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From the 12/14/2016 release of VAERS data (an older release, current is 10/8/2021):

This is VAERS ID 80190



Case Details

VAERS ID: 80190 (history)  
Form: Version .0  
Age: 34.0  
Sex: Female  
Location: Missouri  
Vaccinated:1993-11-04
Onset:1993-11-04
   Days after vaccination:0
Submitted: 1995-12-21
   Days after onset:777
Entered: 1995-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER 2243GC / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal pain, Asthenia, Guillain-Barre syndrome, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Demyelination (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unk
Current Illness: none
Preexisting Conditions: none reported
Allergies:
Diagnostic Lab Data: none reported;07Oct96-MFR f/u-nerve conduction tests showed a severe polyarthropathy,CSF exam - nl protein;
CDC Split Type: ALI95519

Write-up: pt recvd vax; exp abdo cramping,pain,nausea,vomiting p/ flu vax;hosp on 24dec93 & dx w/ acute GBS;exp full paralysis for 5 mo & then partial paralysis since may94;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20161214&IDNUMBER=80190

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