National Vaccine
Information Center

Your Health. Your Family. Your Choice.
Search Results

From the 7/7/2013 release of VAERS data (an older release, current is 1/7/2022):

This is VAERS ID 172391

Government Disclaimer on use of this data

Case Details

VAERS ID: 172391 (history)  
Form: Version .0  
Age: 69.0  
Sex: Female  
Location: Pennsylvania  
   Days after vaccination:14
Submitted: 2001-05-14
   Days after onset:206
Entered: 2001-06-26
   Days after submission:43
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Public       Purchased by: Unknown
Symptoms: Asthenia, Cough, Dysarthria, Dysphagia, Paresis, Rhinitis
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2002-03-20
   Days after onset: 516
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI - neg, Lyme - neg, EMG w/tensilon test - neg
CDC Split Type: PA0147

Write-up: Two weeks following immunizations with flu vaccine developed cough, coryza, weakness over the course of week developed dysarthia, dysphagia with cranial nerve paresis on exam. Diagnosed with ALS. According to 213289, 60 day follow up, patient died 03/20/2002 from ALS, unassociated with flu vaccine. Follow up on 09/18/2001: "The patients right arm was prepped and draped in a sterile fashion. 1% Xylocaine was employed for local anesthesia. A hand injection of contrast through a peripheral angiocath provided opacification of the deep veins of the right arm. The right basilic vein was accessed under fluoroscopic guidance with a micropuncture set. A cook PICC catheter was then trimmed to a length of 36cm and advanced through a peel-away sheath into the SVC. A hand injection of contrast through the catheter reveals the tip in the superior vena cava. The catheter was flushed and sutured in place. The catheter was then heparinized with 400 units Heparin and the patient was returned to the post-operative lounge in stable condition. "

New Search

Link To This Search Result:

Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166