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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 108781 |
VAERS Form: | |
Age: | 48.0 |
Sex: | Male |
Location: | Unknown |
Vaccinated: | 1997-10-16 |
Onset: | 1997-12-30 |
Submitted: | 1998-02-15 |
Entered: | 1998-03-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: UNK. INFLUENZA VACCINE / UNCLASSIFIED | - / - | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND, PNEUMONIA, PLEURAL DIS
Life Threatening? Yes
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? Yes, days:
Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;
Vaccinated: | 1997-10-16 |
Onset: | 1997-12-30 |
Submitted: | 1998-02-15 |
Entered: | 1998-03-24 1998-03-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: UNK. INFLUENZA VACCINE INFLUENZA (SEASONAL) (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER | - / - | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Pleural disorder, Pneumonia, GUILLAIN BARRE SYND, PNEUMONIA, PLEURAL DIS
Life Threatening? Yes
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? Yes, days:
Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;
Vaccinated: | 1997-10-16 |
Onset: | 1997-12-30 |
Submitted: | 1998-02-15 |
Entered: | 1998-03-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / - | - / - |
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / - | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Pleural disorder, Pneumonia
Life Threatening? Yes
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? Yes, days:
Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;
Vaccinated: | 1997-10-16 |
Onset: | 1997-12-30 |
Submitted: | 1998-02-15 |
Entered: | 1998-03-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / - | - / - |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / - | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Pleural disorder, Pneumonia
Life Threatening? Yes
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? Yes, days:
Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;
Vaccinated: | 1997-10-16 |
Onset: | 1997-12-30 |
Submitted: | 1998-02-15 |
Entered: | 1998-03-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / - | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Pleural disorder, Pneumonia
Life Threatening? Yes
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? Yes, days:
Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;
Vaccinated: | 1997-10-16 |
Onset: | 1997-12-30 |
Submitted: | 1998-02-15 |
Entered: | 1998-03-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / - UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Pleural disorder, Pneumonia
Life Threatening? Yes
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? Yes, days:
Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;
Vaccinated: | 1997-10-16 |
Onset: | 1997-12-30 |
Submitted: | 1998-02-15 |
Entered: | 1998-03-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Pleural disorder, Pneumonia
Life Threatening? Yes
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? Yes, days:
Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;
Vaccinated: | 1997-10-16 |
Onset: | 1997-12-30 |
Submitted: | 1998-02-15 |
Entered: | 1998-03-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Pleural disorder, Pneumonia
Life Threatening? Yes
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? Yes, days:
Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;
Vaccinated: | 1997-10-16 |
Onset: | 1997-12-30 |
Submitted: | 1998-02-15 |
Entered: | 1998-03-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Pleural disorder, Pneumonia
Life Threatening? Yes
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? Yes, days:
Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;
Vaccinated: | 1997-10-16 |
Onset: | 1997-12-30 |
Submitted: | 1998-02-15 |
Entered: | 1998-03-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Pleural disorder, Pneumonia
Life Threatening? Yes
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? Yes, days:
Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;
Vaccinated: | 1997-10-16 |
Onset: | 1997-12-30 |
Submitted: | 1998-02-15 |
Entered: | 1998-03-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Pleural disorder, Pneumonia
Life Threatening? Yes
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? Yes, days:
Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;
Vaccinated: | 1997-10-16 |
Onset: | 1997-12-30 |
Submitted: | 1998-02-15 |
Entered: | 1998-03-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Pleural disorder, Pneumonia
Life Threatening? Yes
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? Yes, days:
Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;
Vaccinated: | 1997-10-16 |
Onset: | 1997-12-30 |
Submitted: | 1998-02-15 |
Entered: | 1998-03-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Pleural disorder, Pneumonia
Life Threatening? Yes
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? Yes, days:
Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;
Vaccinated: | 1997-10-16 |
Onset: | 1997-12-30 |
Submitted: | 1998-02-15 |
Entered: | 1998-03-23 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / UNK | - / - |
Administered by: Unknown Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Pleural disorder, Pneumonia
Life Threatening? Yes
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? Yes, days:
Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;
Link To This Search Result:
https://medalerts.org/vaersdb/findfield.php?IDNUMBER=108781&WAYBACKHISTORY=ON
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