National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 106308

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 106308
VAERS Form:
Age:83.5
Sex:Male
Location:Mississippi
Vaccinated:1997-10-20
Onset:0000-00-00
Submitted:1997-12-03
Entered:1998-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUVIRIN 1997-1998 / MEDEVA PHARMS LI E20037KA / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: HYPERTONIA, GUILLAIN BARRE SYND, ASTHENIA, ATAXIA, ATROPHY ADREN

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 13     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: grip strength 80-85%;thininning of muscle bulk to first dorsal interosseous muscle;thyroid nl;CPK nl;sed rate 50;total white count 7,800 w/H&H 12.9 & 39.1;rheumatoid factor neg;EKG nonspecific ST changes plus LAD:
CDC 'Split Type':

Write-up: pt exp worsening weakness x 2mo w/diff walking x2wk;pt exp joint stiffness;devel some numbness in hands & feet;pt noted to have flipped T waves in lateral chest leads;pt hosp;muscle weakness;GBS, ataxic;control dec;polyradiculoneuropathy;


Changed on 12/8/2009

VAERS ID: 106308 Before After
VAERS Form:
Age:83.5
Sex:Male
Location:Mississippi
Vaccinated:1997-10-20
Onset:0000-00-00
Submitted:1997-12-03
Entered:1998-01-13 1998-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUVIRIN 1997-1998 INFLUENZA (SEASONAL) (FLUVIRIN 97-98) / MEDEVA PHARMS LI MEDEVA PHARMA, LTD. E20037KA / - LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Adrenal insufficiency, Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertonia, Myasthenic syndrome, Neuropathy, Paraesthesia, HYPERTONIA, GUILLAIN BARRE SYND, ASTHENIA, ATAXIA, ATROPHY ADREN

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 13     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: grip strength 80-85%;thininning of muscle bulk to first dorsal interosseous muscle;thyroid nl;CPK nl;sed rate 50;total white count 7,800 w/H&H 12.9 & 39.1;rheumatoid factor neg;EKG nonspecific ST changes plus LAD:
CDC 'Split Type': (blank) MS97056

Write-up: pt exp worsening weakness x 2mo w/diff walking x2wk;pt exp joint stiffness;devel some numbness in hands & feet;pt noted to have flipped T waves in lateral chest leads;pt hosp;muscle weakness;GBS, ataxic;control dec;polyradiculoneuropathy;


Changed on 8/31/2010

VAERS ID: 106308 Before After
VAERS Form:
Age:83.5
Sex:Male
Location:Mississippi
Vaccinated:1997-10-20
Onset:0000-00-00
Submitted:1997-12-03
Entered:1998-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUVIRIN 97-98) INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E20037KA / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Adrenal insufficiency, Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertonia, Myasthenic syndrome, Neuropathy, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 13     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: grip strength 80-85%;thininning of muscle bulk to first dorsal interosseous muscle;thyroid nl;CPK nl;sed rate 50;total white count 7,800 w/H&H 12.9 & 39.1;rheumatoid factor neg;EKG nonspecific ST changes plus LAD:
CDC 'Split Type': MS97056

Write-up: pt exp worsening weakness x 2mo w/diff walking x2wk;pt exp joint stiffness;devel some numbness in hands & feet;pt noted to have flipped T waves in lateral chest leads;pt hosp;muscle weakness;GBS, ataxic;control dec;polyradiculoneuropathy;


Changed on 7/7/2013

VAERS ID: 106308 Before After
VAERS Form:
Age:83.5
Sex:Male
Location:Mississippi
Vaccinated:1997-10-20
Onset:0000-00-00
Submitted:1997-12-03
Entered:1998-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E20037KA / - LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E20037KA / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Adrenal insufficiency, Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertonia, Myasthenic syndrome, Neuropathy, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 13     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: grip strength 80-85%;thininning of muscle bulk to first dorsal interosseous muscle;thyroid nl;CPK nl;sed rate 50;total white count 7,800 w/H&H 12.9 & 39.1;rheumatoid factor neg;EKG nonspecific ST changes plus LAD:
CDC 'Split Type': MS97056

