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This is VAERS ID 168255

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Already in VAERS on 12/31/2003

VAERS ID: 168255
VAERS Form:
Age:70.0
Sex:Male
Location:New York
Vaccinated:2000-11-09
Onset:2000-12-27
Submitted:2001-03-26
Entered:2001-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE 00-01) /   U0415AA / - LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: DIZZINESS, ANOREXIA, ASTHENIA, DEPRESSION, ATAXIA

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 59     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI; Spinal Tap; Cat Scan of abdomen; Nerve biopsy; Blood work; Doppler of legs-no clots; Colonoscopy-polyps; 24 hour UA
CDC 'Split Type':

Write-up: On 11/09/00, the patient had a flu vaccine. On 12/27/00, the patient had tingling and prickly feeling in his hands and feet. On 12/28/00, the patient went to the doctors office with decreased feeling in his feet. He made an appt to see the neurologist on"01/02. On 12/29/00, the patient had difficulty waking, with decreased feeling in his legs and feet, and loosing balance. On 12/30/00, the patient called the doctor because loss of sensation was progressing up his legs, arms, and hands. He had difficulty s


Changed on 12/8/2009

VAERS ID: 168255 Before After
VAERS Form:
Age:70.0
Sex:Male
Location:New York
Vaccinated:2000-11-09
Onset:2000-12-27
Submitted:2001-03-26
Entered:2001-04-05 2001-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE 00-01) INFLUENZA (SEASONAL) (FLUZONE 00-01) /   AVENTIS PASTEUR U0415AA / - LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Depression, Difficulty in walking, Dysphagia, Guillain-Barre syndrome, Hypotonia, Insomnia, Lethargy, Paraesthesia, Weight decreased, Balance disorder, DIZZINESS, ANOREXIA, ASTHENIA, DEPRESSION, ATAXIA

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 59     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI; Spinal Tap; Cat Scan of abdomen; Nerve biopsy; Blood work; Doppler of legs-no clots; Colonoscopy-polyps; 24 hour UA
CDC 'Split Type':

Write-up: On 11/09/00, the patient had a flu vaccine. On 12/27/00, the patient had tingling and prickly feeling in his hands and feet. On 12/28/00, the patient went to the doctors office with decreased feeling in his feet. He made an appt to see the neurologist on"01/02. on 01/02. On 12/29/00, the patient had difficulty waking, with decreased feeling in his legs and feet, and loosing balance. On 12/30/00, the patient called the doctor because loss of sensation was progressing up his legs, arms, and hands. He had difficulty s sleeping because of discomfort. 12/31/00, the patient had numbness progressing in his thighs to his hips. The doctor sent him to the ER where he was seen by a neurologist. He was sent for an MRI and return was admission to ICU. On 01/05/01, the patient improved some and was discharged. He was able to use the walker with difficulty. He was evaluated by PT. He had therapy on 01/15,01/18, 01/22 and 01/25, condition declining, he was getting weaker. 01/16/01, More medication was ordered to be given at home for 3 days, an RN came to the house and stayed during treatment. 01/20/01, he felt a little improved. 01/22 & 01/25/00, the patient had PT. 01/26/01, his condition was worse, unable to go upstairs, or walk with a walker without falling. On 01/30/01, he saw a neurologist and was taken to the ER and was admitted and evaluated by referring doctor. The patient was given plasma phoresis prescription on 02/01, 02/02, 02/03, 02/04, 02/05, and 02/07. He had a nerve testing on 02/11 no improvement. On 02/12/00, he was transferred to another hospital via w/ch van for rehab. He had 1 hour of PT in the AM and 1 hour of OT in the PM. The patient''s condition continued to decline. His appetite was poor, he had difficulty swallowing, weight decreased, because he became weaker each day, not eating. 02/20/01, The doctor was notified and the patient was transferred back to the ICU at the original hospital. On 02/21/01, more meds and had a nasogastric tube inserted for feeding. His weight declined from 175 - 137. Still no movement in


Changed on 8/31/2010

VAERS ID: 168255 Before After
VAERS Form:
Age:70.0
Sex:Male
Location:New York
Vaccinated:2000-11-09
Onset:2000-12-27
Submitted:2001-03-26
Entered:2001-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 00-01) INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U0415AA / - LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Depression, Difficulty in walking, Dysphagia, Guillain-Barre syndrome, Hypotonia, Insomnia, Lethargy, Paraesthesia, Weight decreased, Balance disorder

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 59     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI; Spinal Tap; Cat Scan of abdomen; Nerve biopsy; Blood work; Doppler of legs-no clots; Colonoscopy-polyps; 24 hour UA
CDC 'Split Type':

Write-up: On 11/09/00, the patient had a flu vaccine. On 12/27/00, the patient had tingling and prickly feeling in his hands and feet. On 12/28/00, the patient went to the doctors office with decreased feeling in his feet. He made an appt to see the neurologist on 01/02. On 12/29/00, the patient had difficulty waking, with decreased feeling in his legs and feet, and loosing balance. On 12/30/00, the patient called the doctor because loss of sensation was progressing up his legs, arms, and hands. He had difficulty sleeping because of discomfort. 12/31/00, the patient had numbness progressing in his thighs to his hips. The doctor sent him to the ER where he was seen by a neurologist. He was sent for an MRI and return was admission to ICU. On 01/05/01, the patient improved some and was discharged. He was able to use the walker with difficulty. He was evaluated by PT. He had therapy on 01/15,01/18, 01/22 and 01/25, condition declining, he was getting weaker. 01/16/01, More medication was ordered to be given at home for 3 days, an RN came to the house and stayed during treatment. 01/20/01, he felt a little improved. 01/22 & 01/25/00, the patient had PT. 01/26/01, his condition was worse, unable to go upstairs, or walk with a walker without falling. On 01/30/01, he saw a neurologist and was taken to the ER and was admitted and evaluated by referring doctor. The patient was given plasma phoresis prescription on 02/01, 02/02, 02/03, 02/04, 02/05, and 02/07. He had a nerve testing on 02/11 no improvement. On 02/12/00, he was transferred to another hospital via w/ch van for rehab. He had 1 hour of PT in the AM and 1 hour of OT in the PM. The patient''s condition continued to decline. His appetite was poor, he had difficulty swallowing, weight decreased, because he became weaker each day, not eating. 02/20/01, The doctor was notified and the patient was transferred back to the ICU at the original hospital. On 02/21/01, more meds and had a nasogastric tube inserted for feeding. His weight declined from 175 - 137. Still no movement in


