitted for neuro eval. 11/19/09 Pt seen in ER w/ c/o N/V, back pain. DX: post spinal HA. Pt tx for generalized HA and dc. 12/10/09 Hospital neurology consult, progress notes and tests received for DOS 11/14/09-11/17/09 Dx: Prob AIDP, microcytic anemia, back pain Complaint of tingling and numbness progressively worsening. Headache X3 days. Back pain and blurred vision. TX with percocet and ferrous sulfate. 12/11/09 Duplicate ER record for 11/14/09 received and ER record received for DOS 11/19/09 DX: Post spinal headache Patient presented with c/o nausea & vomiting, back pain and abdominal pain. Assess causes-ABD pain from vomiting, nausea caused by headache after lumbar puncture X2 (past week). Treated with Reglan, Morphine and IV fluids. Discharged home. 12/23/09 Hospital discharge summary received for DOS 11/14/09-11/17/09 DX: Possible Guillain-Barre Syndrome. Patient received HPV vaccination and H1N1 flu shot in the same week. Twelve hours after receiving H1N1, the patient experienced tingling and numbness of fingers and toes, which progressed to wrists and feet. The patient then experienced headache, blurred vision, back pain and since morning of admission, experienced generalized weakness. Lumbar puncture and nerve conduction study performed. Discharged home in stable condition.


Changed on 5/13/2011

VAERS ID: 368786 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2009-11-10
Onset:2009-11-12
Submitted:2009-11-19
Entered:2009-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) SANOFI) / SANOFI PASTEUR UP001AA / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Abdominal pain, Asthenia, Ataxia, Back pain, Blood pressure increased, Computerised tomogram normal, Drug abuse, Electrocardiogram ambulatory normal, Fatigue, Gait disturbance, Headache, Hypoaesthesia, Hyporeflexia, Lumbar puncture, Lumbar puncture normal, Malaise, Microcytic anaemia, Muscular weakness, Nausea, Nerve conduction studies normal, Neuropathy peripheral, Paraesthesia, Vision blurred, Vomiting, Drug screen positive, Blood test normal, Post lumbar puncture syndrome, Demyelinating polyneuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.PMH: smoker 12/23/09 PMH: Tonsillectomy
Allergies:
Diagnostic Lab Data: LP done 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.Diag/Labs: CT head WNL, bloodwork WNL, nerve conduction study WNL, holter monitor WNL, drug screen (+)cannabinoids. 12/10/09 LABS and DIAGNOSTICS: LP- WNL, Nerve conduction study-WNL 12/23/09 LABS and DIAGNOSTICS: Head CT-normal, Nerve conduction study-normal.
CDC 'Split Type':

Write-up: tingling sensation at fingertips radiating down arms, ataxia, sluggish reflexes, increased BP, headache Tx''d with Neurontin and Percocet 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09. Seen in ER on 11/13. DX: parasthesias, HA. Pt. c/o numbness/tingling in hands/feet, HA, increased BP. Assessment: (+)parasthesias. Pt declined LP. On 11/14 Seen in ER for worsening sx. DX: peripheral neuropathy Presenting SX: c/o tingling, electrical feeling in hands and feet, generalized weakness x3 days ago. Pt. c/o HA, difficulty walking, fatigue/malaise, blurred vision, Pt states received H1N1 last week and gardasil vax this week. Pt admitted for neuro eval. 11/19/09 Pt seen in ER w/ c/o N/V, back pain. DX: post spinal HA. Pt tx for generalized HA and dc. 12/10/09 Hospital neurology consult, progress notes and tests received for DOS 11/14/09-11/17/09 Dx: Prob AIDP, microcytic anemia, back pain Complaint of tingling and numbness progressively worsening. Headache X3 days. Back pain and blurred vision. TX with percocet and ferrous sulfate. 12/11/09 Duplicate ER record for 11/14/09 received and ER record received for DOS 11/19/09 DX: Post spinal headache Patient presented with c/o nausea & vomiting, back pain and abdominal pain. Assess causes-ABD pain from vomiting, nausea caused by headache after lumbar puncture X2 (past week). Treated with Reglan, Morphine and IV fluids. Discharged home. 12/23/09 Hospital discharge summary received for DOS 11/14/09-11/17/09 DX: Possible Guillain-Barre Syndrome. Patient received HPV vaccination and H1N1 flu shot in the same week. Twelve hours after receiving H1N1, the patient experienced tingling and numbness of fingers and toes, which progressed to wrists and feet. The patient then experienced headache, blurred vision, back pain and since morning of admission, experienced generalized weakness. Lumbar puncture and nerve conduction study performed. Discharged home in stable condition.


