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This is VAERS ID 107835

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 107835
VAERS Form:
Age:65.2
Sex:Male
Location:Ohio
Vaccinated:1997-09-01
Onset:1997-10-01
Submitted:1998-02-25
Entered:1998-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUVIRIN 1997-1998 / MEDEVA PHARMS LI E3367HB / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: HYPOKINESIA, HYPERTONIA, MYALGIA, MYASTHENIA, NEURITIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fiorinal/Butalbital, USP;SYmmetrel/Amantadine
Current Illness:
Preexisting Conditions: Carpal Tunnel synd;carcinoma in porstate;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: pt recv vax & devel muscle soreness & stiffness 1mo post vax;pt devel muscle pain & weakness of upper & lower extremities;pt finds it hard to get up out of chair & suffers from bilat shoulder pain;devel acute neuritis w/brachial plexiopathy

Changed on 12/8/2009

VAERS ID: 107835 Before After
VAERS Form:
Age:65.2
Sex:Male
Location:Ohio
Vaccinated:1997-09-01
Onset:1997-10-01
Submitted:1998-02-25
Entered:1998-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUVIRIN 1997-1998 INFLUENZA (SEASONAL) (FLUVIRIN 97-98) / MEDEVA PHARMS LI MEDEVA PHARMA, LTD. E3367HB / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Hypertonia, Hypokinesia, Myalgia, Myasthenic syndrome, Neuritis, Neuropathy, Pain, HYPOKINESIA, HYPERTONIA, MYALGIA, MYASTHENIA, NEURITIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fiorinal/Butalbital, USP;SYmmetrel/Amantadine
Current Illness:
Preexisting Conditions: Carpal Tunnel synd;carcinoma in porstate;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) MPI98158

Write-up: pt recv vax & devel muscle soreness & stiffness 1mo post vax;pt devel muscle pain & weakness of upper & lower extremities;pt finds it hard to get up out of chair & suffers from bilat shoulder pain;devel acute neuritis w/brachial plexiopathy

Changed on 8/31/2010

VAERS ID: 107835 Before After
VAERS Form:
Age:65.2
Sex:Male
Location:Ohio
Vaccinated:1997-09-01
Onset:1997-10-01
Submitted:1998-02-25
Entered:1998-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUVIRIN 97-98) INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E3367HB / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypertonia, Hypokinesia, Myalgia, Myasthenic syndrome, Neuritis, Neuropathy, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fiorinal/Butalbital, USP;SYmmetrel/Amantadine
Current Illness:
Preexisting Conditions: Carpal Tunnel synd;carcinoma in porstate;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MPI98158

Write-up: pt recv vax & devel muscle soreness & stiffness 1mo post vax;pt devel muscle pain & weakness of upper & lower extremities;pt finds it hard to get up out of chair & suffers from bilat shoulder pain;devel acute neuritis w/brachial plexiopathy

Changed on 7/7/2013

VAERS ID: 107835 Before After
VAERS Form:
Age:65.2
Sex:Male
Location:Ohio
Vaccinated:1997-09-01
Onset:1997-10-01
Submitted:1998-02-25
Entered:1998-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E3367HB / - - / IM
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E3367HB / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypertonia, Hypokinesia, Myalgia, Myasthenic syndrome, Neuritis, Neuropathy, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fiorinal/Butalbital, USP;SYmmetrel/Amantadine
Current Illness:
Preexisting Conditions: Carpal Tunnel synd;carcinoma in porstate;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MPI98158

Write-up: pt recv vax & devel muscle soreness & stiffness 1mo post vax;pt devel muscle pain & weakness of upper & lower extremities;pt finds it hard to get up out of chair & suffers from bilat shoulder pain;devel acute neuritis w/brachial plexiopathy