Changed on 7/7/2013

VAERS ID: 168255 Before After
VAERS Form:
Age:70.0
Sex:Male
Location:New York
Vaccinated:2000-11-09
Onset:2000-12-27
Submitted:2001-03-26
Entered:2001-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U0415AA / - LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U0415AA / - LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Depression, Difficulty in walking, Dysphagia, Guillain-Barre syndrome, Hypotonia, Insomnia, Lethargy, Paraesthesia, Weight decreased, Balance disorder

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 59     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI; Spinal Tap; Cat Scan of abdomen; Nerve biopsy; Blood work; Doppler of legs-no clots; Colonoscopy-polyps; 24 hour UA
CDC 'Split Type':

Write-up: On 11/09/00, the patient had a flu vaccine. On 12/27/00, the patient had tingling and prickly feeling in his hands and feet. On 12/28/00, the patient went to the doctors office with decreased feeling in his feet. He made an appt to see the neurologist on 01/02. On 12/29/00, the patient had difficulty waking, with decreased feeling in his legs and feet, and loosing balance. On 12/30/00, the patient called the doctor because loss of sensation was progressing up his legs, arms, and hands. He had difficulty sleeping because of discomfort. 12/31/00, the patient had numbness progressing in his thighs to his hips. The doctor sent him to the ER where he was seen by a neurologist. He was sent for an MRI and return was admission to ICU. On 01/05/01, the patient improved some and was discharged. He was able to use the walker with difficulty. He was evaluated by PT. He had therapy on 01/15,01/18, 01/22 and 01/25, condition declining, he was getting weaker. 01/16/01, More medication was ordered to be given at home for 3 days, an RN came to the house and stayed during treatment. 01/20/01, he felt a little improved. 01/22 & 01/25/00, the patient had PT. 01/26/01, his condition was worse, unable to go upstairs, or walk with a walker without falling. On 01/30/01, he saw a neurologist and was taken to the ER and was admitted and evaluated by referring doctor. The patient was given plasma phoresis prescription on 02/01, 02/02, 02/03, 02/04, 02/05, and 02/07. He had a nerve testing on 02/11 no improvement. On 02/12/00, he was transferred to another hospital via w/ch van for rehab. He had 1 hour of PT in the AM and 1 hour of OT in the PM. The patient''s condition continued to decline. His appetite was poor, he had difficulty swallowing, weight decreased, because he became weaker each day, not eating. 02/20/01, The doctor was notified and the patient was transferred back to the ICU at the original hospital. On 02/21/01, more meds and had a nasogastric tube inserted for feeding. His weight declined from 175 - 137. Still no movement in


Changed on 5/14/2017

VAERS ID: 168255 Before After
VAERS Form:
Age:70.0
Sex:Male
Location:New York
Vaccinated:2000-11-09
Onset:2000-12-27
Submitted:2001-03-26
Entered:2001-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U0415AA / - LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Depression, Difficulty in walking, Dysphagia, Guillain-Barre syndrome, Hypoaesthesia, Hypotonia, Insomnia, Lethargy, Paraesthesia, Weight decreased, Balance disorder

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 59     Extended hospital stay? No Yes
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI; Spinal Tap; Cat Scan of abdomen; Nerve biopsy; Blood work; Doppler of legs-no clots; Colonoscopy-polyps; 24 hour UA
CDC 'Split Type':

Write-up: On 11/09/00, the patient had a flu vaccine. On 12/27/00, the patient had tingling and prickly feeling in his hands and feet. On 12/28/00, the patient went to the doctors office with decreased feeling in his feet. He made an appt to see the neurologist on 01/02. On 12/29/00, the patient had difficulty waking, with decreased feeling in his legs and feet, and loosing balance. On 12/30/00, the patient called the doctor because loss of sensation was progressing up his legs, arms, and hands. He had difficulty sleeping because of discomfort. 12/31/00, the patient had numbness progressing in his thighs to his hips. The doctor sent him to the ER where he was seen by a neurologist. He was sent for an MRI and return was admission to ICU. On 01/05/01, the patient improved some and was discharged. He was able to use the walker with difficulty. He was evaluated by PT. He had therapy on 01/15,01/18, 01/22 and 01/25, condition declining, he was getting weaker. 01/16/01, More medication was ordered to be given at home for 3 days, an RN came to the house and stayed during treatment. 01/20/01, he felt a little improved. 01/22 & 01/25/00, the patient had PT. 01/26/01, his condition was worse, unable to go upstairs, or walk with a walker without falling. On 01/30/01, he saw a neurologist and was taken to the ER and was admitted and evaluated by referring doctor. The patient was given plasma phoresis prescription on 02/01, 02/02, 02/03, 02/04, 02/05, and 02/07. He had a nerve testing on 02/11 no improvement. On 02/12/00, he was transferred to another hospital via w/ch van for rehab. He had 1 hour of PT in the AM and 1 hour of OT in the PM. The patient''s condition continued to decline. His appetite was poor, he had difficulty swallowing, weight decreased, because he became weaker each day, not eating. 02/20/01, The doctor was notified and the patient was transferred back to the ICU at the original hospital. On 02/21/01, more meds and had a nasogastric tube inserted for feeding. His weight declined from 175 - 137. Still no movement in his legs, moving fingers; continued to improve. On 02/28/01, the patient was transferred out of ICU to a floor unit. He was moving his hands and his arms; able to hold a newspaper. On 03/01/01, doing better, getting OT & PT. Still NPO. Test showed inversion of epiglottis. On 03/02/01, moving arms, able to make a fist, NG tube out and stomach tube inserted via abdomen, sleeping poorly, breathing test improving. On 03/06/01, very lethargic, slept most of the day. 03/08/01, depressed, complains of weakness of arms and legs. Had a sonogram of his leg. 03/09 and 03/10/01 more meds, moving his fingers a little, voice seems stronger.03/11/01, felt like increased strength in his right arm. 03/12/01, he was moving his arms and legs, and able to reach nose. Breathing test 2.6 + 60, chest clear. 03/13/01, weight down to 122, more meds, able to move arm back and forth on tray table (PT). 03/14/01, good spirits, able to move arms and legs but no real control. 03/23/01, patient went home, improving but still unsteady, moving arms and hands, legs still very flaccid. Diagnosed with GBS.


