| VAERS ID: |
48049 (history) |
| Form: |
Version .0 |
| Age: |
84.0 |
| Sex: |
Female |
| Location: |
New York |
| Vaccinated: | 1992-10-22 |
| Onset: | 1992-10-22 |
| Days after vaccination: | 0 |
| Submitted: |
1992-10-23 |
| Days after onset: | 1 |
| Entered: |
1992-12-14 |
| Days after submission: | 52 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH |
4928241 / 5 |
LA / - |
Administered by: Public Purchased by: Public
Symptoms: Cerebral haemorrhage,
Paralysis,
Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic central nervous system vascular conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Life Threatening? Yes
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: NONE
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: dx: intracerebral hemorrhage; no evidence seen by MD of hypersensitivity rxn to vax;
CDC Split Type: BA92001
Write-up: loss of consciousness, paralysis; |
