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This is VAERS ID 27178

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27178
VAERS Form:
Age:53.7
Sex:Male
Location:California
Vaccinated:1990-10-22
Onset:1990-10-27
Submitted:1990-12-18
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS - / - A / IM

Administered by: Military      Purchased by: Unknown
Symptoms: PARALYSIS FACIAL, SPEECH DIS, HYPESTHESIA, MYASTHENIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: lumbar disc disease
Allergies:
Diagnostic Lab Data: Increased ACE level; LP increased protein, MRI 0, compatible w/savcoid
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza onset peripheal hypesthesias, facial diplegia, dysphagia, leg weakness, resolved w/long course prednisone.


Changed on 12/8/2009

VAERS ID: 27178 Before After
VAERS Form:
Age:53.7
Sex:Male
Location:California
Vaccinated:1990-10-22
Onset:1990-10-27
Submitted:1990-12-18
Entered:1991-01-08 1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABS CONNAUGHT LABORATORIES - / - A / IM

Administered by: Military      Purchased by: Unknown Private
Symptoms: Facial palsy, Hypoaesthesia, Myasthenic syndrome, Speech disorder, PARALYSIS FACIAL, SPEECH DIS, HYPESTHESIA, MYASTHENIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: lumbar disc disease
Allergies:
Diagnostic Lab Data: Increased ACE level; LP increased protein, MRI 0, compatible w/savcoid
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza onset peripheal hypesthesias, facial diplegia, dysphagia, leg weakness, resolved w/long course prednisone.


Changed on 8/31/2010

VAERS ID: 27178 Before After
VAERS Form:
Age:53.7
Sex:Male
Location:California
Vaccinated:1990-10-22
Onset:1990-10-27
Submitted:1990-12-18
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - A / IM

Administered by: Military      Purchased by: Private
Symptoms: Facial palsy, Hypoaesthesia, Myasthenic syndrome, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: lumbar disc disease
Allergies:
Diagnostic Lab Data: Increased ACE level; LP increased protein, MRI 0, compatible w/savcoid
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza onset peripheal hypesthesias, facial diplegia, dysphagia, leg weakness, resolved w/long course prednisone.


Changed on 7/7/2013

VAERS ID: 27178 Before After
VAERS Form:
Age:53.7
Sex:Male
Location:California
Vaccinated:1990-10-22
Onset:1990-10-27
Submitted:1990-12-18
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - A / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - A / IM

Administered by: Military      Purchased by: Private
Symptoms: Facial palsy, Hypoaesthesia, Myasthenic syndrome, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: lumbar disc disease
Allergies:
Diagnostic Lab Data: Increased ACE level; LP increased protein, MRI 0, compatible w/savcoid
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza onset peripheal hypesthesias, facial diplegia, dysphagia, leg weakness, resolved w/long course prednisone.


Changed on 2/14/2017

VAERS ID: 27178 Before After
VAERS Form:
Age:53.7 53.0
Sex:Male
Location:California
Vaccinated:1990-10-22
Onset:1990-10-27
Submitted:1990-12-18
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - A / IM

Administered by: Military      Purchased by: Private
Symptoms: Facial palsy, Hypoaesthesia, Myasthenic syndrome, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: lumbar disc disease
Allergies:
Diagnostic Lab Data: Increased ACE level; LP increased protein, MRI 0, compatible w/savcoid
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza onset peripheal hypesthesias, facial diplegia, dysphagia, leg weakness, resolved w/long course prednisone.


Changed on 5/14/2017

VAERS ID: 27178 Before After
VAERS Form:
Age:53.0
Sex:Male
Location:California
Vaccinated:1990-10-22
Onset:1990-10-27
Submitted:1990-12-18
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - A - / IM IM A

Administered by: Military      Purchased by: Private
Symptoms: Facial palsy, Hypoaesthesia, Myasthenic syndrome, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: lumbar disc disease
Allergies:
Diagnostic Lab Data: Increased ACE level; LP increased protein, MRI 0, compatible w/savcoid
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza onset peripheal hypesthesias, facial diplegia, dysphagia, leg weakness, resolved w/long course prednisone.