Changed on 9/14/2017

VAERS ID: 168255 Before After
VAERS Form:(blank) 1
Age:70.0
Sex:Male
Location:New York
Vaccinated:2000-11-09
Onset:2000-12-27
Submitted:2001-03-26
Entered:2001-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U0415AA / - UNK LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Depression, Difficulty in walking, Dysphagia, Guillain-Barre syndrome, Hypoaesthesia, Hypotonia, Insomnia, Lethargy, Paraesthesia, Weight decreased, Balance disorder

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 59     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI; Spinal Tap; Cat Scan of abdomen; Nerve biopsy; Blood work; Doppler of legs-no clots; Colonoscopy-polyps; 24 hour UA
CDC 'Split Type':

Write-up: On 11/09/00, the patient had a flu vaccine. On 12/27/00, the patient had tingling and prickly feeling in his hands and feet. On 12/28/00, the patient went to the doctors office with decreased feeling in his feet. He made an appt to see the neurologist on 01/02. On 12/29/00, the patient had difficulty waking, with decreased feeling in his legs and feet, and loosing balance. On 12/30/00, the patient called the doctor because loss of sensation was progressing up his legs, arms, and hands. He had difficulty sleeping because of discomfort. 12/31/00, the patient had numbness progressing in his thighs to his hips. The doctor sent him to the ER where he was seen by a neurologist. He was sent for an MRI and return was admission to ICU. On 01/05/01, the patient improved some and was discharged. He was able to use the walker with difficulty. He was evaluated by PT. He had therapy on 01/15,01/18, 01/22 and 01/25, condition declining, he was getting weaker. 01/16/01, More medication was ordered to be given at home for 3 days, an RN came to the house and stayed during treatment. 01/20/01, he felt a little improved. 01/22 & 01/25/00, the patient had PT. 01/26/01, his condition was worse, unable to go upstairs, or walk with a walker without falling. On 01/30/01, he saw a neurologist and was taken to the ER and was admitted and evaluated by referring doctor. The patient was given plasma phoresis prescription on 02/01, 02/02, 02/03, 02/04, 02/05, and 02/07. He had a nerve testing on 02/11 no improvement. On 02/12/00, he was transferred to another hospital via w/ch van for rehab. He had 1 hour of PT in the AM and 1 hour of OT in the PM. The patient''s condition continued to decline. His appetite was poor, he had difficulty swallowing, weight decreased, because he became weaker each day, not eating. 02/20/01, The doctor was notified and the patient was transferred back to the ICU at the original hospital. On 02/21/01, more meds and had a nasogastric tube inserted for feeding. His weight declined from 175 - 137. Still no movement in his legs, moving fingers; continued to improve. On 02/28/01, the patient was transferred out of ICU to a floor unit. He was moving his hands and his arms; able to hold a newspaper. On 03/01/01, doing better, getting OT & PT. Still NPO. Test showed inversion of epiglottis. On 03/02/01, moving arms, able to make a fist, NG tube out and stomach tube inserted via abdomen, sleeping poorly, breathing test improving. On 03/06/01, very lethargic, slept most of the day. 03/08/01, depressed, complains of weakness of arms and legs. Had a sonogram of his leg. 03/09 and 03/10/01 more meds, moving his fingers a little, voice seems stronger.03/11/01, felt like increased strength in his right arm. 03/12/01, he was moving his arms and legs, and able to reach nose. Breathing test 2.6 + 60, chest clear. 03/13/01, weight down to 122, more meds, able to move arm back and forth on tray table (PT). 03/14/01, good spirits, able to move arms and legs but no real control. 03/23/01, patient went home, improving but still unsteady, moving arms and hands, legs still very flaccid. Diagnosed with GBS.


Changed on 2/14/2018

VAERS ID: 168255 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:New York
Vaccinated:2000-11-09
Onset:2000-12-27
Submitted:2001-03-26
Entered:2001-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U0415AA / UNK LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Depression, Difficulty in walking, Dysphagia, Guillain-Barre syndrome, Hypoaesthesia, Hypotonia, Insomnia, Lethargy, Paraesthesia, Weight decreased, Balance disorder

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 59     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI; Spinal Tap; Cat Scan of abdomen; Nerve biopsy; Blood work; Doppler of legs-no clots; Colonoscopy-polyps; 24 hour UA
CDC 'Split Type':

