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This is VAERS ID 30242

(NOTE: This result is from the 12/31/2003 version of the VAERS database)

Case Details

VAERS ID: 30242 (history)  
Form: Version .0  
Age: 47.1  
Sex: Female  
Location: Colorado  
Vaccinated:1990-10-26
Onset:1990-11-06
   Days after vaccination:11
Submitted: 1991-04-05
   Days after onset:150
Entered: 1991-05-08
   Days after submission:32
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH 4908181 / 0 A / -

Administered by: Private       Purchased by: Unknown
Symptoms: ABSCESS, CEREBROVASC ACCID, INFARCT CEREBR, NEOPL CNS, NEUROPATHY
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 46 days
   Extended hospital stay? No
Previous Vaccinations: none
Other Medications: none
Current Illness: none
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI-lesion on lt side of brain, biopsy-inconclusive results r/o a glimona & multiple sclerosis.
CDC Split Type:

Write-up: Pt experienced severe vomiting & cold sx approx 1 wk /p receiving vax on 9NOV90; Developed severe speaking difficulties 4mo later & was hospitalized; MRI revealed a lesion on the lt side of brain; dx w/demyelinating encephalopathy;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=30242


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