Changed on 6/11/2011

VAERS ID: 368786 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2009-11-10
Onset:2009-11-12
Submitted:2009-11-19
Entered:2009-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) SANOFI) / SANOFI PASTEUR UP001AA / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Abdominal pain, Asthenia, Ataxia, Back pain, Blood pressure increased, Computerised tomogram normal, Drug abuse, Electrocardiogram ambulatory normal, Fatigue, Gait disturbance, Headache, Hypoaesthesia, Hyporeflexia, Lumbar puncture, Lumbar puncture normal, Malaise, Microcytic anaemia, Muscular weakness, Nausea, Nerve conduction studies normal, Neuropathy peripheral, Paraesthesia, Vision blurred, Vomiting, Drug screen positive, Blood test normal, Post lumbar puncture syndrome, Demyelinating polyneuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.PMH: smoker 12/23/09 PMH: Tonsillectomy
Allergies:
Diagnostic Lab Data: LP done 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.Diag/Labs: CT head WNL, bloodwork WNL, nerve conduction study WNL, holter monitor WNL, drug screen (+)cannabinoids. 12/10/09 LABS and DIAGNOSTICS: LP- WNL, Nerve conduction study-WNL 12/23/09 LABS and DIAGNOSTICS: Head CT-normal, Nerve conduction study-normal.
CDC 'Split Type':

Write-up: tingling sensation at fingertips radiating down arms, ataxia, sluggish reflexes, increased BP, headache Tx''d with Neurontin and Percocet 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09. Seen in ER on 11/13. DX: parasthesias, HA. Pt. c/o numbness/tingling in hands/feet, HA, increased BP. Assessment: (+)parasthesias. Pt declined LP. On 11/14 Seen in ER for worsening sx. DX: peripheral neuropathy Presenting SX: c/o tingling, electrical feeling in hands and feet, generalized weakness x3 days ago. Pt. c/o HA, difficulty walking, fatigue/malaise, blurred vision, Pt states received H1N1 last week and gardasil vax this week. Pt admitted for neuro eval. 11/19/09 Pt seen in ER w/ c/o N/V, back pain. DX: post spinal HA. Pt tx for generalized HA and dc. 12/10/09 Hospital neurology consult, progress notes and tests received for DOS 11/14/09-11/17/09 Dx: Prob AIDP, microcytic anemia, back pain Complaint of tingling and numbness progressively worsening. Headache X3 days. Back pain and blurred vision. TX with percocet and ferrous sulfate. 12/11/09 Duplicate ER record for 11/14/09 received and ER record received for DOS 11/19/09 DX: Post spinal headache Patient presented with c/o nausea & vomiting, back pain and abdominal pain. Assess causes-ABD pain from vomiting, nausea caused by headache after lumbar puncture X2 (past week). Treated with Reglan, Morphine and IV fluids. Discharged home. 12/23/09 Hospital discharge summary received for DOS 11/14/09-11/17/09 DX: Possible Guillain-Barre Syndrome. Patient received HPV vaccination and H1N1 flu shot in the same week. Twelve hours after receiving H1N1, the patient experienced tingling and numbness of fingers and toes, which progressed to wrists and feet. The patient then experienced headache, blurred vision, back pain and since morning of admission, experienced generalized weakness. Lumbar puncture and nerve conduction study performed. Discharged home in stable condition.