Write-up: pt exp worsening weakness x 2mo w/diff walking x2wk;pt exp joint stiffness;devel some numbness in hands & feet;pt noted to have flipped T waves in lateral chest leads;pt hosp;muscle weakness;GBS, ataxic;control dec;polyradiculoneuropathy;


Changed on 2/14/2017

VAERS ID: 106308 Before After
VAERS Form:
Age:83.5 83.0
Sex:Male
Location:Mississippi
Vaccinated:1997-10-20
Onset:0000-00-00
Submitted:1997-12-03
Entered:1998-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E20037KA / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Adrenal insufficiency, Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertonia, Myasthenic syndrome, Neuropathy, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 13     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: grip strength 80-85%;thininning of muscle bulk to first dorsal interosseous muscle;thyroid nl;CPK nl;sed rate 50;total white count 7,800 w/H&H 12.9 & 39.1;rheumatoid factor neg;EKG nonspecific ST changes plus LAD:
CDC 'Split Type': MS97056

Write-up: pt exp worsening weakness x 2mo w/diff walking x2wk;pt exp joint stiffness;devel some numbness in hands & feet;pt noted to have flipped T waves in lateral chest leads;pt hosp;muscle weakness;GBS, ataxic;control dec;polyradiculoneuropathy;


Changed on 5/14/2017

VAERS ID: 106308 Before After
VAERS Form:
Age:83.0
Sex:Male
Location:Mississippi
Vaccinated:1997-10-20
Onset:0000-00-00
Submitted:1997-12-03
Entered:1998-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E20037KA / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Adrenal insufficiency, Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertonia, Myasthenic syndrome, Neuropathy, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 13     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: grip strength 80-85%;thininning of muscle bulk to first dorsal interosseous muscle;thyroid nl;CPK nl;sed rate 50;total white count 7,800 w/H&H 12.9 & 39.1;rheumatoid factor neg;EKG nonspecific ST changes plus LAD:
CDC 'Split Type': MS97056

Write-up: pt exp worsening weakness x 2mo w/diff walking x2wk;pt exp joint stiffness;devel some numbness in hands & feet;pt noted to have flipped T waves in lateral chest leads;pt hosp;muscle weakness;GBS, ataxic;control dec;polyradiculoneuropathy;


Changed on 9/14/2017

VAERS ID: 106308 Before After
VAERS Form:(blank) 1
Age:83.0
Sex:Male
Location:Mississippi
Vaccinated:1997-10-20
Onset:0000-00-00
Submitted:1997-12-03
Entered:1998-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E20037KA / - UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Adrenal insufficiency, Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertonia, Myasthenic syndrome, Neuropathy, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 13     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: grip strength 80-85%;thininning of muscle bulk to first dorsal interosseous muscle;thyroid nl;CPK nl;sed rate 50;total white count 7,800 w/H&H 12.9 & 39.1;rheumatoid factor neg;EKG nonspecific ST changes plus LAD:
CDC 'Split Type': MS97056

Write-up: pt exp worsening weakness x 2mo w/diff walking x2wk;pt exp joint stiffness;devel some numbness in hands & feet;pt noted to have flipped T waves in lateral chest leads;pt hosp;muscle weakness;GBS, ataxic;control dec;polyradiculoneuropathy;


Changed on 2/14/2018

VAERS ID: 106308 Before After
VAERS Form:1
Age:83.0
Sex:Male
Location:Mississippi
Vaccinated:1997-10-20
Onset:0000-00-00
Submitted:1997-12-03
Entered:1998-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E20037KA / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Adrenal insufficiency, Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertonia, Myasthenic syndrome, Neuropathy, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 13     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: grip strength 80-85%;thininning of muscle bulk to first dorsal interosseous muscle;thyroid nl;CPK nl;sed rate 50;total white count 7,800 w/H&H 12.9 & 39.1;rheumatoid factor neg;EKG nonspecific ST changes plus LAD:
CDC 'Split Type': MS97056