Changed on 9/14/2017

VAERS ID: 27178 Before After
VAERS Form:(blank) 1
Age:53.0
Sex:Male
Location:California
Vaccinated:1990-10-22
Onset:1990-10-27
Submitted:1990-12-18
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - UNK - / IM A

Administered by: Military      Purchased by: Private
Symptoms: Facial palsy, Hypoaesthesia, Myasthenic syndrome, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: lumbar disc disease
Allergies:
Diagnostic Lab Data: Increased ACE level; LP increased protein, MRI 0, compatible w/savcoid
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza onset peripheal hypesthesias, facial diplegia, dysphagia, leg weakness, resolved w/long course prednisone.


Changed on 2/14/2018

VAERS ID: 27178 Before After
VAERS Form:1
Age:53.0
Sex:Male
Location:California
Vaccinated:1990-10-22
Onset:1990-10-27
Submitted:1990-12-18
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / IM A

Administered by: Military      Purchased by: Private
Symptoms: Facial palsy, Hypoaesthesia, Myasthenic syndrome, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: lumbar disc disease
Allergies:
Diagnostic Lab Data: Increased ACE level; LP increased protein, MRI 0, compatible w/savcoid
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza onset peripheal hypesthesias, facial diplegia, dysphagia, leg weakness, resolved w/long course prednisone.


Changed on 6/14/2018

VAERS ID: 27178 Before After
VAERS Form:1
Age:53.0
Sex:Male
Location:California
Vaccinated:1990-10-22
Onset:1990-10-27
Submitted:1990-12-18
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / IM A

Administered by: Military      Purchased by: Private
Symptoms: Facial palsy, Hypoaesthesia, Myasthenic syndrome, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: lumbar disc disease
Allergies:
Diagnostic Lab Data: Increased ACE level; LP increased protein, MRI 0, compatible w/savcoid
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza onset peripheal hypesthesias, facial diplegia, dysphagia, leg weakness, resolved w/long course prednisone.


Changed on 8/14/2018

VAERS ID: 27178 Before After
VAERS Form:1
Age:53.0
Sex:Male
Location:California
Vaccinated:1990-10-22
Onset:1990-10-27
Submitted:1990-12-18
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / IM A

Administered by: Military      Purchased by: Private
Symptoms: Facial palsy, Hypoaesthesia, Myasthenic syndrome, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: lumbar disc disease
Allergies:
Diagnostic Lab Data: Increased ACE level; LP increased protein, MRI 0, compatible w/savcoid
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza onset peripheal hypesthesias, facial diplegia, dysphagia, leg weakness, resolved w/long course prednisone.


Changed on 9/14/2018

VAERS ID: 27178 Before After
VAERS Form:1
Age:53.0
Sex:Male
Location:California
Vaccinated:1990-10-22
Onset:1990-10-27
Submitted:1990-12-18
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / IM A

Administered by: Military      Purchased by: Private
Symptoms: Facial palsy, Hypoaesthesia, Myasthenic syndrome, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: lumbar disc disease
Allergies:
Diagnostic Lab Data: Increased ACE level; LP increased protein, MRI 0, compatible w/savcoid
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza onset peripheal hypesthesias, facial diplegia, dysphagia, leg weakness, resolved w/long course prednisone.


Changed on 10/14/2018

VAERS ID: 27178 Before After
VAERS Form:1
Age:53.0
Sex:Male
Location:California
Vaccinated:1990-10-22
Onset:1990-10-27
Submitted:1990-12-18
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / IM A

Administered by: Military      Purchased by: Private
Symptoms: Facial palsy, Hypoaesthesia, Myasthenic syndrome, Speech disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: lumbar disc disease
Allergies:
Diagnostic Lab Data: Increased ACE level; LP increased protein, MRI 0, compatible w/savcoid
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza onset peripheal hypesthesias, facial diplegia, dysphagia, leg weakness, resolved w/long course prednisone.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=27178&WAYBACKHISTORY=ON


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