National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 12/30/2020 release of VAERS data (an older release, current is 4/1/2021):

This is VAERS ID 107835

Case Details

VAERS ID: 107835 (history)  
Form: Version 1.0  
Age: 65.0  
Sex: Male  
Location: Ohio  
Vaccinated:1997-09-01
Onset:1997-10-01
   Days after vaccination:30
Submitted: 1998-02-25
   Days after onset:147
Entered: 1998-02-26
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E3367HB / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Hypertonia, Hypokinesia, Myalgia, Myasthenic syndrome, Neuritis, Neuropathy, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Fiorinal/Butalbital, USP;SYmmetrel/Amantadine
Current Illness:
Preexisting Conditions: Carpal Tunnel synd;carcinoma in porstate;
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: MPI98158

Write-up: pt recv vax & devel muscle soreness & stiffness 1mo post vax;pt devel muscle pain & weakness of upper & lower extremities;pt finds it hard to get up out of chair & suffers from bilat shoulder pain;devel acute neuritis w/brachial plexiopathy


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20201230&IDNUMBER=107835


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166