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This is VAERS ID 37209

(NOTE: This result is from the 9/14/2018 version of the VAERS database)

Case Details

VAERS ID: 37209 (history)  
Form: Version 1.0  
Age: 20.0  
Sex: Male  
Location: New Jersey  
Vaccinated:1992-02-17
Onset:1992-02-18
   Days after vaccination:1
Submitted: 1992-02-19
   Days after onset:1
Entered: 1992-05-20
   Days after submission:90
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES - / UNK - / -
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Military       Purchased by: Military
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: pt had surgery on rt hip related to chondromalacia @ age of 9;
Allergies:
Diagnostic Lab Data:
CDC Split Type: 892051005L

Write-up: pt devel numbness on rt side of body 24 hrs p/flu vax/DT/Meningococcal vax; pt was hospitalized due to adverse effect & was noted to be improving w/numbness currently localized to the rt leg;


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