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This is VAERS ID 108666

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 108666
VAERS Form:
Age:50.6
Sex:Male
Location:Montana
Vaccinated:1997-10-03
Onset:1997-10-05
Submitted:1998-03-14
Entered:1998-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE / UNCLASSIFIED - / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: HYPOKINESIA, NEUROPATHY, VASCULITIS, PARESTHESIA, PARALYSIS

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: NONE
Other Medications: Vasotec;Triamterene
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9MAR98 MRI;12MAR98 nerve biopsy;peripheal neuropathe;paraneal palsy;vasculitis;
CDC 'Split Type': NONE

Write-up: pt recv vax 3OCT97 & 5OCT97 numbness rt foot;13OCT97 saw MD tested for diabetes negative;14NOV97 rt ankle stopped working;7JAN98 myelogram & CAT dx peripheral neuropathy, perineal palsy;12FEB98 ?dx vasculitis;


Changed on 12/8/2009

VAERS ID: 108666 Before After
VAERS Form:
Age:50.6
Sex:Male
Location:Montana
Vaccinated:1997-10-03
Onset:1997-10-05
Submitted:1998-03-14
Entered:1998-03-19 1998-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE INFLUENZA (SEASONAL) (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -

Administered by: Public      Purchased by: Unknown Private
Symptoms: Hypokinesia, Neuropathy, Paraesthesia, Paralysis, Vasculitis, HYPOKINESIA, NEUROPATHY, VASCULITIS, PARESTHESIA, PARALYSIS

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: NONE
Other Medications: Vasotec;Triamterene
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9MAR98 MRI;12MAR98 nerve biopsy;peripheal neuropathe;paraneal palsy;vasculitis;
CDC 'Split Type': NONE (blank)

Write-up: pt recv vax 3OCT97 & 5OCT97 numbness rt foot;13OCT97 saw MD tested for diabetes negative;14NOV97 rt ankle stopped working;7JAN98 myelogram & CAT dx peripheral neuropathy, perineal palsy;12FEB98 ?dx vasculitis;


Changed on 7/7/2013

VAERS ID: 108666 Before After
VAERS Form:
Age:50.6
Sex:Male
Location:Montana
Vaccinated:1997-10-03
Onset:1997-10-05
Submitted:1998-03-14
Entered:1998-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Public      Purchased by: Private
Symptoms: Hypokinesia, Neuropathy, Paraesthesia, Paralysis, Vasculitis

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: NONE
Other Medications: Vasotec;Triamterene
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9MAR98 MRI;12MAR98 nerve biopsy;peripheal neuropathe;paraneal palsy;vasculitis;
CDC 'Split Type':

Write-up: pt recv vax 3OCT97 & 5OCT97 numbness rt foot;13OCT97 saw MD tested for diabetes negative;14NOV97 rt ankle stopped working;7JAN98 myelogram & CAT dx peripheral neuropathy, perineal palsy;12FEB98 ?dx vasculitis;


Changed on 12/14/2016

VAERS ID: 108666 Before After
VAERS Form:
Age:50.6
Sex:Male
Location:Montana
Vaccinated:1997-10-03
Onset:1997-10-05
Submitted:1998-03-14
Entered:1998-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Public      Purchased by: Private
Symptoms: Hypokinesia, Neuropathy, Paraesthesia, Paralysis, Vasculitis

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: NONE
Other Medications: Vasotec;Triamterene
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9MAR98 MRI;12MAR98 nerve biopsy;peripheal neuropathe;paraneal palsy;vasculitis;
CDC 'Split Type':

Write-up: pt recv vax 3OCT97 & 5OCT97 numbness rt foot;13OCT97 saw MD tested for diabetes negative;14NOV97 rt ankle stopped working;7JAN98 myelogram & CAT dx peripheral neuropathy, perineal palsy;12FEB98 ?dx vasculitis;


Changed on 2/14/2017

VAERS ID: 108666 Before After
VAERS Form:
Age:50.6 50.0
Sex:Male
Location:Montana
Vaccinated:1997-10-03
Onset:1997-10-05
Submitted:1998-03-14
Entered:1998-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Public      Purchased by: Private
Symptoms: Hypokinesia, Neuropathy, Paraesthesia, Paralysis, Vasculitis