Changed on 2/14/2017

VAERS ID: 107835 Before After
VAERS Form:
Age:65.2 65.0
Sex:Male
Location:Ohio
Vaccinated:1997-09-01
Onset:1997-10-01
Submitted:1998-02-25
Entered:1998-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E3367HB / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypertonia, Hypokinesia, Myalgia, Myasthenic syndrome, Neuritis, Neuropathy, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fiorinal/Butalbital, USP;SYmmetrel/Amantadine
Current Illness:
Preexisting Conditions: Carpal Tunnel synd;carcinoma in porstate;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MPI98158

Write-up: pt recv vax & devel muscle soreness & stiffness 1mo post vax;pt devel muscle pain & weakness of upper & lower extremities;pt finds it hard to get up out of chair & suffers from bilat shoulder pain;devel acute neuritis w/brachial plexiopathy

Changed on 5/14/2017

VAERS ID: 107835 Before After
VAERS Form:
Age:65.0
Sex:Male
Location:Ohio
Vaccinated:1997-09-01
Onset:1997-10-01
Submitted:1998-02-25
Entered:1998-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E3367HB / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypertonia, Hypokinesia, Myalgia, Myasthenic syndrome, Neuritis, Neuropathy, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Fiorinal/Butalbital, USP;SYmmetrel/Amantadine
Current Illness:
Preexisting Conditions: Carpal Tunnel synd;carcinoma in porstate;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MPI98158

Write-up: pt recv vax & devel muscle soreness & stiffness 1mo post vax;pt devel muscle pain & weakness of upper & lower extremities;pt finds it hard to get up out of chair & suffers from bilat shoulder pain;devel acute neuritis w/brachial plexiopathy

Changed on 9/14/2017

VAERS ID: 107835 Before After
VAERS Form:(blank) 1
Age:65.0
Sex:Male
Location:Ohio
Vaccinated:1997-09-01
Onset:1997-10-01
Submitted:1998-02-25
Entered:1998-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E3367HB / - UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypertonia, Hypokinesia, Myalgia, Myasthenic syndrome, Neuritis, Neuropathy, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Fiorinal/Butalbital, USP;SYmmetrel/Amantadine
Current Illness:
Preexisting Conditions: Carpal Tunnel synd;carcinoma in porstate;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MPI98158

Write-up: pt recv vax & devel muscle soreness & stiffness 1mo post vax;pt devel muscle pain & weakness of upper & lower extremities;pt finds it hard to get up out of chair & suffers from bilat shoulder pain;devel acute neuritis w/brachial plexiopathy

Changed on 2/14/2018

VAERS ID: 107835 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:Ohio
Vaccinated:1997-09-01
Onset:1997-10-01
Submitted:1998-02-25
Entered:1998-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E3367HB / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypertonia, Hypokinesia, Myalgia, Myasthenic syndrome, Neuritis, Neuropathy, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Fiorinal/Butalbital, USP;SYmmetrel/Amantadine
Current Illness:
Preexisting Conditions: Carpal Tunnel synd;carcinoma in porstate;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MPI98158

Write-up: pt recv vax & devel muscle soreness & stiffness 1mo post vax;pt devel muscle pain & weakness of upper & lower extremities;pt finds it hard to get up out of chair & suffers from bilat shoulder pain;devel acute neuritis w/brachial plexiopathy

Changed on 6/14/2018

VAERS ID: 107835 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:Ohio
Vaccinated:1997-09-01
Onset:1997-10-01
Submitted:1998-02-25
Entered:1998-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E3367HB / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypertonia, Hypokinesia, Myalgia, Myasthenic syndrome, Neuritis, Neuropathy, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Fiorinal/Butalbital, USP;SYmmetrel/Amantadine
Current Illness:
Preexisting Conditions: Carpal Tunnel synd;carcinoma in porstate;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MPI98158

Write-up: pt recv vax & devel muscle soreness & stiffness 1mo post vax;pt devel muscle pain & weakness of upper & lower extremities;pt finds it hard to get up out of chair & suffers from bilat shoulder pain;devel acute neuritis w/brachial plexiopathy

