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This is VAERS ID 25862

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25862
VAERS Form:
Age:91.0
Sex:Female
Location:Georgia
Vaccinated:1990-02-06
Onset:1990-02-25
Submitted:1990-09-04
Entered:1990-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1989-1990 TRIVALENT TYPES A&B / WYETH 9F01201C / - A / -

Administered by: Private      Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND, MYASTHENIA

Life Threatening? No
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:
Other Medications: Hydrochlorothiazide 25 daily, Corgard 40 daily
Current Illness: Hypertension, ischemic heart disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza experienced weakness of the lower extremities with aching progressing to the trunk and upper extremities - GBS. Pt hospitalized transferred to EUH for plasma exchange.


Changed on 12/8/2009

VAERS ID: 25862 Before After
VAERS Form:
Age:91.0
Sex:Female
Location:Georgia
Vaccinated:1990-02-06
Onset:1990-02-25
Submitted:1990-09-04
Entered:1990-09-12 1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1989-1990 TRIVALENT TYPES A&B INFLUENZA (SEASONAL) (NO BRAND NAME, 89-90) / WYETH WYETH PHARMACEUTICALS, INC 9F01201C / - A / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome, GUILLAIN BARRE SYND, MYASTHENIA

Life Threatening? No
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:
Other Medications: Hydrochlorothiazide 25 daily, Corgard 40 daily
Current Illness: Hypertension, ischemic heart disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza experienced weakness of the lower extremities with aching progressing to the trunk and upper extremities - GBS. Pt hospitalized transferred to EUH for plasma exchange.


Changed on 8/31/2010

VAERS ID: 25862 Before After
VAERS Form:
Age:91.0
Sex:Female
Location:Georgia
Vaccinated:1990-02-06
Onset:1990-02-25
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 89-90) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 9F01201C / - A / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
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:
Other Medications: Hydrochlorothiazide 25 daily, Corgard 40 daily
Current Illness: Hypertension, ischemic heart disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza experienced weakness of the lower extremities with aching progressing to the trunk and upper extremities - GBS. Pt hospitalized transferred to EUH for plasma exchange.


Changed on 7/7/2013

VAERS ID: 25862 Before After
VAERS Form:
Age:91.0
Sex:Female
Location:Georgia
Vaccinated:1990-02-06
Onset:1990-02-25
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 9F01201C / - A / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 9F01201C / - A / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
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:
Other Medications: Hydrochlorothiazide 25 daily, Corgard 40 daily
Current Illness: Hypertension, ischemic heart disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza experienced weakness of the lower extremities with aching progressing to the trunk and upper extremities - GBS. Pt hospitalized transferred to EUH for plasma exchange.


Changed on 12/14/2016

VAERS ID: 25862 Before After
VAERS Form:
Age:91.0
Sex:Female
Location:Georgia
Vaccinated:1990-02-06
Onset:1990-02-25
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 9F01201C / - A / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 9F01201C / - A / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
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:
Other Medications: Hydrochlorothiazide 25 daily, Corgard 40 daily
Current Illness: Hypertension, ischemic heart disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza experienced weakness of the lower extremities with aching progressing to the trunk and upper extremities - GBS. Pt hospitalized transferred to EUH for plasma exchange.


Changed on 5/14/2017

VAERS ID: 25862 Before After
VAERS Form:
Age:91.0
Sex:Female
Location:Georgia
Vaccinated:1990-02-06
Onset:1990-02-25
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 9F01201C / - A - / - A

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
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: ~ ()~~~In patient
Other Medications: Hydrochlorothiazide 25 daily, Corgard 40 daily
Current Illness: Hypertension, ischemic heart disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza experienced weakness of the lower extremities with aching progressing to the trunk and upper extremities - GBS. Pt hospitalized transferred to EUH for plasma exchange.


Changed on 9/14/2017

VAERS ID: 25862 Before After
VAERS Form:(blank) 1
Age:91.0
Sex:Female
Location:Georgia
Vaccinated:1990-02-06
Onset:1990-02-25
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 9F01201C / - UNK - / A

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
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: ~ ()~~~In patient
Other Medications: Hydrochlorothiazide 25 daily, Corgard 40 daily
Current Illness: Hypertension, ischemic heart disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza experienced weakness of the lower extremities with aching progressing to the trunk and upper extremities - GBS. Pt hospitalized transferred to EUH for plasma exchange.


Changed on 2/14/2018

VAERS ID: 25862 Before After
VAERS Form:1
Age:91.0
Sex:Female
Location:Georgia
Vaccinated:1990-02-06
Onset:1990-02-25
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 9F01201C / UNK - / A

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
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: ~ ()~~~In patient
Other Medications: Hydrochlorothiazide 25 daily, Corgard 40 daily
Current Illness: Hypertension, ischemic heart disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza experienced weakness of the lower extremities with aching progressing to the trunk and upper extremities - GBS. Pt hospitalized transferred to EUH for plasma exchange.


Changed on 6/14/2018

VAERS ID: 25862 Before After
VAERS Form:1
Age:91.0
Sex:Female
Location:Georgia
Vaccinated:1990-02-06
Onset:1990-02-25
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 9F01201C / UNK - / A

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
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: ~ ()~~~In patient
Other Medications: Hydrochlorothiazide 25 daily, Corgard 40 daily
Current Illness: Hypertension, ischemic heart disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza experienced weakness of the lower extremities with aching progressing to the trunk and upper extremities - GBS. Pt hospitalized transferred to EUH for plasma exchange.


Changed on 8/14/2018

VAERS ID: 25862 Before After
VAERS Form:1
Age:91.0
Sex:Female
Location:Georgia
Vaccinated:1990-02-06
Onset:1990-02-25
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 9F01201C / UNK - / A

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
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: ~ ()~~~In patient
Other Medications: Hydrochlorothiazide 25 daily, Corgard 40 daily
Current Illness: Hypertension, ischemic heart disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza experienced weakness of the lower extremities with aching progressing to the trunk and upper extremities - GBS. Pt hospitalized transferred to EUH for plasma exchange.


Changed on 9/14/2018

VAERS ID: 25862 Before After
VAERS Form:1
Age:91.0
Sex:Female
Location:Georgia
Vaccinated:1990-02-06
Onset:1990-02-25
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 9F01201C / UNK - / A

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
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: ~ ()~~~In patient
Other Medications: Hydrochlorothiazide 25 daily, Corgard 40 daily
Current Illness: Hypertension, ischemic heart disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza experienced weakness of the lower extremities with aching progressing to the trunk and upper extremities - GBS. Pt hospitalized transferred to EUH for plasma exchange.


Changed on 10/14/2018

VAERS ID: 25862 Before After
VAERS Form:1
Age:91.0
Sex:Female
Location:Georgia
Vaccinated:1990-02-06
Onset:1990-02-25
Submitted:1990-09-04
Entered:1990-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 9F01201C / UNK - / A

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
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: ~ ()~~~In patient
Other Medications: Hydrochlorothiazide 25 daily, Corgard 40 daily
Current Illness: Hypertension, ischemic heart disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza experienced weakness of the lower extremities with aching progressing to the trunk and upper extremities - GBS. Pt hospitalized transferred to EUH for plasma exchange.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=25862&WAYBACKHISTORY=ON


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