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This is VAERS ID 108781

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;prior to GBS dx in good health;no med problems;NKDA;started w/course of ATB on 22DEC97 for pneumonia P pleurisy;

Changed on 12/8/2009

VAERS ID: 108781 Before After
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 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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;prior to GBS dx in good health;no med problems;NKDA;started w/course of ATB on 22DEC97 for pneumonia P pleurisy;

Changed on 7/7/2013

VAERS ID: 108781 Before After
VAERS Form:
Age:48.0
Sex:Male
Location:Unknown
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;prior to GBS dx in good health;no med problems;NKDA;started w/course of ATB on 22DEC97 for pneumonia P pleurisy;

Changed on 12/14/2016

VAERS ID: 108781 Before After
VAERS Form:
Age:48.0
Sex:Male
Location:Unknown
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;prior to GBS dx in good health;no med problems;NKDA;started w/course of ATB on 22DEC97 for pneumonia P pleurisy;

Changed on 5/14/2017

VAERS ID: 108781 Before After
VAERS Form:
Age:48.0
Sex:Male
Location:Unknown
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;prior to GBS dx in good health;no med problems;NKDA;started w/course of ATB on 22DEC97 for pneumonia P pleurisy;

Changed on 9/14/2017

VAERS ID: 108781 Before After
VAERS Form:(blank) 1
Age:48.0
Sex:Male
Location:Unknown
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;prior to GBS dx in good health;no med problems;NKDA;started w/course of ATB on 22DEC97 for pneumonia P pleurisy;

Changed on 2/14/2018

VAERS ID: 108781 Before After
VAERS Form:1
Age:48.0
Sex:Male
Location:Unknown
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;prior to GBS dx in good health;no med problems;NKDA;started w/course of ATB on 22DEC97 for pneumonia P pleurisy;

Changed on 6/14/2018

VAERS ID: 108781 Before After
VAERS Form:1
Age:48.0
Sex:Male
Location:Unknown
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;prior to GBS dx in good health;no med problems;NKDA;started w/course of ATB on 22DEC97 for pneumonia P pleurisy;

Changed on 8/14/2018

VAERS ID: 108781 Before After
VAERS Form:1
Age:48.0
Sex:Male
Location:Unknown
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;prior to GBS dx in good health;no med problems;NKDA;started w/course of ATB on 22DEC97 for pneumonia P pleurisy;

Changed on 9/14/2018

VAERS ID: 108781 Before After
VAERS Form:1
Age:48.0
Sex:Male
Location:Unknown
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;prior to GBS dx in good health;no med problems;NKDA;started w/course of ATB on 22DEC97 for pneumonia P pleurisy;

Changed on 10/14/2018

VAERS ID: 108781 Before After
VAERS Form:1
Age:48.0
Sex:Male
Location:Unknown
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;prior to GBS dx in good health;no med problems;NKDA;started w/course of ATB on 22DEC97 for pneumonia P pleurisy;

Changed on 12/10/2020

VAERS ID: 108781 Before After
VAERS Form:1
Age:48.0
Sex:Male
Location:Unknown Virginia
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;prior to GBS dx in good health;no med problems;NKDA;started w/course of ATB on 22DEC97 for pneumonia P pleurisy;

Changed on 12/24/2020

VAERS ID: 108781 Before After
VAERS Form:1
Age:48.0
Sex:Male
Location:Virginia
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;prior to GBS dx in good health;no med problems;NKDA;started w/course of ATB on 22DEC97 for pneumonia P pleurisy;

Changed on 12/30/2020

VAERS ID: 108781 Before After
VAERS Form:1
Age:48.0
Sex:Male
Location:Virginia
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax 16OCT97 & dx w/GBS on 30DEC97 to 17FEB98;prior to GBS dx in good health;no med problems;NKDA;started w/course of ATB on 22DEC97 for pneumonia P pleurisy;

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