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This is VAERS ID 26281

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26281
VAERS Form:
Age:79.0
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-04
Onset:1990-10-06
Submitted:0000-00-00
Entered:1990-10-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE / UNCLASSIFIED - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND, GAIT ABNORM, PARESTHESIA, MYASTHENIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: Theodur; Allopurinol; Hydrocholorthiazide
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG RBBB & Lafb; NA + 139, K 3.1, MGH 1.7, TH 09.2, BUN, Creat, GLC WNL ER 8 WBC 9.3 HIH 15.5/46.6 PLT 296
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine developed Guillian Barres Synd progressive numbness & tingling both legs & hands weakness. Unsteady gait.


Changed on 12/8/2009

VAERS ID: 26281 Before After
VAERS Form:
Age:79.0
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-04
Onset:1990-10-06
Submitted:0000-00-00
Entered:1990-10-23 1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE INFLUENZA (SEASONAL) (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Myasthenic syndrome, Paraesthesia, GUILLAIN BARRE SYND, GAIT ABNORM, PARESTHESIA, MYASTHENIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: Theodur; Allopurinol; Hydrocholorthiazide
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG RBBB & Lafb; NA + 139, K 3.1, MGH 1.7, TH 09.2, BUN, Creat, GLC WNL ER 8 WBC 9.3 HIH 15.5/46.6 PLT 296
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine developed Guillian Barres Synd progressive numbness & tingling both legs & hands weakness. Unsteady gait.


Changed on 7/7/2013

VAERS ID: 26281 Before After
VAERS Form:
Age:79.0
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-04
Onset:1990-10-06
Submitted:0000-00-00
Entered:1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Myasthenic syndrome, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: Theodur; Allopurinol; Hydrocholorthiazide
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG RBBB & Lafb; NA + 139, K 3.1, MGH 1.7, TH 09.2, BUN, Creat, GLC WNL ER 8 WBC 9.3 HIH 15.5/46.6 PLT 296
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine developed Guillian Barres Synd progressive numbness & tingling both legs & hands weakness. Unsteady gait.


Changed on 12/14/2016

VAERS ID: 26281 Before After
VAERS Form:
Age:79.0
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-04
Onset:1990-10-06
Submitted:0000-00-00
Entered:1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Myasthenic syndrome, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: Theodur; Allopurinol; Hydrocholorthiazide
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG RBBB & Lafb; NA + 139, K 3.1, MGH 1.7, TH 09.2, BUN, Creat, GLC WNL ER 8 WBC 9.3 HIH 15.5/46.6 PLT 296
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine developed Guillian Barres Synd progressive numbness & tingling both legs & hands weakness. Unsteady gait.


Changed on 5/14/2017

VAERS ID: 26281 Before After
VAERS Form:
Age:79.0
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-04
Onset:1990-10-06
Submitted:0000-00-00
Entered:1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Myasthenic syndrome, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: Theodur; Allopurinol; Hydrocholorthiazide
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG RBBB & Lafb; NA + 139, K 3.1, MGH 1.7, TH 09.2, BUN, Creat, GLC WNL ER 8 WBC 9.3 HIH 15.5/46.6 PLT 296
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine developed Guillian Barres Synd progressive numbness & tingling both legs & hands weakness. Unsteady gait.


Changed on 9/14/2017

VAERS ID: 26281 Before After
VAERS Form:(blank) 1
Age:79.0
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-04
Onset:1990-10-06
Submitted:0000-00-00
Entered:1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Myasthenic syndrome, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: Theodur; Allopurinol; Hydrocholorthiazide
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG RBBB & Lafb; NA + 139, K 3.1, MGH 1.7, TH 09.2, BUN, Creat, GLC WNL ER 8 WBC 9.3 HIH 15.5/46.6 PLT 296
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine developed Guillian Barres Synd progressive numbness & tingling both legs & hands weakness. Unsteady gait.


Changed on 2/14/2018

VAERS ID: 26281 Before After
VAERS Form:1
Age:79.0
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-04
Onset:1990-10-06
Submitted:0000-00-00
Entered:1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Myasthenic syndrome, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: Theodur; Allopurinol; Hydrocholorthiazide
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG RBBB & Lafb; NA + 139, K 3.1, MGH 1.7, TH 09.2, BUN, Creat, GLC WNL ER 8 WBC 9.3 HIH 15.5/46.6 PLT 296
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine developed Guillian Barres Synd progressive numbness & tingling both legs & hands weakness. Unsteady gait.


Changed on 6/14/2018

VAERS ID: 26281 Before After
VAERS Form:1
Age:79.0
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-04
Onset:1990-10-06
Submitted:0000-00-00
Entered:1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Myasthenic syndrome, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: Theodur; Allopurinol; Hydrocholorthiazide
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG RBBB & Lafb; NA + 139, K 3.1, MGH 1.7, TH 09.2, BUN, Creat, GLC WNL ER 8 WBC 9.3 HIH 15.5/46.6 PLT 296
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine developed Guillian Barres Synd progressive numbness & tingling both legs & hands weakness. Unsteady gait.


Changed on 8/14/2018

VAERS ID: 26281 Before After
VAERS Form:1
Age:79.0
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-04
Onset:1990-10-06
Submitted:0000-00-00
Entered:1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Myasthenic syndrome, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: Theodur; Allopurinol; Hydrocholorthiazide
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG RBBB & Lafb; NA + 139, K 3.1, MGH 1.7, TH 09.2, BUN, Creat, GLC WNL ER 8 WBC 9.3 HIH 15.5/46.6 PLT 296
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine developed Guillian Barres Synd progressive numbness & tingling both legs & hands weakness. Unsteady gait.


Changed on 9/14/2018

VAERS ID: 26281 Before After
VAERS Form:1
Age:79.0
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-04
Onset:1990-10-06
Submitted:0000-00-00
Entered:1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Myasthenic syndrome, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: Theodur; Allopurinol; Hydrocholorthiazide
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG RBBB & Lafb; NA + 139, K 3.1, MGH 1.7, TH 09.2, BUN, Creat, GLC WNL ER 8 WBC 9.3 HIH 15.5/46.6 PLT 296
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine developed Guillian Barres Synd progressive numbness & tingling both legs & hands weakness. Unsteady gait.


Changed on 10/14/2018

VAERS ID: 26281 Before After
VAERS Form:1
Age:79.0
Sex:Male
Location:Pennsylvania
Vaccinated:1990-10-04
Onset:1990-10-06
Submitted:0000-00-00
Entered:1990-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Myasthenic syndrome, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: Theodur; Allopurinol; Hydrocholorthiazide
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: EKG RBBB & Lafb; NA + 139, K 3.1, MGH 1.7, TH 09.2, BUN, Creat, GLC WNL ER 8 WBC 9.3 HIH 15.5/46.6 PLT 296
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine developed Guillian Barres Synd progressive numbness & tingling both legs & hands weakness. Unsteady gait.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=26281&WAYBACKHISTORY=ON


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