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This is VAERS ID 36486

(NOTE: This result is from the 7/7/2013 version of the VAERS database)

Case Details

VAERS ID: 36486 (history)  
Form: Version .0  
Age: 78.7  
Sex: Female  
Location: California  
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1991-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Public       Purchased by: Unknown
Symptoms: Dizziness, Hypokinesia, Infection, Lung disorder, Myalgia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: Hypertension, "mild heartattack" in Jun, 1991
Diagnostic Lab Data: CXR-showed Bilateral infiltrates;
CDC Split Type: CA91133

Write-up: At about MN, dizzy, unable to stand, vomiting; Ambulance transported pt to Hosp; treated w/IV ATB x 5 days, discharged on po ATB; no fever or cold sx; myalgia;

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