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This is VAERS ID 197342

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 197342
VAERS Form:
Age:75.0
Sex:Female
Location:New York
Vaccinated:2002-10-04
Onset:2002-10-06
Submitted:2003-02-05
Entered:2003-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (UNKNOWN MFR) / UNKNOWN MFR - / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: ENCEPHALITIS, GAIT ABNORM, VERTIGO, DEHYDRAT, DIPLOPIA

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? No
Previous Vaccinations: encephalitis;Influenza (unknown mfr);;903;In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Osteoarthritis, degenerative joint disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': Osteoarthritis, degenerative joint disease

Write-up: The 60 day follow up states pt is in intensive care with encephalitis and as of today is not responding well.


Changed on 12/8/2009

VAERS ID: 197342 Before After
VAERS Form:
Age:75.0
Sex:Female
Location:New York
Vaccinated:2002-10-04
Onset:2002-10-06
Submitted:2003-02-05
Entered:2003-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (UNKNOWN MFR) INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MFR UNKNOWN MANUFACTURER - / - - / -

Administered by: Public      Purchased by: Unknown Private
Symptoms: Dehydration, Difficulty in walking, Diplopia, Encephalitis, Vertigo, ENCEPHALITIS, GAIT ABNORM, VERTIGO, DEHYDRAT, DIPLOPIA

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? No
Previous Vaccinations: encephalitis;Influenza Influenza (unknown mfr);;903;In mfr);encephalitis;;903;In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: Osteoarthritis, thryoid and high cholesterol;Osteoarthritis, degenerative joint disease
Allergies:
Diagnostic Lab Data: She ended up being diagnosed with encephalitis and vertigo.
CDC 'Split Type': Osteoarthritis, degenerative joint disease (blank)

Write-up: My mother received the flu shot on October 4, 2002 and two days later was having problems walking. This progressed until the end of Dec. when she became sick and dehydrated and had double vision. The 60 day follow up states pt is in intensive care with encephalitis and as of today is not responding well.


Changed on 7/7/2013

VAERS ID: 197342 Before After
VAERS Form:
Age:75.0
Sex:Female
Location:New York
Vaccinated:2002-10-04
Onset:2002-10-06
Submitted:2003-02-05
Entered:2003-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Public      Purchased by: Private
Symptoms: Dehydration, Difficulty in walking, Diplopia, Encephalitis, Vertigo

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? No
Previous Vaccinations: Influenza (unknown mfr);encephalitis;;903;In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: thryoid and high cholesterol;Osteoarthritis, degenerative joint disease
Allergies:
Diagnostic Lab Data: She ended up being diagnosed with encephalitis and vertigo.
CDC 'Split Type':

Write-up: My mother received the flu shot on October 4, 2002 and two days later was having problems walking. This progressed until the end of Dec. when she became sick and dehydrated and had double vision. The 60 day follow up states pt is in intensive care with encephalitis and as of today is not responding well.


Changed on 12/14/2016

VAERS ID: 197342 Before After
VAERS Form:
Age:75.0
Sex:Female
Location:New York
Vaccinated:2002-10-04
Onset:2002-10-06
Submitted:2003-02-05
Entered:2003-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Public      Purchased by: Private
Symptoms: Dehydration, Difficulty in walking, Diplopia, Encephalitis, Vertigo

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? No
Previous Vaccinations: Influenza (unknown mfr);encephalitis;;903;In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: thryoid and high cholesterol;Osteoarthritis, degenerative joint disease
Allergies:
Diagnostic Lab Data: She ended up being diagnosed with encephalitis and vertigo.
CDC 'Split Type':

Write-up: My mother received the flu shot on October 4, 2002 and two days later was having problems walking. This progressed until the end of Dec. when she became sick and dehydrated and had double vision. The 60 day follow up states pt is in intensive care with encephalitis and as of today is not responding well.


Changed on 2/14/2017

VAERS ID: 197342 Before After
VAERS Form:
Age:75.0
Sex:Female
Location:New York
Vaccinated:2002-10-04
Onset:2002-10-06
Submitted:2003-02-05
Entered:2003-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Public      Purchased by: Private
Symptoms: Dehydration, Difficulty in walking, Diplopia, Encephalitis, Vertigo

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? No
Previous Vaccinations: Influenza (unknown mfr);encephalitis;;903;In encephalitis~Influenza (Seasonal) (no brand name)~~75.30~In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: thryoid and high cholesterol;Osteoarthritis, degenerative joint disease
Allergies:
Diagnostic Lab Data: She ended up being diagnosed with encephalitis and vertigo.
CDC 'Split Type':

Write-up: My mother received the flu shot on October 4, 2002 and two days later was having problems walking. This progressed until the end of Dec. when she became sick and dehydrated and had double vision. The 60 day follow up states pt is in intensive care with encephalitis and as of today is not responding well.