Changed on 8/14/2018

VAERS ID: 107835 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:Ohio
Vaccinated:1997-09-01
Onset:1997-10-01
Submitted:1998-02-25
Entered:1998-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E3367HB / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypertonia, Hypokinesia, Myalgia, Myasthenic syndrome, Neuritis, Neuropathy, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Fiorinal/Butalbital, USP;SYmmetrel/Amantadine
Current Illness:
Preexisting Conditions: Carpal Tunnel synd;carcinoma in porstate;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MPI98158

Write-up: pt recv vax & devel muscle soreness & stiffness 1mo post vax;pt devel muscle pain & weakness of upper & lower extremities;pt finds it hard to get up out of chair & suffers from bilat shoulder pain;devel acute neuritis w/brachial plexiopathy

Changed on 9/14/2018

VAERS ID: 107835 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:Ohio
Vaccinated:1997-09-01
Onset:1997-10-01
Submitted:1998-02-25
Entered:1998-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E3367HB / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypertonia, Hypokinesia, Myalgia, Myasthenic syndrome, Neuritis, Neuropathy, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Fiorinal/Butalbital, USP;SYmmetrel/Amantadine
Current Illness:
Preexisting Conditions: Carpal Tunnel synd;carcinoma in porstate;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MPI98158

Write-up: pt recv vax & devel muscle soreness & stiffness 1mo post vax;pt devel muscle pain & weakness of upper & lower extremities;pt finds it hard to get up out of chair & suffers from bilat shoulder pain;devel acute neuritis w/brachial plexiopathy

Changed on 10/14/2018

VAERS ID: 107835 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:Ohio
Vaccinated:1997-09-01
Onset:1997-10-01
Submitted:1998-02-25
Entered:1998-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E3367HB / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypertonia, Hypokinesia, Myalgia, Myasthenic syndrome, Neuritis, Neuropathy, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Fiorinal/Butalbital, USP;SYmmetrel/Amantadine
Current Illness:
Preexisting Conditions: Carpal Tunnel synd;carcinoma in porstate;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MPI98158

Write-up: pt recv vax & devel muscle soreness & stiffness 1mo post vax;pt devel muscle pain & weakness of upper & lower extremities;pt finds it hard to get up out of chair & suffers from bilat shoulder pain;devel acute neuritis w/brachial plexiopathy

Changed on 12/24/2020

VAERS ID: 107835 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:Ohio
Vaccinated:1997-09-01
Onset:1997-10-01
Submitted:1998-02-25
Entered:1998-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E3367HB / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypertonia, Hypokinesia, Myalgia, Myasthenic syndrome, Neuritis, Neuropathy, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Fiorinal/Butalbital, USP;SYmmetrel/Amantadine
Current Illness:
Preexisting Conditions: Carpal Tunnel synd;carcinoma in porstate;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MPI98158

Write-up: pt recv vax & devel muscle soreness & stiffness 1mo post vax;pt devel muscle pain & weakness of upper & lower extremities;pt finds it hard to get up out of chair & suffers from bilat shoulder pain;devel acute neuritis w/brachial plexiopathy

Changed on 12/30/2020

VAERS ID: 107835 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:Ohio
Vaccinated:1997-09-01
Onset:1997-10-01
Submitted:1998-02-25
Entered:1998-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. E3367HB / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypertonia, Hypokinesia, Myalgia, Myasthenic syndrome, Neuritis, Neuropathy, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Fiorinal/Butalbital, USP;SYmmetrel/Amantadine
Current Illness:
Preexisting Conditions: Carpal Tunnel synd;carcinoma in porstate;
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MPI98158

Write-up: pt recv vax & devel muscle soreness & stiffness 1mo post vax;pt devel muscle pain & weakness of upper & lower extremities;pt finds it hard to get up out of chair & suffers from bilat shoulder pain;devel acute neuritis w/brachial plexiopathy

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=107835&WAYBACKHISTORY=ON


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