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This is VAERS ID 39455

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

Case Details

VAERS ID: 39455 (history)  
Form: Version .0  
Age: 70.0  
Sex: Unknown  
Location: Michigan  
Vaccinated:1991-12-14
Onset:1991-12-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1992-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1991-1992 / CONNAUGHT LABS 1F21218 / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: ENCEPHALITIS, HYPOKINESIA, PARESTHESIA, THINKING ABNORM
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Encephalitis; As of 11FEB92 no reports on lot # 1F21218 have been reported;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=39455


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