Changed on 9/14/2017

VAERS ID: 197342 Before After
VAERS Form:(blank) 1
Age:75.0
Sex:Female
Location:New York
Vaccinated:2002-10-04
Onset:2002-10-06
Submitted:2003-02-05
Entered:2003-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Dehydration, Difficulty in walking, Diplopia, Encephalitis, Vertigo

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? No
Previous Vaccinations: encephalitis~Influenza (Seasonal) (no brand name)~~75.30~In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: thryoid and high cholesterol;Osteoarthritis, degenerative joint disease
Allergies:
Diagnostic Lab Data: She ended up being diagnosed with encephalitis and vertigo.
CDC 'Split Type':

Write-up: My mother received the flu shot on October 4, 2002 and two days later was having problems walking. This progressed until the end of Dec. when she became sick and dehydrated and had double vision. The 60 day follow up states pt is in intensive care with encephalitis and as of today is not responding well.


Changed on 2/14/2018

VAERS ID: 197342 Before After
VAERS Form:1
Age:75.0
Sex:Female
Location:New York
Vaccinated:2002-10-04
Onset:2002-10-06
Submitted:2003-02-05
Entered:2003-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Dehydration, Difficulty in walking, Diplopia, Encephalitis, Vertigo

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? No
Previous Vaccinations: encephalitis~Influenza (Seasonal) (no brand name)~~75.30~In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: thryoid and high cholesterol;Osteoarthritis, degenerative joint disease
Allergies:
Diagnostic Lab Data: She ended up being diagnosed with encephalitis and vertigo.
CDC 'Split Type':

Write-up: My mother received the flu shot on October 4, 2002 and two days later was having problems walking. This progressed until the end of Dec. when she became sick and dehydrated and had double vision. The 60 day follow up states pt is in intensive care with encephalitis and as of today is not responding well.


Changed on 6/14/2018

VAERS ID: 197342 Before After
VAERS Form:1
Age:75.0
Sex:Female
Location:New York
Vaccinated:2002-10-04
Onset:2002-10-06
Submitted:2003-02-05
Entered:2003-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Dehydration, Difficulty in walking, Diplopia, Encephalitis, Vertigo

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? No
Previous Vaccinations: encephalitis~Influenza (Seasonal) (no brand name)~~75.30~In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: thryoid and high cholesterol;Osteoarthritis, degenerative joint disease
Allergies:
Diagnostic Lab Data: She ended up being diagnosed with encephalitis and vertigo.
CDC 'Split Type':

Write-up: My mother received the flu shot on October 4, 2002 and two days later was having problems walking. This progressed until the end of Dec. when she became sick and dehydrated and had double vision. The 60 day follow up states pt is in intensive care with encephalitis and as of today is not responding well.


Changed on 8/14/2018

VAERS ID: 197342 Before After
VAERS Form:1
Age:75.0
Sex:Female
Location:New York
Vaccinated:2002-10-04
Onset:2002-10-06
Submitted:2003-02-05
Entered:2003-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Dehydration, Difficulty in walking, Diplopia, Encephalitis, Vertigo

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? No
Previous Vaccinations: encephalitis~Influenza (Seasonal) (no brand name)~~75.30~In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: thryoid and high cholesterol;Osteoarthritis, degenerative joint disease
Allergies:
Diagnostic Lab Data: She ended up being diagnosed with encephalitis and vertigo.
CDC 'Split Type':

Write-up: My mother received the flu shot on October 4, 2002 and two days later was having problems walking. This progressed until the end of Dec. when she became sick and dehydrated and had double vision. The 60 day follow up states pt is in intensive care with encephalitis and as of today is not responding well.


Changed on 9/14/2018

VAERS ID: 197342 Before After
VAERS Form:1
Age:75.0
Sex:Female
Location:New York
Vaccinated:2002-10-04
Onset:2002-10-06
Submitted:2003-02-05
Entered:2003-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Dehydration, Difficulty in walking, Diplopia, Encephalitis, Vertigo

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? No
Previous Vaccinations: encephalitis~Influenza (Seasonal) (no brand name)~~75.30~In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: thryoid and high cholesterol;Osteoarthritis, degenerative joint disease
Allergies:
Diagnostic Lab Data: She ended up being diagnosed with encephalitis and vertigo.
CDC 'Split Type':

Write-up: My mother received the flu shot on October 4, 2002 and two days later was having problems walking. This progressed until the end of Dec. when she became sick and dehydrated and had double vision. The 60 day follow up states pt is in intensive care with encephalitis and as of today is not responding well.


