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This is VAERS ID 183661

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 183661
VAERS Form:
Age:62.0
Sex:Female
Location:Kentucky
Vaccinated:2000-12-13
Onset:2000-12-13
Submitted:2002-04-12
Entered:2002-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) / AVENTIS PASTEUR, V0488AA / - LA / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / LEDERLE LABORATO 466025 / - RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: PAIN INJECT SITE, PAIN, RESPIRAT DIS, PARALYSIS FLACCID

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Several ENG''s and other neurological function tests
CDC 'Split Type':

Write-up: Immediate severe pain, burning and throbbing sensation, followed by gradual paralysis of 1st the injected limb, then the other side, as well as her respiratory system. Pt is now on ventilator, suffering from upper body paralysis. Has permanent motor neuro"n disease.


Changed on 12/8/2009

VAERS ID: 183661 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:Kentucky
Vaccinated:2000-12-13
Onset:2000-12-13
Submitted:2002-04-12
Entered:2002-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR, AVENTIS PASTEUR V0488AA / - LA / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / LEDERLE LABORATO LEDERLE LABORATORIES 466025 / - RA / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Injection site pain, Pain, Paralysis flaccid, Respiratory disorder, PAIN INJECT SITE, PAIN, RESPIRAT DIS, PARALYSIS FLACCID

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Several ENG''s and other neurological function tests
CDC 'Split Type':

Write-up: Immediate severe pain, burning and throbbing sensation, followed by gradual paralysis of 1st the injected limb, then the other side, as well as her respiratory system. Pt is now on ventilator, suffering from upper body paralysis. Has permanent motor neuro"n neuron disease.


Changed on 7/7/2013

VAERS ID: 183661 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:Kentucky
Vaccinated:2000-12-13
Onset:2000-12-13
Submitted:2002-04-12
Entered:2002-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR V0488AA / - LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR V0488AA / - LA / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / LEDERLE LABORATORIES 466025 / - RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site pain, Pain, Paralysis flaccid, Respiratory 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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Several ENG''s and other neurological function tests
CDC 'Split Type':

Write-up: Immediate severe pain, burning and throbbing sensation, followed by gradual paralysis of 1st the injected limb, then the other side, as well as her respiratory system. Pt is now on ventilator, suffering from upper body paralysis. Has permanent motor neuron disease.


Changed on 5/14/2017

VAERS ID: 183661 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:Kentucky
Vaccinated:2000-12-13
Onset:2000-12-13
Submitted:2002-04-12
Entered:2002-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR SANOFI PASTEUR V0488AA / - LA / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / LEDERLE LABORATORIES 466025 / - RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site pain, Pain, Paralysis flaccid, Respiratory 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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Several ENG''s and other neurological function tests
CDC 'Split Type':

Write-up: Immediate severe pain, burning and throbbing sensation, followed by gradual paralysis of 1st the injected limb, then the other side, as well as her respiratory system. Pt is now on ventilator, suffering from upper body paralysis. Has permanent motor neuron disease.


Changed on 9/14/2017

VAERS ID: 183661 Before After
VAERS Form:(blank) 1
Age:62.0
Sex:Female
Location:Kentucky
Vaccinated:2000-12-13
Onset:2000-12-13
Submitted:2002-04-12
Entered:2002-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V0488AA / - UNK LA / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / LEDERLE LABORATORIES 466025 / - UNK RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site pain, Pain, Paralysis flaccid, Respiratory 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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Several ENG''s and other neurological function tests
CDC 'Split Type':

Write-up: Immediate severe pain, burning and throbbing sensation, followed by gradual paralysis of 1st the injected limb, then the other side, as well as her respiratory system. Pt is now on ventilator, suffering from upper body paralysis. Has permanent motor neuron disease.


Changed on 2/14/2018

VAERS ID: 183661 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Kentucky
Vaccinated:2000-12-13
Onset:2000-12-13
Submitted:2002-04-12
Entered:2002-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V0488AA / UNK LA / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / LEDERLE LABORATORIES 466025 / UNK RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site pain, Pain, Paralysis flaccid, Respiratory 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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Several ENG''s and other neurological function tests
CDC 'Split Type':

Write-up: Immediate severe pain, burning and throbbing sensation, followed by gradual paralysis of 1st the injected limb, then the other side, as well as her respiratory system. Pt is now on ventilator, suffering from upper body paralysis. Has permanent motor neuron disease.


Changed on 6/14/2018

VAERS ID: 183661 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Kentucky
Vaccinated:2000-12-13
Onset:2000-12-13
Submitted:2002-04-12
Entered:2002-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V0488AA / UNK LA / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / LEDERLE LABORATORIES 466025 / UNK RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site pain, Pain, Paralysis flaccid, Respiratory 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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Several ENG''s and other neurological function tests
CDC 'Split Type':

Write-up: Immediate severe pain, burning and throbbing sensation, followed by gradual paralysis of 1st the injected limb, then the other side, as well as her respiratory system. Pt is now on ventilator, suffering from upper body paralysis. Has permanent motor neuron disease.