Changed on 11/13/2012

VAERS ID: 368786 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2009-11-10
Onset:2009-11-12
Submitted:2009-11-19
Entered:2009-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) SANOFI) INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI) / SANOFI PASTEUR UP001AA / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Abdominal pain, Asthenia, Ataxia, Back pain, Blood pressure increased, Computerised tomogram normal, Drug abuse, Electrocardiogram ambulatory normal, Fatigue, Gait disturbance, Headache, Hypoaesthesia, Hyporeflexia, Lumbar puncture, Lumbar puncture normal, Malaise, Microcytic anaemia, Muscular weakness, Nausea, Nerve conduction studies normal, Neuropathy peripheral, Paraesthesia, Vision blurred, Vomiting, Drug screen positive, Blood test normal, Post lumbar puncture syndrome, Demyelinating polyneuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.PMH: smoker 12/23/09 PMH: Tonsillectomy
Allergies:
Diagnostic Lab Data: LP done 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.Diag/Labs: CT head WNL, bloodwork WNL, nerve conduction study WNL, holter monitor WNL, drug screen (+)cannabinoids. 12/10/09 LABS and DIAGNOSTICS: LP- WNL, Nerve conduction study-WNL 12/23/09 LABS and DIAGNOSTICS: Head CT-normal, Nerve conduction study-normal.
CDC 'Split Type':

Write-up: tingling sensation at fingertips radiating down arms, ataxia, sluggish reflexes, increased BP, headache Tx''d with Neurontin and Percocet 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09. Seen in ER on 11/13. DX: parasthesias, HA. Pt. c/o numbness/tingling in hands/feet, HA, increased BP. Assessment: (+)parasthesias. Pt declined LP. On 11/14 Seen in ER for worsening sx. DX: peripheral neuropathy Presenting SX: c/o tingling, electrical feeling in hands and feet, generalized weakness x3 days ago. Pt. c/o HA, difficulty walking, fatigue/malaise, blurred vision, Pt states received H1N1 last week and gardasil vax this week. Pt admitted for neuro eval. 11/19/09 Pt seen in ER w/ c/o N/V, back pain. DX: post spinal HA. Pt tx for generalized HA and dc. 12/10/09 Hospital neurology consult, progress notes and tests received for DOS 11/14/09-11/17/09 Dx: Prob AIDP, microcytic anemia, back pain Complaint of tingling and numbness progressively worsening. Headache X3 days. Back pain and blurred vision. TX with percocet and ferrous sulfate. 12/11/09 Duplicate ER record for 11/14/09 received and ER record received for DOS 11/19/09 DX: Post spinal headache Patient presented with c/o nausea & vomiting, back pain and abdominal pain. Assess causes-ABD pain from vomiting, nausea caused by headache after lumbar puncture X2 (past week). Treated with Reglan, Morphine and IV fluids. Discharged home. 12/23/09 Hospital discharge summary received for DOS 11/14/09-11/17/09 DX: Possible Guillain-Barre Syndrome. Patient received HPV vaccination and H1N1 flu shot in the same week. Twelve hours after receiving H1N1, the patient experienced tingling and numbness of fingers and toes, which progressed to wrists and feet. The patient then experienced headache, blurred vision, back pain and since morning of admission, experienced generalized weakness. Lumbar puncture and nerve conduction study performed. Discharged home in stable condition.