Write-up: On 11/09/00, the patient had a flu vaccine. On 12/27/00, the patient had tingling and prickly feeling in his hands and feet. On 12/28/00, the patient went to the doctors office with decreased feeling in his feet. He made an appt to see the neurologist on 01/02. On 12/29/00, the patient had difficulty waking, with decreased feeling in his legs and feet, and loosing balance. On 12/30/00, the patient called the doctor because loss of sensation was progressing up his legs, arms, and hands. He had difficulty sleeping because of discomfort. 12/31/00, the patient had numbness progressing in his thighs to his hips. The doctor sent him to the ER where he was seen by a neurologist. He was sent for an MRI and return was admission to ICU. On 01/05/01, the patient improved some and was discharged. He was able to use the walker with difficulty. He was evaluated by PT. He had therapy on 01/15,01/18, 01/22 and 01/25, condition declining, he was getting weaker. 01/16/01, More medication was ordered to be given at home for 3 days, an RN came to the house and stayed during treatment. 01/20/01, he felt a little improved. 01/22 & 01/25/00, the patient had PT. 01/26/01, his condition was worse, unable to go upstairs, or walk with a walker without falling. On 01/30/01, he saw a neurologist and was taken to the ER and was admitted and evaluated by referring doctor. The patient was given plasma phoresis prescription on 02/01, 02/02, 02/03, 02/04, 02/05, and 02/07. He had a nerve testing on 02/11 no improvement. On 02/12/00, he was transferred to another hospital via w/ch van for rehab. He had 1 hour of PT in the AM and 1 hour of OT in the PM. The patient''s condition continued to decline. His appetite was poor, he had difficulty swallowing, weight decreased, because he became weaker each day, not eating. 02/20/01, The doctor was notified and the patient was transferred back to the ICU at the original hospital. On 02/21/01, more meds and had a nasogastric tube inserted for feeding. His weight declined from 175 - 137. Still no movement in his legs, moving fingers; continued to improve. On 02/28/01, the patient was transferred out of ICU to a floor unit. He was moving his hands and his arms; able to hold a newspaper. On 03/01/01, doing better, getting OT & PT. Still NPO. Test showed inversion of epiglottis. On 03/02/01, moving arms, able to make a fist, NG tube out and stomach tube inserted via abdomen, sleeping poorly, breathing test improving. On 03/06/01, very lethargic, slept most of the day. 03/08/01, depressed, complains of weakness of arms and legs. Had a sonogram of his leg. 03/09 and 03/10/01 more meds, moving his fingers a little, voice seems stronger.03/11/01, felt like increased strength in his right arm. 03/12/01, he was moving his arms and legs, and able to reach nose. Breathing test 2.6 + 60, chest clear. 03/13/01, weight down to 122, more meds, able to move arm back and forth on tray table (PT). 03/14/01, good spirits, able to move arms and legs but no real control. 03/23/01, patient went home, improving but still unsteady, moving arms and hands, legs still very flaccid. Diagnosed with GBS.


Changed on 6/14/2018

VAERS ID: 168255 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:New York
Vaccinated:2000-11-09
Onset:2000-12-27
Submitted:2001-03-26
Entered:2001-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U0415AA / UNK LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Depression, Difficulty in walking, Dysphagia, Guillain-Barre syndrome, Hypoaesthesia, Hypotonia, Insomnia, Lethargy, Paraesthesia, Weight decreased, Balance disorder

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 59     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI; Spinal Tap; Cat Scan of abdomen; Nerve biopsy; Blood work; Doppler of legs-no clots; Colonoscopy-polyps; 24 hour UA
CDC 'Split Type':

Write-up: On 11/09/00, the patient had a flu vaccine. On 12/27/00, the patient had tingling and prickly feeling in his hands and feet. On 12/28/00, the patient went to the doctors office with decreased feeling in his feet. He made an appt to see the neurologist on 01/02. On 12/29/00, the patient had difficulty waking, with decreased feeling in his legs and feet, and loosing balance. On 12/30/00, the patient called the doctor because loss of sensation was progressing up his legs, arms, and hands. He had difficulty sleeping because of discomfort. 12/31/00, the patient had numbness progressing in his thighs to his hips. The doctor sent him to the ER where he was seen by a neurologist. He was sent for an MRI and return was admission to ICU. On 01/05/01, the patient improved some and was discharged. He was able to use the walker with difficulty. He was evaluated by PT. He had therapy on 01/15,01/18, 01/22 and 01/25, condition declining, he was getting weaker. 01/16/01, More medication was ordered to be given at home for 3 days, an RN came to the house and stayed during treatment. 01/20/01, he felt a little improved. 01/22 & 01/25/00, the patient had PT. 01/26/01, his condition was worse, unable to go upstairs, or walk with a walker without falling. On 01/30/01, he saw a neurologist and was taken to the ER and was admitted and evaluated by referring doctor. The patient was given plasma phoresis prescription on 02/01, 02/02, 02/03, 02/04, 02/05, and 02/07. He had a nerve testing on 02/11 no improvement. On 02/12/00, he was transferred to another hospital via w/ch van for rehab. He had 1 hour of PT in the AM and 1 hour of OT in the PM. The patient''s condition continued to decline. His appetite was poor, he had difficulty swallowing, weight decreased, because he became weaker each day, not eating. 02/20/01, The doctor was notified and the patient was transferred back to the ICU at the original hospital. On 02/21/01, more meds and had a nasogastric tube inserted for feeding. His weight declined from 175 - 137. Still no movement in his legs, moving fingers; continued to improve. On 02/28/01, the patient was transferred out of ICU to a floor unit. He was moving his hands and his arms; able to hold a newspaper. On 03/01/01, doing better, getting OT & PT. Still NPO. Test showed inversion of epiglottis. On 03/02/01, moving arms, able to make a fist, NG tube out and stomach tube inserted via abdomen, sleeping poorly, breathing test improving. On 03/06/01, very lethargic, slept most of the day. 03/08/01, depressed, complains of weakness of arms and legs. Had a sonogram of his leg. 03/09 and 03/10/01 more meds, moving his fingers a little, voice seems stronger.03/11/01, felt like increased strength in his right arm. 03/12/01, he was moving his arms and legs, and able to reach nose. Breathing test 2.6 + 60, chest clear. 03/13/01, weight down to 122, more meds, able to move arm back and forth on tray table (PT). 03/14/01, good spirits, able to move arms and legs but no real control. 03/23/01, patient went home, improving but still unsteady, moving arms and hands, legs still very flaccid. Diagnosed with GBS.


