National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 5/7/2021 release of VAERS data (an older release, current is 10/8/2021):

This is VAERS ID 80782



Case Details

VAERS ID: 80782 (history)  
Form: Version 1.0  
Age: 55.0  
Sex: Male  
Location: Washington  
Vaccinated:1995-10-09
Onset:1995-11-20
   Days after vaccination:42
Submitted: 1995-12-12
   Days after onset:22
Entered: 1996-01-11
   Days after submission:30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 4 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: CSF test abnormal, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Neuropathy, Pain
SMQs:, Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow), Hypotonic-hyporesponsive episode (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC Split Type:

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210507&IDNUMBER=80782

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166