VAERS ID: 25030

AGE: 66| SEX: F|STATE: NY (United States)

Description

Mylagias occurred within 3 days of immun. Seen on 4 additional occasions for continued pain & increasing eye/temporal pain. Considered poss. meningoencephalitis due to vaccine. Admit to hosp for Guillain-Barre Synd. on 15Feb90.

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Symptoms

Guillain-Barre syndrome, Encephalitis, Myalgia

Vaccines

VAX DATE: 12-01-1989| ONSET DATE: 12-03-1989| DAYS TO ONSET: 2
NameDose #TypeManufacturerLotRouteSite
INFLUENZA (SEASONAL) (FLUZONE) 0 FLU3 CONNAUGHT LABORATORIES 9F01202 Unknown Unknown

RECVDATE:07-09-1990
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:
V_ADMINBY:
OTHER_MEDS:Lisinopril 20mg, Verapamil 120mg, HCTZ 25mg, Thyrolar
CUR_ILL:
HISTORY:
PRIOR_VAX:~ ()~~~In patient
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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