Changed on 8/14/2018

VAERS ID: 183661 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Kentucky
Vaccinated:2000-12-13
Onset:2000-12-13
Submitted:2002-04-12
Entered:2002-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V0488AA / UNK LA / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / LEDERLE LABORATORIES 466025 / UNK RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site pain, Pain, Paralysis flaccid, Respiratory 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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Several ENG''s and other neurological function tests
CDC 'Split Type':

Write-up: Immediate severe pain, burning and throbbing sensation, followed by gradual paralysis of 1st the injected limb, then the other side, as well as her respiratory system. Pt is now on ventilator, suffering from upper body paralysis. Has permanent motor neuron disease.


Changed on 9/14/2018

VAERS ID: 183661 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Kentucky
Vaccinated:2000-12-13
Onset:2000-12-13
Submitted:2002-04-12
Entered:2002-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V0488AA / UNK LA / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / LEDERLE LABORATORIES 466025 / UNK RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site pain, Pain, Paralysis flaccid, Respiratory 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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Several ENG''s and other neurological function tests
CDC 'Split Type':

Write-up: Immediate severe pain, burning and throbbing sensation, followed by gradual paralysis of 1st the injected limb, then the other side, as well as her respiratory system. Pt is now on ventilator, suffering from upper body paralysis. Has permanent motor neuron disease.


Changed on 10/14/2018

VAERS ID: 183661 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Kentucky
Vaccinated:2000-12-13
Onset:2000-12-13
Submitted:2002-04-12
Entered:2002-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V0488AA / UNK LA / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / LEDERLE LABORATORIES 466025 / UNK RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site pain, Pain, Paralysis flaccid, Respiratory 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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Several ENG''s and other neurological function tests
CDC 'Split Type':

Write-up: Immediate severe pain, burning and throbbing sensation, followed by gradual paralysis of 1st the injected limb, then the other side, as well as her respiratory system. Pt is now on ventilator, suffering from upper body paralysis. Has permanent motor neuron disease.


Changed on 12/24/2020

VAERS ID: 183661 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Kentucky
Vaccinated:2000-12-13
Onset:2000-12-13
Submitted:2002-04-12
Entered:2002-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V0488AA / UNK LA / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / LEDERLE LABORATORIES 466025 / UNK RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site pain, Pain, Paralysis flaccid, Respiratory 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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Several ENG''s and other neurological function tests
CDC 'Split Type':

Write-up: Immediate severe pain, burning and throbbing sensation, followed by gradual paralysis of 1st the injected limb, then the other side, as well as her respiratory system. Pt is now on ventilator, suffering from upper body paralysis. Has permanent motor neuron disease.


Changed on 12/30/2020

VAERS ID: 183661 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Kentucky
Vaccinated:2000-12-13
Onset:2000-12-13
Submitted:2002-04-12
Entered:2002-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V0488AA / UNK LA / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / LEDERLE LABORATORIES 466025 / UNK RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site pain, Pain, Paralysis flaccid, Respiratory 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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Several ENG''s and other neurological function tests
CDC 'Split Type':

Write-up: Immediate severe pain, burning and throbbing sensation, followed by gradual paralysis of 1st the injected limb, then the other side, as well as her respiratory system. Pt is now on ventilator, suffering from upper body paralysis. Has permanent motor neuron disease.


Changed on 5/7/2021

VAERS ID: 183661 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Kentucky
Vaccinated:2000-12-13
Onset:2000-12-13
Submitted:2002-04-12
Entered:2002-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V0488AA / UNK LA / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / LEDERLE LABORATORIES 466025 / UNK RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site pain, Pain, Paralysis flaccid, Respiratory 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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Several ENG''s and other neurological function tests
CDC 'Split Type':

Write-up: Immediate severe pain, burning and throbbing sensation, followed by gradual paralysis of 1st the injected limb, then the other side, as well as her respiratory system. Pt is now on ventilator, suffering from upper body paralysis. Has permanent motor neuron disease.


Changed on 5/21/2021

VAERS ID: 183661 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Kentucky
Vaccinated:2000-12-13
Onset:2000-12-13
Submitted:2002-04-12
Entered:2002-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V0488AA / UNK LA / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / LEDERLE LABORATORIES 466025 / UNK RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site pain, Pain, Paralysis flaccid, Respiratory 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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Several ENG''s and other neurological function tests
CDC 'Split Type':

Write-up: Immediate severe pain, burning and throbbing sensation, followed by gradual paralysis of 1st the injected limb, then the other side, as well as her respiratory system. Pt is now on ventilator, suffering from upper body paralysis. Has permanent motor neuron disease.

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