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From the 12/31/2003 release of VAERS data (an older release, current is 10/15/2021):

This is VAERS ID 97013



Case Details

VAERS ID: 97013 (history)  
Form: Version .0  
Age: 38.2  
Sex: Male  
Location: New York  
Vaccinated:1996-10-23
Onset:1996-10-23
   Days after vaccination:0
Submitted: 1997-02-14
   Days after onset:114
Entered: 1997-04-22
   Days after submission:66
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1996-1997 / WYETH - / 0 LA / -

Administered by: Private       Purchased by: Unknown
Symptoms: ATROPHY MUSCLE, CSF ABNORM, ENCEPHALITIS, INFECT, MYOSITIS
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:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EMG/Nerve conduction lower extremities: reportedly abn;CPK: reportedly elevated;CSF: reportedly contained protein;
CDC Split Type:

Write-up: pt devel back pain p/vax;exp paresthesias, described as band-like feeling around the abd, arms, & legs as well as flip-flop sensation in feet & puffiness in hands;nerve damage;muscle atrophy;encephalomyelitis;myositis;polyneuropathy synd;


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=97013

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