Write-up: pt exp worsening weakness x 2mo w/diff walking x2wk;pt exp joint stiffness;devel some numbness in hands & feet;pt noted to have flipped T waves in lateral chest leads;pt hosp;muscle weakness;GBS, ataxic;control dec;polyradiculoneuropathy;


Changed on 6/14/2018

VAERS ID: 106308 Before After
VAERS Form:1
Age:83.0
Sex:Male
Location:Mississippi
Vaccinated:1997-10-20
Onset:0000-00-00
Submitted:1997-12-03
Entered:1998-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E20037KA / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Adrenal insufficiency, Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertonia, Myasthenic syndrome, Neuropathy, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 13     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: grip strength 80-85%;thininning of muscle bulk to first dorsal interosseous muscle;thyroid nl;CPK nl;sed rate 50;total white count 7,800 w/H&H 12.9 & 39.1;rheumatoid factor neg;EKG nonspecific ST changes plus LAD:
CDC 'Split Type': MS97056

Write-up: pt exp worsening weakness x 2mo w/diff walking x2wk;pt exp joint stiffness;devel some numbness in hands & feet;pt noted to have flipped T waves in lateral chest leads;pt hosp;muscle weakness;GBS, ataxic;control dec;polyradiculoneuropathy;


Changed on 8/14/2018

VAERS ID: 106308 Before After
VAERS Form:1
Age:83.0
Sex:Male
Location:Mississippi
Vaccinated:1997-10-20
Onset:0000-00-00
Submitted:1997-12-03
Entered:1998-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E20037KA / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Adrenal insufficiency, Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertonia, Myasthenic syndrome, Neuropathy, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 13     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: grip strength 80-85%;thininning of muscle bulk to first dorsal interosseous muscle;thyroid nl;CPK nl;sed rate 50;total white count 7,800 w/H&H 12.9 & 39.1;rheumatoid factor neg;EKG nonspecific ST changes plus LAD:
CDC 'Split Type': MS97056

Write-up: pt exp worsening weakness x 2mo w/diff walking x2wk;pt exp joint stiffness;devel some numbness in hands & feet;pt noted to have flipped T waves in lateral chest leads;pt hosp;muscle weakness;GBS, ataxic;control dec;polyradiculoneuropathy;


Changed on 9/14/2018

VAERS ID: 106308 Before After
VAERS Form:1
Age:83.0
Sex:Male
Location:Mississippi
Vaccinated:1997-10-20
Onset:0000-00-00
Submitted:1997-12-03
Entered:1998-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E20037KA / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Adrenal insufficiency, Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertonia, Myasthenic syndrome, Neuropathy, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 13     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: grip strength 80-85%;thininning of muscle bulk to first dorsal interosseous muscle;thyroid nl;CPK nl;sed rate 50;total white count 7,800 w/H&H 12.9 & 39.1;rheumatoid factor neg;EKG nonspecific ST changes plus LAD:
CDC 'Split Type': MS97056

Write-up: pt exp worsening weakness x 2mo w/diff walking x2wk;pt exp joint stiffness;devel some numbness in hands & feet;pt noted to have flipped T waves in lateral chest leads;pt hosp;muscle weakness;GBS, ataxic;control dec;polyradiculoneuropathy;


Changed on 10/14/2018

VAERS ID: 106308 Before After
VAERS Form:1
Age:83.0
Sex:Male
Location:Mississippi
Vaccinated:1997-10-20
Onset:0000-00-00
Submitted:1997-12-03
Entered:1998-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E20037KA / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Adrenal insufficiency, Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertonia, Myasthenic syndrome, Neuropathy, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 13     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: grip strength 80-85%;thininning of muscle bulk to first dorsal interosseous muscle;thyroid nl;CPK nl;sed rate 50;total white count 7,800 w/H&H 12.9 & 39.1;rheumatoid factor neg;EKG nonspecific ST changes plus LAD:
CDC 'Split Type': MS97056

Write-up: pt exp worsening weakness x 2mo w/diff walking x2wk;pt exp joint stiffness;devel some numbness in hands & feet;pt noted to have flipped T waves in lateral chest leads;pt hosp;muscle weakness;GBS, ataxic;control dec;polyradiculoneuropathy;

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=106308&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166