Changed on 2/14/2017

VAERS ID: 368786 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2009-11-10
Onset:2009-11-12
Submitted:2009-11-19
Entered:2009-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI) INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)) / SANOFI PASTEUR UP001AA / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Abdominal pain, Asthenia, Ataxia, Back pain, Blood pressure increased, Computerised tomogram normal, Drug abuse, Electrocardiogram ambulatory normal, Fatigue, Gait disturbance, Headache, Hypoaesthesia, Hyporeflexia, Lumbar puncture, Lumbar puncture normal, Malaise, Microcytic anaemia, Muscular weakness, Nausea, Nerve conduction studies normal, Neuropathy peripheral, Paraesthesia, Vision blurred, Vomiting, Drug screen positive, Blood test normal, Post lumbar puncture syndrome, Demyelinating polyneuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.PMH: smoker 12/23/09 PMH: Tonsillectomy
Allergies:
Diagnostic Lab Data: LP done 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.Diag/Labs: CT head WNL, bloodwork WNL, nerve conduction study WNL, holter monitor WNL, drug screen (+)cannabinoids. 12/10/09 LABS and DIAGNOSTICS: LP- WNL, Nerve conduction study-WNL 12/23/09 LABS and DIAGNOSTICS: Head CT-normal, Nerve conduction study-normal.
CDC 'Split Type':

Write-up: tingling sensation at fingertips radiating down arms, ataxia, sluggish reflexes, increased BP, headache Tx''d with Neurontin and Percocet 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09. Seen in ER on 11/13. DX: parasthesias, HA. Pt. c/o numbness/tingling in hands/feet, HA, increased BP. Assessment: (+)parasthesias. Pt declined LP. On 11/14 Seen in ER for worsening sx. DX: peripheral neuropathy Presenting SX: c/o tingling, electrical feeling in hands and feet, generalized weakness x3 days ago. Pt. c/o HA, difficulty walking, fatigue/malaise, blurred vision, Pt states received H1N1 last week and gardasil vax this week. Pt admitted for neuro eval. 11/19/09 Pt seen in ER w/ c/o N/V, back pain. DX: post spinal HA. Pt tx for generalized HA and dc. 12/10/09 Hospital neurology consult, progress notes and tests received for DOS 11/14/09-11/17/09 Dx: Prob AIDP, microcytic anemia, back pain Complaint of tingling and numbness progressively worsening. Headache X3 days. Back pain and blurred vision. TX with percocet and ferrous sulfate. 12/11/09 Duplicate ER record for 11/14/09 received and ER record received for DOS 11/19/09 DX: Post spinal headache Patient presented with c/o nausea & vomiting, back pain and abdominal pain. Assess causes-ABD pain from vomiting, nausea caused by headache after lumbar puncture X2 (past week). Treated with Reglan, Morphine and IV fluids. Discharged home. 12/23/09 Hospital discharge summary received for DOS 11/14/09-11/17/09 DX: Possible Guillain-Barre Syndrome. Patient received HPV vaccination and H1N1 flu shot in the same week. Twelve hours after receiving H1N1, the patient experienced tingling and numbness of fingers and toes, which progressed to wrists and feet. The patient then experienced headache, blurred vision, back pain and since morning of admission, experienced generalized weakness. Lumbar puncture and nerve conduction study performed. Discharged home in stable condition.


Changed on 4/14/2017

VAERS ID: 368786 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2009-11-10
Onset:2009-11-12
Submitted:2009-11-19
Entered:2009-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)) / SANOFI PASTEUR UP001AA / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Abdominal pain, Asthenia, Ataxia, Back pain, Blood pressure increased, Computerised tomogram normal, Drug abuse, Electrocardiogram ambulatory normal, Fatigue, Gait disturbance, Headache, Hypoaesthesia, Hyporeflexia, Lumbar puncture, Lumbar puncture normal, Malaise, Microcytic anaemia, Muscular weakness, Nausea, Nerve conduction studies normal, Neuropathy peripheral, Paraesthesia, Vision blurred, Vomiting, Drug screen positive, Blood test normal, Post lumbar puncture syndrome, Demyelinating polyneuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.PMH: smoker 12/23/09 PMH: Tonsillectomy
Allergies:
Diagnostic Lab Data: LP done 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.Diag/Labs: CT head 11/19/09[[address]]head WNL, bloodwork WNL, nerve conduction study WNL, holter monitor WNL, drug screen (+)cannabinoids. 12/10/09 LABS and DIAGNOSTICS: LP- WNL, Nerve conduction study-WNL 12/23/09 LABS and DIAGNOSTICS: Head [[name]] CT-normal, Nerve conduction study-normal.
CDC 'Split Type':