Changed on 10/14/2018

VAERS ID: 197342 Before After
VAERS Form:1
Age:75.0
Sex:Female
Location:New York
Vaccinated:2002-10-04
Onset:2002-10-06
Submitted:2003-02-05
Entered:2003-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Dehydration, Difficulty in walking, Diplopia, Encephalitis, Vertigo

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? No
Previous Vaccinations: encephalitis~Influenza (Seasonal) (no brand name)~~75.30~In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: thryoid and high cholesterol;Osteoarthritis, degenerative joint disease
Allergies:
Diagnostic Lab Data: She ended up being diagnosed with encephalitis and vertigo.
CDC 'Split Type':

Write-up: My mother received the flu shot on October 4, 2002 and two days later was having problems walking. This progressed until the end of Dec. when she became sick and dehydrated and had double vision. The 60 day follow up states pt is in intensive care with encephalitis and as of today is not responding well.


Changed on 12/24/2020

VAERS ID: 197342 Before After
VAERS Form:1
Age:75.0
Sex:Female
Location:New York
Vaccinated:2002-10-04
Onset:2002-10-06
Submitted:2003-02-05
Entered:2003-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Dehydration, Difficulty in walking, Diplopia, Encephalitis, Vertigo

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? No
Previous Vaccinations: encephalitis~Influenza (Seasonal) (no brand name)~~75.30~In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: thryoid and high cholesterol;Osteoarthritis, degenerative joint disease
Allergies:
Diagnostic Lab Data: She ended up being diagnosed with encephalitis and vertigo.
CDC 'Split Type':

Write-up: My mother received the flu shot on October 4, 2002 and two days later was having problems walking. This progressed until the end of Dec. when she became sick and dehydrated and had double vision. The 60 day follow up states pt is in intensive care with encephalitis and as of today is not responding well.


Changed on 12/30/2020

VAERS ID: 197342 Before After
VAERS Form:1
Age:75.0
Sex:Female
Location:New York
Vaccinated:2002-10-04
Onset:2002-10-06
Submitted:2003-02-05
Entered:2003-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Dehydration, Difficulty in walking, Diplopia, Encephalitis, Vertigo

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? No
Previous Vaccinations: encephalitis~Influenza (Seasonal) (no brand name)~~75.30~In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: thryoid and high cholesterol;Osteoarthritis, degenerative joint disease
Allergies:
Diagnostic Lab Data: She ended up being diagnosed with encephalitis and vertigo.
CDC 'Split Type':

Write-up: My mother received the flu shot on October 4, 2002 and two days later was having problems walking. This progressed until the end of Dec. when she became sick and dehydrated and had double vision. The 60 day follow up states pt is in intensive care with encephalitis and as of today is not responding well.


Changed on 5/7/2021

VAERS ID: 197342 Before After
VAERS Form:1
Age:75.0
Sex:Female
Location:New York
Vaccinated:2002-10-04
Onset:2002-10-06
Submitted:2003-02-05
Entered:2003-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Dehydration, Difficulty in walking, Diplopia, Encephalitis, Vertigo

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? No
Previous Vaccinations: encephalitis~Influenza (Seasonal) (no brand name)~~75.30~In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: thryoid and high cholesterol;Osteoarthritis, degenerative joint disease
Allergies:
Diagnostic Lab Data: She ended up being diagnosed with encephalitis and vertigo.
CDC 'Split Type':

Write-up: My mother received the flu shot on October 4, 2002 and two days later was having problems walking. This progressed until the end of Dec. when she became sick and dehydrated and had double vision. The 60 day follow up states pt is in intensive care with encephalitis and as of today is not responding well.


Changed on 5/21/2021

VAERS ID: 197342 Before After
VAERS Form:1
Age:75.0
Sex:Female
Location:New York
Vaccinated:2002-10-04
Onset:2002-10-06
Submitted:2003-02-05
Entered:2003-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Dehydration, Difficulty in walking, Diplopia, Encephalitis, Vertigo

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? No
Previous Vaccinations: encephalitis~Influenza (Seasonal) (no brand name)~~75.30~In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: thryoid and high cholesterol;Osteoarthritis, degenerative joint disease
Allergies:
Diagnostic Lab Data: She ended up being diagnosed with encephalitis and vertigo.
CDC 'Split Type':

Write-up: My mother received the flu shot on October 4, 2002 and two days later was having problems walking. This progressed until the end of Dec. when she became sick and dehydrated and had double vision. The 60 day follow up states pt is in intensive care with encephalitis and as of today is not responding well.

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