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: NONE
Other Medications: Vasotec;Triamterene
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9MAR98 MRI;12MAR98 nerve biopsy;peripheal neuropathe;paraneal palsy;vasculitis;
CDC 'Split Type':

Write-up: pt recv vax 3OCT97 & 5OCT97 numbness rt foot;13OCT97 saw MD tested for diabetes negative;14NOV97 rt ankle stopped working;7JAN98 myelogram & CAT dx peripheral neuropathy, perineal palsy;12FEB98 ?dx vasculitis;


Changed on 5/14/2017

VAERS ID: 108666 Before After
VAERS Form:
Age:50.0
Sex:Male
Location:Montana
Vaccinated:1997-10-03
Onset:1997-10-05
Submitted:1998-03-14
Entered:1998-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Public      Purchased by: Private
Symptoms: Hypokinesia, Neuropathy, Paraesthesia, Paralysis, Vasculitis

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: NONE NONE~ ()~~~In patient
Other Medications: Vasotec;Triamterene
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9MAR98 MRI;12MAR98 nerve biopsy;peripheal neuropathe;paraneal palsy;vasculitis;
CDC 'Split Type':

Write-up: pt recv vax 3OCT97 & 5OCT97 numbness rt foot;13OCT97 saw MD tested for diabetes negative;14NOV97 rt ankle stopped working;7JAN98 myelogram & CAT dx peripheral neuropathy, perineal palsy;12FEB98 ?dx vasculitis;


Changed on 9/14/2017

VAERS ID: 108666 Before After
VAERS Form:(blank) 1
Age:50.0
Sex:Male
Location:Montana
Vaccinated:1997-10-03
Onset:1997-10-05
Submitted:1998-03-14
Entered:1998-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Hypokinesia, Neuropathy, Paraesthesia, Paralysis, Vasculitis

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: NONE~ ()~~~In patient
Other Medications: Vasotec;Triamterene
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9MAR98 MRI;12MAR98 nerve biopsy;peripheal neuropathe;paraneal palsy;vasculitis;
CDC 'Split Type':

Write-up: pt recv vax 3OCT97 & 5OCT97 numbness rt foot;13OCT97 saw MD tested for diabetes negative;14NOV97 rt ankle stopped working;7JAN98 myelogram & CAT dx peripheral neuropathy, perineal palsy;12FEB98 ?dx vasculitis;


Changed on 2/14/2018

VAERS ID: 108666 Before After
VAERS Form:1
Age:50.0
Sex:Male
Location:Montana
Vaccinated:1997-10-03
Onset:1997-10-05
Submitted:1998-03-14
Entered:1998-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Hypokinesia, Neuropathy, Paraesthesia, Paralysis, Vasculitis

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: NONE~ ()~~~In patient
Other Medications: Vasotec;Triamterene
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9MAR98 MRI;12MAR98 nerve biopsy;peripheal neuropathe;paraneal palsy;vasculitis;
CDC 'Split Type':

Write-up: pt recv vax 3OCT97 & 5OCT97 numbness rt foot;13OCT97 saw MD tested for diabetes negative;14NOV97 rt ankle stopped working;7JAN98 myelogram & CAT dx peripheral neuropathy, perineal palsy;12FEB98 ?dx vasculitis;


Changed on 6/14/2018

VAERS ID: 108666 Before After
VAERS Form:1
Age:50.0
Sex:Male
Location:Montana
Vaccinated:1997-10-03
Onset:1997-10-05
Submitted:1998-03-14
Entered:1998-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Hypokinesia, Neuropathy, Paraesthesia, Paralysis, Vasculitis

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: NONE~ ()~~~In patient
Other Medications: Vasotec;Triamterene
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9MAR98 MRI;12MAR98 nerve biopsy;peripheal neuropathe;paraneal palsy;vasculitis;
CDC 'Split Type':

Write-up: pt recv vax 3OCT97 & 5OCT97 numbness rt foot;13OCT97 saw MD tested for diabetes negative;14NOV97 rt ankle stopped working;7JAN98 myelogram & CAT dx peripheral neuropathy, perineal palsy;12FEB98 ?dx vasculitis;


