National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 63926

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

Case Details

VAERS ID: 63926 (history)  
Form: Version .0  
Age: 51.7  
Sex: Female  
Location: Washington  
Vaccinated:1989-10-30
Onset:1989-11-07
   Days after vaccination:8
Submitted: 1994-06-23
   Days after onset:1688
Entered: 1994-07-05
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE / UNCLASSIFIED - / - - / -

Administered by: Private       Purchased by: Unknown
Symptoms: ASTHENIA, DYSPNEA, INFECT
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp resp rxn @ 48 y/o w/flu dose #1;
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: pos titers: EBV AUG1991; cortisol level .41;
CDC Split Type: NONE

Write-up: severe react lost 2 wks work-could not breathe; exp onset of stroke like weakness 8MAR90; dx CFS-dx EBV;


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=63926


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166