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This is VAERS ID 27752

(NOTE: This result is from the 8/31/2010 version of the VAERS database)

Case Details

VAERS ID: 27752 (history)  
Form: Version .0  
Age: 60.0  
Sex: Male  
Location: Florida  
Vaccinated:1990-11-20
Onset:1990-11-27
   Days after vaccination:7
Submitted: 1991-01-25
   Days after onset:59
Entered: 1991-02-05
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / - - / -

Administered by: Public       Purchased by: Private
Symptoms: Back pain, Guillain-Barre syndrome, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 35 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Approx 7d, pain lower back, tingling hands. Approx 14d, severe back pain & pain shooting up arms & legs & numbness in trunk & same area of pain. Hosp 5 wks-Therapy; Meds at home.unk when reflexs, nerves heal or numbness subsides. + GBS.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20100831&IDNUMBER=27752


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