Write-up: tingling sensation at fingertips radiating down arms, ataxia, sluggish reflexes, increased BP, headache Tx''d with Neurontin and Percocet 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09. Seen in ER on 11/13. DX: parasthesias, HA. Pt. c/o numbness/tingling in hands/feet, HA, increased BP. Assessment: (+)parasthesias. Pt declined LP. On 11/14 Seen in ER for worsening sx. DX: peripheral neuropathy Presenting SX: c/o tingling, electrical feeling in hands and feet, generalized weakness x3 days ago. Pt. c/o HA, difficulty walking, fatigue/malaise, blurred vision, Pt states received H1N1 last week and gardasil vax this week. Pt admitted for neuro eval. 11/19/09 Pt seen in ER w/ c/o N/V, back pain. DX: post spinal HA. Pt tx for generalized HA and dc. 12/10/09 Hospital neurology consult, progress notes and tests received for DOS 11/14/09-11/17/09 Dx: Prob AIDP, microcytic anemia, back pain Complaint of tingling and numbness progressively worsening. Headache X3 days. Back pain and blurred vision. TX with percocet and ferrous sulfate. 12/11/09 Duplicate ER record for 11/14/09 received and ER record received for DOS 11/19/09 DX: Post spinal headache Patient presented with c/o nausea & vomiting, back pain and abdominal pain. Assess causes-ABD pain from vomiting, nausea caused by headache after lumbar puncture X2 (past week). Treated with Reglan, Morphine and IV fluids. Discharged home. 12/23/09 Hospital discharge summary received for DOS 11/14/09-11/17/09 DX: Possible Guillain-Barre Syndrome. Patient received HPV vaccination and H1N1 flu shot in the same week. Twelve hours after receiving H1N1, the patient experienced tingling and numbness of fingers and toes, which progressed to wrists and feet. The patient then experienced headache, blurred vision, back pain and since morning of admission, experienced generalized weakness. Lumbar puncture and nerve conduction study performed. Discharged home in stable condition.


Changed on 9/14/2017

VAERS ID: 368786 Before After
VAERS Form:(blank) 1
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2009-11-10
Onset:2009-11-12
Submitted:2009-11-19
Entered:2009-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)) / SANOFI PASTEUR UP001AA / 0 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Abdominal pain, Ataxia, Blood pressure increased, Headache, Hypoaesthesia, Hyporeflexia, Lumbar puncture, Lumbar puncture normal, Microcytic anaemia, Muscular weakness, Nausea, Paraesthesia, Vomiting, Demyelinating polyneuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.PMH: smoker 12/23/09 PMH: Tonsillectomy
Allergies:
Diagnostic Lab Data: LP done 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09[[address]]head WNL, bloodwork WNL, nerve conduction study WNL, holter monitor WNL, drug screen (+)cannabinoids. 12/10/09 LABS and DIAGNOSTICS: LP- WNL, Nerve conduction study-WNL 12/23/09 LABS and DIAGNOSTICS: [[name]] CT-normal, Nerve conduction study-normal.
CDC 'Split Type':

