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This is VAERS ID 26302

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26302
VAERS Form:
Age:62.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-08-21
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE / UNCLASSIFIED - / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bentyl, Zantac, Tylenol, Maalox, Centrium Vitamins
Current Illness:
Preexisting Conditions: Plasmapheresis
Allergies:
Diagnostic Lab Data: CSF Protein 104
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine development of Guillain Barre Synd had influenza vaccine on 21AUG90.


Changed on 12/8/2009

VAERS ID: 26302 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-08-21
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-10-29 1990-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE INFLUENZA (SEASONAL) (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, GUILLAIN BARRE SYND

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bentyl, Zantac, Tylenol, Maalox, Centrium Vitamins
Current Illness:
Preexisting Conditions: Plasmapheresis
Allergies:
Diagnostic Lab Data: CSF Protein 104
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine development of Guillain Barre Synd had influenza vaccine on 21AUG90.


Changed on 7/7/2013

VAERS ID: 26302 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-08-21
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-10-17
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: Unknown
Symptoms: Guillain-Barre syndrome

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bentyl, Zantac, Tylenol, Maalox, Centrium Vitamins
Current Illness:
Preexisting Conditions: Plasmapheresis
Allergies:
Diagnostic Lab Data: CSF Protein 104
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine development of Guillain Barre Synd had influenza vaccine on 21AUG90.


Changed on 12/14/2016

VAERS ID: 26302 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-08-21
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-10-17
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: Unknown
Symptoms: Guillain-Barre syndrome

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bentyl, Zantac, Tylenol, Maalox, Centrium Vitamins
Current Illness:
Preexisting Conditions: Plasmapheresis
Allergies:
Diagnostic Lab Data: CSF Protein 104
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine development of Guillain Barre Synd had influenza vaccine on 21AUG90.


Changed on 5/14/2017

VAERS ID: 26302 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-08-21
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Bentyl, Zantac, Tylenol, Maalox, Centrium Vitamins
Current Illness:
Preexisting Conditions: Plasmapheresis
Allergies:
Diagnostic Lab Data: CSF Protein 104
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine development of Guillain Barre Synd had influenza vaccine on 21AUG90.


Changed on 9/14/2017

VAERS ID: 26302 Before After
VAERS Form:(blank) 1
Age:62.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-08-21
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Bentyl, Zantac, Tylenol, Maalox, Centrium Vitamins
Current Illness:
Preexisting Conditions: Plasmapheresis
Allergies:
Diagnostic Lab Data: CSF Protein 104
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine development of Guillain Barre Synd had influenza vaccine on 21AUG90.


Changed on 2/14/2018

VAERS ID: 26302 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-08-21
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Bentyl, Zantac, Tylenol, Maalox, Centrium Vitamins
Current Illness:
Preexisting Conditions: Plasmapheresis
Allergies:
Diagnostic Lab Data: CSF Protein 104
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine development of Guillain Barre Synd had influenza vaccine on 21AUG90.


Changed on 6/14/2018

VAERS ID: 26302 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-08-21
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Bentyl, Zantac, Tylenol, Maalox, Centrium Vitamins
Current Illness:
Preexisting Conditions: Plasmapheresis
Allergies:
Diagnostic Lab Data: CSF Protein 104
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine development of Guillain Barre Synd had influenza vaccine on 21AUG90.


Changed on 8/14/2018

VAERS ID: 26302 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-08-21
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Bentyl, Zantac, Tylenol, Maalox, Centrium Vitamins
Current Illness:
Preexisting Conditions: Plasmapheresis
Allergies:
Diagnostic Lab Data: CSF Protein 104
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine development of Guillain Barre Synd had influenza vaccine on 21AUG90.


Changed on 9/14/2018

VAERS ID: 26302 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-08-21
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Bentyl, Zantac, Tylenol, Maalox, Centrium Vitamins
Current Illness:
Preexisting Conditions: Plasmapheresis
Allergies:
Diagnostic Lab Data: CSF Protein 104
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine development of Guillain Barre Synd had influenza vaccine on 21AUG90.


Changed on 10/14/2018

VAERS ID: 26302 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-08-21
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Bentyl, Zantac, Tylenol, Maalox, Centrium Vitamins
Current Illness:
Preexisting Conditions: Plasmapheresis
Allergies:
Diagnostic Lab Data: CSF Protein 104
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine development of Guillain Barre Synd had influenza vaccine on 21AUG90.

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