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This is VAERS ID 133423

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 133423
VAERS Form:
Age:67.6
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1999-2000 / CONNAUGHT LABS 7581819 / 1 - / IM
PPV: PNEUMOVAX 23 / MSD 0994E / 1 - / -

Administered by: ??      Purchased by: Unknown
Symptoms: HYPOKINESIA, MYASTHENIA, MYOSITIS

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular"weakness and ongoing treatment for general weakness with drugs.


Changed on 12/8/2009

VAERS ID: 133423 Before After
VAERS Form:
Age:67.6 67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-28 2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1999-2000 INFLUENZA (SEASONAL) (FLUZONE 99-00) / CONNAUGHT LABS CONNAUGHT LABORATORIES 7581819 / 1 - / IM
PPV: PNEUMOVAX 23 PNEUMO (PNEUMOVAX) / MSD MERCK & CO. INC. 0994E / 1 - / -

Administered by: (blank) Unknown      Purchased by: Unknown
Symptoms: Hypokinesia, Myasthenic syndrome, Myositis, HYPOKINESIA, MYASTHENIA, MYOSITIS

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular"weakness muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.


Changed on 1/5/2010

VAERS ID: 133423 Before After
VAERS Form:
Age:67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 99-00) / CONNAUGHT LABORATORIES 7581819 / 1 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0994E / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypokinesia, Myasthenic syndrome, Myositis

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.


Changed on 7/31/2010

VAERS ID: 133423 Before After
VAERS Form:
Age:67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 99-00) / CONNAUGHT LABORATORIES 7581819 / 1 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0994E / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Biopsy muscle abnormal, Blood product transfusion, Electromyogram abnormal, Hypokinesia, Muscular weakness, Myasthenic syndrome, Polymyositis, Abasia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.


Changed on 8/31/2010

VAERS ID: 133423 Before After
VAERS Form:
Age:67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 99-00) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7581819 / 1 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0994E / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Biopsy muscle abnormal, Blood product transfusion, Electromyogram abnormal, Hypokinesia, Muscular weakness, Myasthenic syndrome, Polymyositis, Abasia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.


Changed on 7/7/2013

VAERS ID: 133423 Before After
VAERS Form:
Age:67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7581819 / 1 - / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7581819 / 1 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0994E / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Biopsy muscle abnormal, Blood product transfusion, Electromyogram abnormal, Hypokinesia, Muscular weakness, Myasthenic syndrome, Polymyositis, Abasia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.


Changed on 6/14/2014

VAERS ID: 133423 Before After
VAERS Form:
Age:67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7581819 / 1 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0994E / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Biopsy muscle abnormal, Blood product transfusion, Electromyogram abnormal, Hypokinesia, Muscular weakness, Myasthenic syndrome, Polymyositis, Abasia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.


Changed on 5/14/2017

VAERS ID: 133423 Before After
VAERS Form:
Age:67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7581819 / 1 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0994E / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Biopsy muscle abnormal, Blood product transfusion, Electromyogram abnormal, Hypokinesia, Muscular weakness, Myasthenic syndrome, Polymyositis, Abasia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.


Changed on 9/14/2017

VAERS ID: 133423 Before After
VAERS Form:(blank) 1
Age:67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7581819 / 1 2 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0994E / 1 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Biopsy muscle abnormal, Blood product transfusion, Electromyogram abnormal, Hypokinesia, Muscular weakness, Myasthenic syndrome, Polymyositis, Abasia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.


Changed on 2/14/2018

VAERS ID: 133423 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7581819 / 2 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0994E / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Biopsy muscle abnormal, Blood product transfusion, Electromyogram abnormal, Hypokinesia, Muscular weakness, Myasthenic syndrome, Polymyositis, Abasia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.


Changed on 6/14/2018

VAERS ID: 133423 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7581819 / 2 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0994E / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Biopsy muscle abnormal, Blood product transfusion, Electromyogram abnormal, Hypokinesia, Muscular weakness, Myasthenic syndrome, Polymyositis, Abasia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.


Changed on 8/14/2018

VAERS ID: 133423 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7581819 / 2 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0994E / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Biopsy muscle abnormal, Blood product transfusion, Electromyogram abnormal, Hypokinesia, Muscular weakness, Myasthenic syndrome, Polymyositis, Abasia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.


Changed on 9/14/2018

VAERS ID: 133423 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7581819 / 2 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0994E / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Biopsy muscle abnormal, Blood product transfusion, Electromyogram abnormal, Hypokinesia, Muscular weakness, Myasthenic syndrome, Polymyositis, Abasia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.


Changed on 10/14/2018

VAERS ID: 133423 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7581819 / 2 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0994E / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Biopsy muscle abnormal, Blood product transfusion, Electromyogram abnormal, Hypokinesia, Muscular weakness, Myasthenic syndrome, Polymyositis, Abasia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.


Changed on 12/24/2020

VAERS ID: 133423 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7581819 / 2 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0994E / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Biopsy muscle abnormal, Blood product transfusion, Electromyogram abnormal, Hypokinesia, Muscular weakness, Myasthenic syndrome, Polymyositis, Abasia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.


Changed on 12/30/2020

VAERS ID: 133423 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7581819 / 2 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0994E / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Biopsy muscle abnormal, Blood product transfusion, Electromyogram abnormal, Hypokinesia, Muscular weakness, Myasthenic syndrome, Polymyositis, Abasia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.


Changed on 5/7/2021

VAERS ID: 133423 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7581819 / 2 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0994E / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Biopsy muscle abnormal, Blood product transfusion, Electromyogram abnormal, Hypokinesia, Muscular weakness, Myasthenic syndrome, Polymyositis, Abasia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.


Changed on 5/14/2021

VAERS ID: 133423 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:California
Vaccinated:1997-10-27
Onset:1997-11-27
Submitted:0000-00-00
Entered:2000-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7581819 / 2 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0994E / 2 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Biopsy muscle abnormal, Blood product transfusion, Electromyogram abnormal, Hypokinesia, Muscular weakness, Myasthenic syndrome, Polymyositis, Abasia

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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Immuran, Prednisone, Thyroxin
Current Illness: NONE
Preexisting Conditions: hypothyroidism
Allergies:
Diagnostic Lab Data: muscle biopsy-confirming dx, EMG-changes in motor units
CDC 'Split Type':

Write-up: Extreme muscle weakness, inability to walk, rollover in bed, rise from a chair or bathe unassisted. Rcving. IV-gamma Globulin infusions (8) txmts. Dx with polymyositis. 60 day follow-up dated 10/16/00 states the pt is still suffering from general muscular weakness and ongoing treatment for general weakness with drugs. Follow-up: 02/15/00 - Consent form returned by pt - sent with letter to medical center.

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