Write-up: tingling sensation at fingertips radiating down arms, ataxia, sluggish reflexes, increased BP, headache Tx''d with Neurontin and Percocet 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09. Seen in ER on 11/13. DX: parasthesias, HA. Pt. c/o numbness/tingling in hands/feet, HA, increased BP. Assessment: (+)parasthesias. Pt declined LP. On 11/14 Seen in ER for worsening sx. DX: peripheral neuropathy Presenting SX: c/o tingling, electrical feeling in hands and feet, generalized weakness x3 days ago. Pt. c/o HA, difficulty walking, fatigue/malaise, blurred vision, Pt states received H1N1 last week and gardasil vax this week. Pt admitted for neuro eval. 11/19/09 Pt seen in ER w/ c/o N/V, back pain. DX: post spinal HA. Pt tx for generalized HA and dc. 12/10/09 Hospital neurology consult, progress notes and tests received for DOS 11/14/09-11/17/09 Dx: Prob AIDP, microcytic anemia, back pain Complaint of tingling and numbness progressively worsening. Headache X3 days. Back pain and blurred vision. TX with percocet and ferrous sulfate. 12/11/09 Duplicate ER record for 11/14/09 received and ER record received for DOS 11/19/09 DX: Post spinal headache Patient presented with c/o nausea & vomiting, back pain and abdominal pain. Assess causes-ABD pain from vomiting, nausea caused by headache after lumbar puncture X2 (past week). Treated with Reglan, Morphine and IV fluids. Discharged home. 12/23/09 Hospital discharge summary received for DOS 11/14/09-11/17/09 DX: Possible Guillain-Barre Syndrome. Patient received HPV vaccination and H1N1 flu shot in the same week. Twelve hours after receiving H1N1, the patient experienced tingling and numbness of fingers and toes, which progressed to wrists and feet. The patient then experienced headache, blurred vision, back pain and since morning of admission, experienced generalized weakness. Lumbar puncture and nerve conduction study performed. Discharged home in stable condition.


Changed on 2/14/2018

VAERS ID: 368786 Before After
VAERS Form:1
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2009-11-10
Onset:2009-11-12
Submitted:2009-11-19
Entered:2009-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)) / SANOFI PASTEUR UP001AA / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Abdominal pain, Ataxia, Blood pressure increased, Headache, Hypoaesthesia, Hyporeflexia, Lumbar puncture, Lumbar puncture normal, Microcytic anaemia, Muscular weakness, Nausea, Paraesthesia, Vomiting, Demyelinating polyneuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.PMH: smoker 12/23/09 PMH: Tonsillectomy
Allergies:
Diagnostic Lab Data: LP done 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09[[address]]head WNL, bloodwork WNL, nerve conduction study WNL, holter monitor WNL, drug screen (+)cannabinoids. 12/10/09 LABS and DIAGNOSTICS: LP- WNL, Nerve conduction study-WNL 12/23/09 LABS and DIAGNOSTICS: [[name]] CT-normal, Nerve conduction study-normal.
CDC 'Split Type':

Write-up: tingling sensation at fingertips radiating down arms, ataxia, sluggish reflexes, increased BP, headache Tx''d with Neurontin and Percocet 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09. Seen in ER on 11/13. DX: parasthesias, HA. Pt. c/o numbness/tingling in hands/feet, HA, increased BP. Assessment: (+)parasthesias. Pt declined LP. On 11/14 Seen in ER for worsening sx. DX: peripheral neuropathy Presenting SX: c/o tingling, electrical feeling in hands and feet, generalized weakness x3 days ago. Pt. c/o HA, difficulty walking, fatigue/malaise, blurred vision, Pt states received H1N1 last week and gardasil vax this week. Pt admitted for neuro eval. 11/19/09 Pt seen in ER w/ c/o N/V, back pain. DX: post spinal HA. Pt tx for generalized HA and dc. 12/10/09 Hospital neurology consult, progress notes and tests received for DOS 11/14/09-11/17/09 Dx: Prob AIDP, microcytic anemia, back pain Complaint of tingling and numbness progressively worsening. Headache X3 days. Back pain and blurred vision. TX with percocet and ferrous sulfate. 12/11/09 Duplicate ER record for 11/14/09 received and ER record received for DOS 11/19/09 DX: Post spinal headache Patient presented with c/o nausea & vomiting, back pain and abdominal pain. Assess causes-ABD pain from vomiting, nausea caused by headache after lumbar puncture X2 (past week). Treated with Reglan, Morphine and IV fluids. Discharged home. 12/23/09 Hospital discharge summary received for DOS 11/14/09-11/17/09 DX: Possible Guillain-Barre Syndrome. Patient received HPV vaccination and H1N1 flu shot in the same week. Twelve hours after receiving H1N1, the patient experienced tingling and numbness of fingers and toes, which progressed to wrists and feet. The patient then experienced headache, blurred vision, back pain and since morning of admission, experienced generalized weakness. Lumbar puncture and nerve conduction study performed. Discharged home in stable condition.


