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This is VAERS ID 43894

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

Case Details

VAERS ID: 43894 (history)  
Form: Version .0  
Age: 62.5  
Sex: Male  
Location: New York  
Vaccinated:1988-11-25
Onset:1988-12-10
   Days after vaccination:15
Submitted: 1991-01-04
   Days after onset:755
Entered: 1992-08-05
   Days after submission:578
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1989-1990 TRIVALENT TYPES A&B / WYETH - / - - / IM

Administered by: Other       Purchased by: Unknown
Symptoms: ASTHENIA, CSF ABNORM, ECG ABNORM, GUILLAIN BARRE SYND, HYPERTENS
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Orudis Capsules
Current Illness: NONE
Preexisting Conditions: pt has known allergy to PCN; inc cholesterol in the past; pos for diabetes mellitus in mom & dad; father also had emphysema;
Allergies:
Diagnostic Lab Data: Spinal fluid analysis-inc spinal fluid protein, nl glucose & w/o leukocytes; Cholesterol 319; Triglycerides 276; EMG & Nerve conduction velocities showed mltifocal conduction abn;
CDC Split Type:

Write-up: Pt recvd flu vax & was admitted to hosp w/extremity weakness & numbness; approx 4-5 days prior to admission, pt had dorsal & epigastric pain assoc w/tingling in hands & feet;poss GBS; also areflexia; BP 190/100;


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