Changed on 8/14/2018

VAERS ID: 168255 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:New York
Vaccinated:2000-11-09
Onset:2000-12-27
Submitted:2001-03-26
Entered:2001-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U0415AA / UNK LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Depression, Difficulty in walking, Dysphagia, Guillain-Barre syndrome, Hypoaesthesia, Hypotonia, Insomnia, Lethargy, Paraesthesia, Weight decreased, Balance disorder

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 59     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI; Spinal Tap; Cat Scan of abdomen; Nerve biopsy; Blood work; Doppler of legs-no clots; Colonoscopy-polyps; 24 hour UA
CDC 'Split Type':

Write-up: On 11/09/00, the patient had a flu vaccine. On 12/27/00, the patient had tingling and prickly feeling in his hands and feet. On 12/28/00, the patient went to the doctors office with decreased feeling in his feet. He made an appt to see the neurologist on 01/02. On 12/29/00, the patient had difficulty waking, with decreased feeling in his legs and feet, and loosing balance. On 12/30/00, the patient called the doctor because loss of sensation was progressing up his legs, arms, and hands. He had difficulty sleeping because of discomfort. 12/31/00, the patient had numbness progressing in his thighs to his hips. The doctor sent him to the ER where he was seen by a neurologist. He was sent for an MRI and return was admission to ICU. On 01/05/01, the patient improved some and was discharged. He was able to use the walker with difficulty. He was evaluated by PT. He had therapy on 01/15,01/18, 01/22 and 01/25, condition declining, he was getting weaker. 01/16/01, More medication was ordered to be given at home for 3 days, an RN came to the house and stayed during treatment. 01/20/01, he felt a little improved. 01/22 & 01/25/00, the patient had PT. 01/26/01, his condition was worse, unable to go upstairs, or walk with a walker without falling. On 01/30/01, he saw a neurologist and was taken to the ER and was admitted and evaluated by referring doctor. The patient was given plasma phoresis prescription on 02/01, 02/02, 02/03, 02/04, 02/05, and 02/07. He had a nerve testing on 02/11 no improvement. On 02/12/00, he was transferred to another hospital via w/ch van for rehab. He had 1 hour of PT in the AM and 1 hour of OT in the PM. The patient''s condition continued to decline. His appetite was poor, he had difficulty swallowing, weight decreased, because he became weaker each day, not eating. 02/20/01, The doctor was notified and the patient was transferred back to the ICU at the original hospital. On 02/21/01, more meds and had a nasogastric tube inserted for feeding. His weight declined from 175 - 137. Still no movement in his legs, moving fingers; continued to improve. On 02/28/01, the patient was transferred out of ICU to a floor unit. He was moving his hands and his arms; able to hold a newspaper. On 03/01/01, doing better, getting OT & PT. Still NPO. Test showed inversion of epiglottis. On 03/02/01, moving arms, able to make a fist, NG tube out and stomach tube inserted via abdomen, sleeping poorly, breathing test improving. On 03/06/01, very lethargic, slept most of the day. 03/08/01, depressed, complains of weakness of arms and legs. Had a sonogram of his leg. 03/09 and 03/10/01 more meds, moving his fingers a little, voice seems stronger.03/11/01, felt like increased strength in his right arm. 03/12/01, he was moving his arms and legs, and able to reach nose. Breathing test 2.6 + 60, chest clear. 03/13/01, weight down to 122, more meds, able to move arm back and forth on tray table (PT). 03/14/01, good spirits, able to move arms and legs but no real control. 03/23/01, patient went home, improving but still unsteady, moving arms and hands, legs still very flaccid. Diagnosed with GBS.


Changed on 9/14/2018

VAERS ID: 168255 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:New York
Vaccinated:2000-11-09
Onset:2000-12-27
Submitted:2001-03-26
Entered:2001-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U0415AA / UNK LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Depression, Difficulty in walking, Dysphagia, Guillain-Barre syndrome, Hypoaesthesia, Hypotonia, Insomnia, Lethargy, Paraesthesia, Weight decreased, Balance disorder

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 59     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI; Spinal Tap; Cat Scan of abdomen; Nerve biopsy; Blood work; Doppler of legs-no clots; Colonoscopy-polyps; 24 hour UA
CDC 'Split Type':

Write-up: On 11/09/00, the patient had a flu vaccine. On 12/27/00, the patient had tingling and prickly feeling in his hands and feet. On 12/28/00, the patient went to the doctors office with decreased feeling in his feet. He made an appt to see the neurologist on 01/02. On 12/29/00, the patient had difficulty waking, with decreased feeling in his legs and feet, and loosing balance. On 12/30/00, the patient called the doctor because loss of sensation was progressing up his legs, arms, and hands. He had difficulty sleeping because of discomfort. 12/31/00, the patient had numbness progressing in his thighs to his hips. The doctor sent him to the ER where he was seen by a neurologist. He was sent for an MRI and return was admission to ICU. On 01/05/01, the patient improved some and was discharged. He was able to use the walker with difficulty. He was evaluated by PT. He had therapy on 01/15,01/18, 01/22 and 01/25, condition declining, he was getting weaker. 01/16/01, More medication was ordered to be given at home for 3 days, an RN came to the house and stayed during treatment. 01/20/01, he felt a little improved. 01/22 & 01/25/00, the patient had PT. 01/26/01, his condition was worse, unable to go upstairs, or walk with a walker without falling. On 01/30/01, he saw a neurologist and was taken to the ER and was admitted and evaluated by referring doctor. The patient was given plasma phoresis prescription on 02/01, 02/02, 02/03, 02/04, 02/05, and 02/07. He had a nerve testing on 02/11 no improvement. On 02/12/00, he was transferred to another hospital via w/ch van for rehab. He had 1 hour of PT in the AM and 1 hour of OT in the PM. The patient''s condition continued to decline. His appetite was poor, he had difficulty swallowing, weight decreased, because he became weaker each day, not eating. 02/20/01, The doctor was notified and the patient was transferred back to the ICU at the original hospital. On 02/21/01, more meds and had a nasogastric tube inserted for feeding. His weight declined from 175 - 137. Still no movement in his legs, moving fingers; continued to improve. On 02/28/01, the patient was transferred out of ICU to a floor unit. He was moving his hands and his arms; able to hold a newspaper. On 03/01/01, doing better, getting OT & PT. Still NPO. Test showed inversion of epiglottis. On 03/02/01, moving arms, able to make a fist, NG tube out and stomach tube inserted via abdomen, sleeping poorly, breathing test improving. On 03/06/01, very lethargic, slept most of the day. 03/08/01, depressed, complains of weakness of arms and legs. Had a sonogram of his leg. 03/09 and 03/10/01 more meds, moving his fingers a little, voice seems stronger.03/11/01, felt like increased strength in his right arm. 03/12/01, he was moving his arms and legs, and able to reach nose. Breathing test 2.6 + 60, chest clear. 03/13/01, weight down to 122, more meds, able to move arm back and forth on tray table (PT). 03/14/01, good spirits, able to move arms and legs but no real control. 03/23/01, patient went home, improving but still unsteady, moving arms and hands, legs still very flaccid. Diagnosed with GBS.


