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This is VAERS ID 26802

Case Details

VAERS ID: 26802 (history)  
Form: Version 1.0  
Age: 28.0  
Sex: Female  
Location: Delaware  
Vaccinated:1990-10-24
Onset:1990-10-25
   Days after vaccination:1
Submitted: 1990-11-19
   Days after onset:25
Entered: 1990-11-27
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES - / UNK LA / -

Administered by: Private       Purchased by: Other
Symptoms: Asthenia, Neuropathy, Pain, Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: PCN, Codeine allergies
Allergies:
Diagnostic Lab Data: Post vaccine Peripheral Polyneuropathy
CDC Split Type:

Write-up: Pt vaccinated with MMR/Tetanus developed paresthesia of hands & feet w/numbness, fatigue, weakness, aches, fever 99.9.


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