Changed on 8/14/2018

VAERS ID: 108666 Before After
VAERS Form:1
Age:50.0
Sex:Male
Location:Montana
Vaccinated:1997-10-03
Onset:1997-10-05
Submitted:1998-03-14
Entered:1998-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Hypokinesia, Neuropathy, Paraesthesia, Paralysis, Vasculitis

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: NONE~ ()~~~In patient
Other Medications: Vasotec;Triamterene
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9MAR98 MRI;12MAR98 nerve biopsy;peripheal neuropathe;paraneal palsy;vasculitis;
CDC 'Split Type':

Write-up: pt recv vax 3OCT97 & 5OCT97 numbness rt foot;13OCT97 saw MD tested for diabetes negative;14NOV97 rt ankle stopped working;7JAN98 myelogram & CAT dx peripheral neuropathy, perineal palsy;12FEB98 ?dx vasculitis;


Changed on 9/14/2018

VAERS ID: 108666 Before After
VAERS Form:1
Age:50.0
Sex:Male
Location:Montana
Vaccinated:1997-10-03
Onset:1997-10-05
Submitted:1998-03-14
Entered:1998-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Hypokinesia, Neuropathy, Paraesthesia, Paralysis, Vasculitis

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: NONE~ ()~~~In patient
Other Medications: Vasotec;Triamterene
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9MAR98 MRI;12MAR98 nerve biopsy;peripheal neuropathe;paraneal palsy;vasculitis;
CDC 'Split Type':

Write-up: pt recv vax 3OCT97 & 5OCT97 numbness rt foot;13OCT97 saw MD tested for diabetes negative;14NOV97 rt ankle stopped working;7JAN98 myelogram & CAT dx peripheral neuropathy, perineal palsy;12FEB98 ?dx vasculitis;


Changed on 10/14/2018

VAERS ID: 108666 Before After
VAERS Form:1
Age:50.0
Sex:Male
Location:Montana
Vaccinated:1997-10-03
Onset:1997-10-05
Submitted:1998-03-14
Entered:1998-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Hypokinesia, Neuropathy, Paraesthesia, Paralysis, Vasculitis

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: NONE~ ()~~~In patient
Other Medications: Vasotec;Triamterene
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9MAR98 MRI;12MAR98 nerve biopsy;peripheal neuropathe;paraneal palsy;vasculitis;
CDC 'Split Type':

Write-up: pt recv vax 3OCT97 & 5OCT97 numbness rt foot;13OCT97 saw MD tested for diabetes negative;14NOV97 rt ankle stopped working;7JAN98 myelogram & CAT dx peripheral neuropathy, perineal palsy;12FEB98 ?dx vasculitis;


Changed on 12/24/2020

VAERS ID: 108666 Before After
VAERS Form:1
Age:50.0
Sex:Male
Location:Montana
Vaccinated:1997-10-03
Onset:1997-10-05
Submitted:1998-03-14
Entered:1998-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Hypokinesia, Neuropathy, Paraesthesia, Paralysis, Vasculitis

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: NONE~ ()~~~In patient
Other Medications: Vasotec;Triamterene
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9MAR98 MRI;12MAR98 nerve biopsy;peripheal neuropathe;paraneal palsy;vasculitis;
CDC 'Split Type':

Write-up: pt recv vax 3OCT97 & 5OCT97 numbness rt foot;13OCT97 saw MD tested for diabetes negative;14NOV97 rt ankle stopped working;7JAN98 myelogram & CAT dx peripheral neuropathy, perineal palsy;12FEB98 ?dx vasculitis;


Changed on 12/30/2020

VAERS ID: 108666 Before After
VAERS Form:1
Age:50.0
Sex:Male
Location:Montana
Vaccinated:1997-10-03
Onset:1997-10-05
Submitted:1998-03-14
Entered:1998-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Hypokinesia, Neuropathy, Paraesthesia, Paralysis, Vasculitis

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: NONE~ ()~~~In patient
Other Medications: Vasotec;Triamterene
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 9MAR98 MRI;12MAR98 nerve biopsy;peripheal neuropathe;paraneal palsy;vasculitis;
CDC 'Split Type':

Write-up: pt recv vax 3OCT97 & 5OCT97 numbness rt foot;13OCT97 saw MD tested for diabetes negative;14NOV97 rt ankle stopped working;7JAN98 myelogram & CAT dx peripheral neuropathy, perineal palsy;12FEB98 ?dx vasculitis;

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