Changed on 10/14/2018

VAERS ID: 168255 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:New York
Vaccinated:2000-11-09
Onset:2000-12-27
Submitted:2001-03-26
Entered:2001-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U0415AA / UNK LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Depression, Difficulty in walking, Dysphagia, Guillain-Barre syndrome, Hypoaesthesia, Hypotonia, Insomnia, Lethargy, Paraesthesia, Weight decreased, Balance disorder

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 59     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI; Spinal Tap; Cat Scan of abdomen; Nerve biopsy; Blood work; Doppler of legs-no clots; Colonoscopy-polyps; 24 hour UA
CDC 'Split Type':

Write-up: On 11/09/00, the patient had a flu vaccine. On 12/27/00, the patient had tingling and prickly feeling in his hands and feet. On 12/28/00, the patient went to the doctors office with decreased feeling in his feet. He made an appt to see the neurologist on 01/02. On 12/29/00, the patient had difficulty waking, with decreased feeling in his legs and feet, and loosing balance. On 12/30/00, the patient called the doctor because loss of sensation was progressing up his legs, arms, and hands. He had difficulty sleeping because of discomfort. 12/31/00, the patient had numbness progressing in his thighs to his hips. The doctor sent him to the ER where he was seen by a neurologist. He was sent for an MRI and return was admission to ICU. On 01/05/01, the patient improved some and was discharged. He was able to use the walker with difficulty. He was evaluated by PT. He had therapy on 01/15,01/18, 01/22 and 01/25, condition declining, he was getting weaker. 01/16/01, More medication was ordered to be given at home for 3 days, an RN came to the house and stayed during treatment. 01/20/01, he felt a little improved. 01/22 & 01/25/00, the patient had PT. 01/26/01, his condition was worse, unable to go upstairs, or walk with a walker without falling. On 01/30/01, he saw a neurologist and was taken to the ER and was admitted and evaluated by referring doctor. The patient was given plasma phoresis prescription on 02/01, 02/02, 02/03, 02/04, 02/05, and 02/07. He had a nerve testing on 02/11 no improvement. On 02/12/00, he was transferred to another hospital via w/ch van for rehab. He had 1 hour of PT in the AM and 1 hour of OT in the PM. The patient''s condition continued to decline. His appetite was poor, he had difficulty swallowing, weight decreased, because he became weaker each day, not eating. 02/20/01, The doctor was notified and the patient was transferred back to the ICU at the original hospital. On 02/21/01, more meds and had a nasogastric tube inserted for feeding. His weight declined from 175 - 137. Still no movement in his legs, moving fingers; continued to improve. On 02/28/01, the patient was transferred out of ICU to a floor unit. He was moving his hands and his arms; able to hold a newspaper. On 03/01/01, doing better, getting OT & PT. Still NPO. Test showed inversion of epiglottis. On 03/02/01, moving arms, able to make a fist, NG tube out and stomach tube inserted via abdomen, sleeping poorly, breathing test improving. On 03/06/01, very lethargic, slept most of the day. 03/08/01, depressed, complains of weakness of arms and legs. Had a sonogram of his leg. 03/09 and 03/10/01 more meds, moving his fingers a little, voice seems stronger.03/11/01, felt like increased strength in his right arm. 03/12/01, he was moving his arms and legs, and able to reach nose. Breathing test 2.6 + 60, chest clear. 03/13/01, weight down to 122, more meds, able to move arm back and forth on tray table (PT). 03/14/01, good spirits, able to move arms and legs but no real control. 03/23/01, patient went home, improving but still unsteady, moving arms and hands, legs still very flaccid. Diagnosed with GBS.


Changed on 12/24/2020

VAERS ID: 168255 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:New York
Vaccinated:2000-11-09
Onset:2000-12-27
Submitted:2001-03-26
Entered:2001-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U0415AA / UNK LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Depression, Difficulty in walking, Dysphagia, Guillain-Barre syndrome, Hypoaesthesia, Hypotonia, Insomnia, Lethargy, Paraesthesia, Weight decreased, Balance disorder

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 59     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI; Spinal Tap; Cat Scan of abdomen; Nerve biopsy; Blood work; Doppler of legs-no clots; Colonoscopy-polyps; 24 hour UA
CDC 'Split Type':

Write-up: On 11/09/00, the patient had a flu vaccine. On 12/27/00, the patient had tingling and prickly feeling in his hands and feet. On 12/28/00, the patient went to the doctors office with decreased feeling in his feet. He made an appt to see the neurologist on 01/02. On 12/29/00, the patient had difficulty waking, with decreased feeling in his legs and feet, and loosing balance. On 12/30/00, the patient called the doctor because loss of sensation was progressing up his legs, arms, and hands. He had difficulty sleeping because of discomfort. 12/31/00, the patient had numbness progressing in his thighs to his hips. The doctor sent him to the ER where he was seen by a neurologist. He was sent for an MRI and return was admission to ICU. On 01/05/01, the patient improved some and was discharged. He was able to use the walker with difficulty. He was evaluated by PT. He had therapy on 01/15,01/18, 01/22 and 01/25, condition declining, he was getting weaker. 01/16/01, More medication was ordered to be given at home for 3 days, an RN came to the house and stayed during treatment. 01/20/01, he felt a little improved. 01/22 & 01/25/00, the patient had PT. 01/26/01, his condition was worse, unable to go upstairs, or walk with a walker without falling. On 01/30/01, he saw a neurologist and was taken to the ER and was admitted and evaluated by referring doctor. The patient was given plasma phoresis prescription on 02/01, 02/02, 02/03, 02/04, 02/05, and 02/07. He had a nerve testing on 02/11 no improvement. On 02/12/00, he was transferred to another hospital via w/ch van for rehab. He had 1 hour of PT in the AM and 1 hour of OT in the PM. The patient''s condition continued to decline. His appetite was poor, he had difficulty swallowing, weight decreased, because he became weaker each day, not eating. 02/20/01, The doctor was notified and the patient was transferred back to the ICU at the original hospital. On 02/21/01, more meds and had a nasogastric tube inserted for feeding. His weight declined from 175 - 137. Still no movement in his legs, moving fingers; continued to improve. On 02/28/01, the patient was transferred out of ICU to a floor unit. He was moving his hands and his arms; able to hold a newspaper. On 03/01/01, doing better, getting OT & PT. Still NPO. Test showed inversion of epiglottis. On 03/02/01, moving arms, able to make a fist, NG tube out and stomach tube inserted via abdomen, sleeping poorly, breathing test improving. On 03/06/01, very lethargic, slept most of the day. 03/08/01, depressed, complains of weakness of arms and legs. Had a sonogram of his leg. 03/09 and 03/10/01 more meds, moving his fingers a little, voice seems stronger.03/11/01, felt like increased strength in his right arm. 03/12/01, he was moving his arms and legs, and able to reach nose. Breathing test 2.6 + 60, chest clear. 03/13/01, weight down to 122, more meds, able to move arm back and forth on tray table (PT). 03/14/01, good spirits, able to move arms and legs but no real control. 03/23/01, patient went home, improving but still unsteady, moving arms and hands, legs still very flaccid. Diagnosed with GBS.


