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This is VAERS ID 26716

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26716
VAERS Form:
Age:53.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-24
Onset:1990-11-05
Submitted:1990-11-15
Entered:1990-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH 4908201 / - A / IM

Administered by: Other      Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND, PAIN, ASTHENIA, DYSPHAGIA, PAIN NECK

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Elevated CSF protein
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza c/o severe neck & throat pain spreaded down resulting in generalized weakness & arm numbness. Admitted to hosp w/proximal weakness & difficulty swollowing & paralysis. Probable GBS.


Changed on 12/8/2009

VAERS ID: 26716 Before After
VAERS Form:
Age:53.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-24
Onset:1990-11-05
Submitted:1990-11-15
Entered:1990-11-27 1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) / WYETH WYETH PHARMACEUTICALS, INC 4908201 / - A / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Asthenia, Dysphagia, Guillain-Barre syndrome, Neck pain, Pain, Paraesthesia, Paralysis, GUILLAIN BARRE SYND, PAIN, ASTHENIA, DYSPHAGIA, PAIN NECK

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Elevated CSF protein
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza c/o severe neck & throat pain spreaded down resulting in generalized weakness & arm numbness. Admitted to hosp w/proximal weakness & difficulty swollowing & paralysis. Probable GBS.


Changed on 8/31/2010

VAERS ID: 26716 Before After
VAERS Form:
Age:53.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-24
Onset:1990-11-05
Submitted:1990-11-15
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4908201 / - A / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Dysphagia, Guillain-Barre syndrome, Neck pain, Pain, Paraesthesia, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Elevated CSF protein
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza c/o severe neck & throat pain spreaded down resulting in generalized weakness & arm numbness. Admitted to hosp w/proximal weakness & difficulty swollowing & paralysis. Probable GBS.


Changed on 7/7/2013

VAERS ID: 26716 Before After
VAERS Form:
Age:53.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-24
Onset:1990-11-05
Submitted:1990-11-15
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / - A / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / - A / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Dysphagia, Guillain-Barre syndrome, Neck pain, Pain, Paraesthesia, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Elevated CSF protein
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza c/o severe neck & throat pain spreaded down resulting in generalized weakness & arm numbness. Admitted to hosp w/proximal weakness & difficulty swollowing & paralysis. Probable GBS.


Changed on 12/14/2016

VAERS ID: 26716 Before After
VAERS Form:
Age:53.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-24
Onset:1990-11-05
Submitted:1990-11-15
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / - A / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / - A / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Dysphagia, Guillain-Barre syndrome, Neck pain, Pain, Paraesthesia, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Elevated CSF protein
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza c/o severe neck & throat pain spreaded down resulting in generalized weakness & arm numbness. Admitted to hosp w/proximal weakness & difficulty swollowing & paralysis. Probable GBS.


Changed on 5/14/2017

VAERS ID: 26716 Before After
VAERS Form:
Age:53.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-24
Onset:1990-11-05
Submitted:1990-11-15
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / - A - / IM IM A

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Dysphagia, Guillain-Barre syndrome, Neck pain, Pain, Paraesthesia, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Elevated CSF protein
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza c/o severe neck & throat pain spreaded down resulting in generalized weakness & arm numbness. Admitted to hosp w/proximal weakness & difficulty swollowing & paralysis. Probable GBS.


Changed on 9/14/2017

VAERS ID: 26716 Before After
VAERS Form:(blank) 1
Age:53.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-24
Onset:1990-11-05
Submitted:1990-11-15
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / - UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Dysphagia, Guillain-Barre syndrome, Neck pain, Pain, Paraesthesia, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Elevated CSF protein
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza c/o severe neck & throat pain spreaded down resulting in generalized weakness & arm numbness. Admitted to hosp w/proximal weakness & difficulty swollowing & paralysis. Probable GBS.


Changed on 2/14/2018

VAERS ID: 26716 Before After
VAERS Form:1
Age:53.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-24
Onset:1990-11-05
Submitted:1990-11-15
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Dysphagia, Guillain-Barre syndrome, Neck pain, Pain, Paraesthesia, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Elevated CSF protein
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza c/o severe neck & throat pain spreaded down resulting in generalized weakness & arm numbness. Admitted to hosp w/proximal weakness & difficulty swollowing & paralysis. Probable GBS.


Changed on 6/14/2018

VAERS ID: 26716 Before After
VAERS Form:1
Age:53.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-24
Onset:1990-11-05
Submitted:1990-11-15
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Dysphagia, Guillain-Barre syndrome, Neck pain, Pain, Paraesthesia, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Elevated CSF protein
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza c/o severe neck & throat pain spreaded down resulting in generalized weakness & arm numbness. Admitted to hosp w/proximal weakness & difficulty swollowing & paralysis. Probable GBS.


Changed on 8/14/2018

VAERS ID: 26716 Before After
VAERS Form:1
Age:53.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-24
Onset:1990-11-05
Submitted:1990-11-15
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Dysphagia, Guillain-Barre syndrome, Neck pain, Pain, Paraesthesia, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Elevated CSF protein
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza c/o severe neck & throat pain spreaded down resulting in generalized weakness & arm numbness. Admitted to hosp w/proximal weakness & difficulty swollowing & paralysis. Probable GBS.


Changed on 9/14/2018

VAERS ID: 26716 Before After
VAERS Form:1
Age:53.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-24
Onset:1990-11-05
Submitted:1990-11-15
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Dysphagia, Guillain-Barre syndrome, Neck pain, Pain, Paraesthesia, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Elevated CSF protein
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza c/o severe neck & throat pain spreaded down resulting in generalized weakness & arm numbness. Admitted to hosp w/proximal weakness & difficulty swollowing & paralysis. Probable GBS.


Changed on 10/14/2018

VAERS ID: 26716 Before After
VAERS Form:1
Age:53.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-24
Onset:1990-11-05
Submitted:1990-11-15
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Dysphagia, Guillain-Barre syndrome, Neck pain, Pain, Paraesthesia, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Elevated CSF protein
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza c/o severe neck & throat pain spreaded down resulting in generalized weakness & arm numbness. Admitted to hosp w/proximal weakness & difficulty swollowing & paralysis. Probable GBS.

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