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This is VAERS ID 69389

Case Details

VAERS ID: 69389 (history)  
Form: Version 1.0  
Age: 75.0  
Sex: Female  
Location: California  
Vaccinated:1994-11-23
Onset:1994-11-28
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 1994-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4948120 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Blood creatine phosphokinase increased, CSF test abnormal, Malaise, Myelitis, Paralysis
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Immune-mediated/autoimmune disorders (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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 30nov elevated ck(232 u/l);29nov csf total protein elevated (112 mg/dl);
CDC Split Type:

Write-up: pt recvd vax on 23nov94; felt ill by next day; to hosp 28nov94 w/ leg paralysis; pt dx w/ idiopathic transverse myelitis of the spine;as of 1dec94 sxs improved but remained hosp;


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