Changed on 12/30/2020

VAERS ID: 168255 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:New York
Vaccinated:2000-11-09
Onset:2000-12-27
Submitted:2001-03-26
Entered:2001-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U0415AA / UNK LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Depression, Difficulty in walking, Dysphagia, Guillain-Barre syndrome, Hypoaesthesia, Hypotonia, Insomnia, Lethargy, Paraesthesia, Weight decreased, Balance disorder

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 59     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI; Spinal Tap; Cat Scan of abdomen; Nerve biopsy; Blood work; Doppler of legs-no clots; Colonoscopy-polyps; 24 hour UA
CDC 'Split Type':

Write-up: On 11/09/00, the patient had a flu vaccine. On 12/27/00, the patient had tingling and prickly feeling in his hands and feet. On 12/28/00, the patient went to the doctors office with decreased feeling in his feet. He made an appt to see the neurologist on 01/02. On 12/29/00, the patient had difficulty waking, with decreased feeling in his legs and feet, and loosing balance. On 12/30/00, the patient called the doctor because loss of sensation was progressing up his legs, arms, and hands. He had difficulty sleeping because of discomfort. 12/31/00, the patient had numbness progressing in his thighs to his hips. The doctor sent him to the ER where he was seen by a neurologist. He was sent for an MRI and return was admission to ICU. On 01/05/01, the patient improved some and was discharged. He was able to use the walker with difficulty. He was evaluated by PT. He had therapy on 01/15,01/18, 01/22 and 01/25, condition declining, he was getting weaker. 01/16/01, More medication was ordered to be given at home for 3 days, an RN came to the house and stayed during treatment. 01/20/01, he felt a little improved. 01/22 & 01/25/00, the patient had PT. 01/26/01, his condition was worse, unable to go upstairs, or walk with a walker without falling. On 01/30/01, he saw a neurologist and was taken to the ER and was admitted and evaluated by referring doctor. The patient was given plasma phoresis prescription on 02/01, 02/02, 02/03, 02/04, 02/05, and 02/07. He had a nerve testing on 02/11 no improvement. On 02/12/00, he was transferred to another hospital via w/ch van for rehab. He had 1 hour of PT in the AM and 1 hour of OT in the PM. The patient''s condition continued to decline. His appetite was poor, he had difficulty swallowing, weight decreased, because he became weaker each day, not eating. 02/20/01, The doctor was notified and the patient was transferred back to the ICU at the original hospital. On 02/21/01, more meds and had a nasogastric tube inserted for feeding. His weight declined from 175 - 137. Still no movement in his legs, moving fingers; continued to improve. On 02/28/01, the patient was transferred out of ICU to a floor unit. He was moving his hands and his arms; able to hold a newspaper. On 03/01/01, doing better, getting OT & PT. Still NPO. Test showed inversion of epiglottis. On 03/02/01, moving arms, able to make a fist, NG tube out and stomach tube inserted via abdomen, sleeping poorly, breathing test improving. On 03/06/01, very lethargic, slept most of the day. 03/08/01, depressed, complains of weakness of arms and legs. Had a sonogram of his leg. 03/09 and 03/10/01 more meds, moving his fingers a little, voice seems stronger.03/11/01, felt like increased strength in his right arm. 03/12/01, he was moving his arms and legs, and able to reach nose. Breathing test 2.6 + 60, chest clear. 03/13/01, weight down to 122, more meds, able to move arm back and forth on tray table (PT). 03/14/01, good spirits, able to move arms and legs but no real control. 03/23/01, patient went home, improving but still unsteady, moving arms and hands, legs still very flaccid. Diagnosed with GBS.


Changed on 5/7/2021

VAERS ID: 168255 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:New York
Vaccinated:2000-11-09
Onset:2000-12-27
Submitted:2001-03-26
Entered:2001-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U0415AA / UNK LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Depression, Difficulty in walking, Dysphagia, Guillain-Barre syndrome, Hypoaesthesia, Hypotonia, Insomnia, Lethargy, Paraesthesia, Weight decreased, Balance disorder

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 59     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI; Spinal Tap; Cat Scan of abdomen; Nerve biopsy; Blood work; Doppler of legs-no clots; Colonoscopy-polyps; 24 hour UA
CDC 'Split Type':

