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This is VAERS ID 44216

Case Details

VAERS ID: 44216 (history)  
Form: Version 1.0  
Age: 34.0  
Sex: Male  
Location: California  
Vaccinated:1990-11-30
Onset:1990-12-12
   Days after vaccination:12
Submitted: 0000-00-00
Entered: 1992-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ADEN: ADENOVIRUS (TYPE 7, NO BRAND NAME) / PFIZER/WYETH 4888220 / UNK - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0511019 / UNK - / -
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0D21085 / UNK - / -
MER: MEASLES + RUBELLA (MR-VAX II) / MERCK & CO. INC. 0302R / UNK - / -
MU: MUMPS (MUMPSVAX I) / MERCK & CO. INC. 02106 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0611C / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 9L11011 / UNK - / -

Administered by: Military       Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypokinesia, Laboratory test abnormal, Pharyngitis
SMQs:, Agranulocytosis (broad), Peripheral neuropathy (narrow), Parkinson-like events (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 18 days
   Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Given 30NOV92 PPD Connaught Labs lot# 231712;and Bicyllin Wyth Lot# 2891626;
Current Illness:
Preexisting Conditions: hos of pos PPD;
Allergies:
Diagnostic Lab Data: IGM-17DEC90-abn consistent w/GBS;
CDC Split Type:

Write-up: 12DEC90 devel elevated weakness which began in feet & moved upwards; unable to walk, drops things; mild URI sx x 1 wk PTA; IGM-17DEC abn consistent w/GBS; plasmaphoresis x 5 exchgs;


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