Changed on 6/14/2018

VAERS ID: 368786 Before After
VAERS Form:1
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2009-11-10
Onset:2009-11-12
Submitted:2009-11-19
Entered:2009-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)) / SANOFI PASTEUR UP001AA / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Abdominal pain, Ataxia, Blood pressure increased, Headache, Hypoaesthesia, Hyporeflexia, Lumbar puncture, Lumbar puncture normal, Microcytic anaemia, Muscular weakness, Nausea, Paraesthesia, Vomiting, Demyelinating polyneuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09.PMH: smoker 12/23/09 PMH: Tonsillectomy
Allergies:
Diagnostic Lab Data: LP done 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09[[address]]head WNL, bloodwork WNL, nerve conduction study WNL, holter monitor WNL, drug screen (+)cannabinoids. 12/10/09 LABS and DIAGNOSTICS: LP- WNL, Nerve conduction study-WNL 12/23/09 LABS and DIAGNOSTICS: [[name]] CT-normal, Nerve conduction study-normal.
CDC 'Split Type':

Write-up: tingling sensation at fingertips radiating down arms, ataxia, sluggish reflexes, increased BP, headache Tx''d with Neurontin and Percocet 11/20/09 Hosp. records received for dates 11/13/09, 11/14/09 and 11/19/09. Seen in ER on 11/13. DX: parasthesias, HA. Pt. c/o numbness/tingling in hands/feet, HA, increased BP. Assessment: (+)parasthesias. Pt declined LP. On 11/14 Seen in ER for worsening sx. DX: peripheral neuropathy Presenting SX: c/o tingling, electrical feeling in hands and feet, generalized weakness x3 days ago. Pt. c/o HA, difficulty walking, fatigue/malaise, blurred vision, Pt states received H1N1 last week and gardasil vax this week. Pt admitted for neuro eval. 11/19/09 Pt seen in ER w/ c/o N/V, back pain. DX: post spinal HA. Pt tx for generalized HA and dc. 12/10/09 Hospital neurology consult, progress notes and tests received for DOS 11/14/09-11/17/09 Dx: Prob AIDP, microcytic anemia, back pain Complaint of tingling and numbness progressively worsening. Headache X3 days. Back pain and blurred vision. TX with percocet and ferrous sulfate. 12/11/09 Duplicate ER record for 11/14/09 received and ER record received for DOS 11/19/09 DX: Post spinal headache Patient presented with c/o nausea & vomiting, back pain and abdominal pain. Assess causes-ABD pain from vomiting, nausea caused by headache after lumbar puncture X2 (past week). Treated with Reglan, Morphine and IV fluids. Discharged home. 12/23/09 Hospital discharge summary received for DOS 11/14/09-11/17/09 DX: Possible Guillain-Barre Syndrome. Patient received HPV vaccination and H1N1 flu shot in the same week. Twelve hours after receiving H1N1, the patient experienced tingling and numbness of fingers and toes, which progressed to wrists and feet. The patient then experienced headache, blurred vision, back pain and since morning of admission, experienced generalized weakness. Lumbar puncture and nerve conduction study performed. Discharged home in stable condition.

New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=368786&WAYBACKHISTORY=ON


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166