Write-up: On 11/09/00, the patient had a flu vaccine. On 12/27/00, the patient had tingling and prickly feeling in his hands and feet. On 12/28/00, the patient went to the doctors office with decreased feeling in his feet. He made an appt to see the neurologist on 01/02. On 12/29/00, the patient had difficulty waking, with decreased feeling in his legs and feet, and loosing balance. On 12/30/00, the patient called the doctor because loss of sensation was progressing up his legs, arms, and hands. He had difficulty sleeping because of discomfort. 12/31/00, the patient had numbness progressing in his thighs to his hips. The doctor sent him to the ER where he was seen by a neurologist. He was sent for an MRI and return was admission to ICU. On 01/05/01, the patient improved some and was discharged. He was able to use the walker with difficulty. He was evaluated by PT. He had therapy on 01/15,01/18, 01/22 and 01/25, condition declining, he was getting weaker. 01/16/01, More medication was ordered to be given at home for 3 days, an RN came to the house and stayed during treatment. 01/20/01, he felt a little improved. 01/22 & 01/25/00, the patient had PT. 01/26/01, his condition was worse, unable to go upstairs, or walk with a walker without falling. On 01/30/01, he saw a neurologist and was taken to the ER and was admitted and evaluated by referring doctor. The patient was given plasma phoresis prescription on 02/01, 02/02, 02/03, 02/04, 02/05, and 02/07. He had a nerve testing on 02/11 no improvement. On 02/12/00, he was transferred to another hospital via w/ch van for rehab. He had 1 hour of PT in the AM and 1 hour of OT in the PM. The patient''s condition continued to decline. His appetite was poor, he had difficulty swallowing, weight decreased, because he became weaker each day, not eating. 02/20/01, The doctor was notified and the patient was transferred back to the ICU at the original hospital. On 02/21/01, more meds and had a nasogastric tube inserted for feeding. His weight declined from 175 - 137. Still no movement in his legs, moving fingers; continued to improve. On 02/28/01, the patient was transferred out of ICU to a floor unit. He was moving his hands and his arms; able to hold a newspaper. On 03/01/01, doing better, getting OT & PT. Still NPO. Test showed inversion of epiglottis. On 03/02/01, moving arms, able to make a fist, NG tube out and stomach tube inserted via abdomen, sleeping poorly, breathing test improving. On 03/06/01, very lethargic, slept most of the day. 03/08/01, depressed, complains of weakness of arms and legs. Had a sonogram of his leg. 03/09 and 03/10/01 more meds, moving his fingers a little, voice seems stronger.03/11/01, felt like increased strength in his right arm. 03/12/01, he was moving his arms and legs, and able to reach nose. Breathing test 2.6 + 60, chest clear. 03/13/01, weight down to 122, more meds, able to move arm back and forth on tray table (PT). 03/14/01, good spirits, able to move arms and legs but no real control. 03/23/01, patient went home, improving but still unsteady, moving arms and hands, legs still very flaccid. Diagnosed with GBS.


Changed on 5/14/2021

VAERS ID: 168255 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:New York
Vaccinated:2000-11-09
Onset:2000-12-27
Submitted:2001-03-26
Entered:2001-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U0415AA / UNK LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Depression, Difficulty in walking, Dysphagia, Guillain-Barre syndrome, Hypoaesthesia, Hypotonia, Insomnia, Lethargy, Paraesthesia, Weight decreased, Balance disorder

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 59     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI; Spinal Tap; Cat Scan of abdomen; Nerve biopsy; Blood work; Doppler of legs-no clots; Colonoscopy-polyps; 24 hour UA
CDC 'Split Type':

Write-up: On 11/09/00, the patient had a flu vaccine. On 12/27/00, the patient had tingling and prickly feeling in his hands and feet. On 12/28/00, the patient went to the doctors office with decreased feeling in his feet. He made an appt to see the neurologist on 01/02. On 12/29/00, the patient had difficulty waking, with decreased feeling in his legs and feet, and loosing balance. On 12/30/00, the patient called the doctor because loss of sensation was progressing up his legs, arms, and hands. He had difficulty sleeping because of discomfort. 12/31/00, the patient had numbness progressing in his thighs to his hips. The doctor sent him to the ER where he was seen by a neurologist. He was sent for an MRI and return was admission to ICU. On 01/05/01, the patient improved some and was discharged. He was able to use the walker with difficulty. He was evaluated by PT. He had therapy on 01/15,01/18, 01/22 and 01/25, condition declining, he was getting weaker. 01/16/01, More medication was ordered to be given at home for 3 days, an RN came to the house and stayed during treatment. 01/20/01, he felt a little improved. 01/22 & 01/25/00, the patient had PT. 01/26/01, his condition was worse, unable to go upstairs, or walk with a walker without falling. On 01/30/01, he saw a neurologist and was taken to the ER and was admitted and evaluated by referring doctor. The patient was given plasma phoresis prescription on 02/01, 02/02, 02/03, 02/04, 02/05, and 02/07. He had a nerve testing on 02/11 no improvement. On 02/12/00, he was transferred to another hospital via w/ch van for rehab. He had 1 hour of PT in the AM and 1 hour of OT in the PM. The patient''s condition continued to decline. His appetite was poor, he had difficulty swallowing, weight decreased, because he became weaker each day, not eating. 02/20/01, The doctor was notified and the patient was transferred back to the ICU at the original hospital. On 02/21/01, more meds and had a nasogastric tube inserted for feeding. His weight declined from 175 - 137. Still no movement in his legs, moving fingers; continued to improve. On 02/28/01, the patient was transferred out of ICU to a floor unit. He was moving his hands and his arms; able to hold a newspaper. On 03/01/01, doing better, getting OT & PT. Still NPO. Test showed inversion of epiglottis. On 03/02/01, moving arms, able to make a fist, NG tube out and stomach tube inserted via abdomen, sleeping poorly, breathing test improving. On 03/06/01, very lethargic, slept most of the day. 03/08/01, depressed, complains of weakness of arms and legs. Had a sonogram of his leg. 03/09 and 03/10/01 more meds, moving his fingers a little, voice seems stronger.03/11/01, felt like increased strength in his right arm. 03/12/01, he was moving his arms and legs, and able to reach nose. Breathing test 2.6 + 60, chest clear. 03/13/01, weight down to 122, more meds, able to move arm back and forth on tray table (PT). 03/14/01, good spirits, able to move arms and legs but no real control. 03/23/01, patient went home, improving but still unsteady, moving arms and hands, legs still very flaccid. Diagnosed with GBS.

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