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This is VAERS ID 27204

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27204
VAERS Form:
Age:58.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-01
Submitted:0000-00-00
Entered:1991-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLU-IMUNE 1990-1991 LEDERLE / LEDERLE 287973 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: APNEA, DYSPNEA, GUILLAIN BARRE SYND, ASTHENIA, DYSPHAGIA

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Following vax 62 yo male c/o weakness & difficulty swallowing&talking came to ER-hospitalized for 8 days Developed quadriplegia & resp difficulty,15Nov resp arrest. preliminary DX was Guillian Barre Synd.Final DX: GBS & resp failure


Changed on 12/8/2009

VAERS ID: 27204 Before After
VAERS Form:
Age:58.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-01
Submitted:0000-00-00
Entered:1991-01-10 1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLU-IMUNE 1990-1991 LEDERLE INFLUENZA (SEASONAL) (FLU-IMUNE 90-91) / LEDERLE LEDERLE LABORATORIES 287973 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Asthenia, Dysphagia, Dyspnoea, Guillain-Barre syndrome, APNEA, DYSPNEA, GUILLAIN BARRE SYND, ASTHENIA, DYSPHAGIA

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 900211201

Write-up: Following vax 62 yo male c/o weakness & difficulty swallowing&talking came to ER-hospitalized for 8 days Developed quadriplegia & resp difficulty,15Nov resp arrest. preliminary DX was Guillian Barre Synd.Final DX: GBS & resp failure


Changed on 8/31/2010

VAERS ID: 27204 Before After
VAERS Form:
Age:58.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-01
Submitted:0000-00-00
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLU-IMUNE 90-91) INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Asthenia, Dysphagia, Dyspnoea, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900211201

Write-up: Following vax 62 yo male c/o weakness & difficulty swallowing&talking came to ER-hospitalized for 8 days Developed quadriplegia & resp difficulty,15Nov resp arrest. preliminary DX was Guillian Barre Synd.Final DX: GBS & resp failure


Changed on 7/7/2013

VAERS ID: 27204 Before After
VAERS Form:
Age:58.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-01
Submitted:0000-00-00
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / - - / -
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Asthenia, Dysphagia, Dyspnoea, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900211201

Write-up: Following vax 62 yo male c/o weakness & difficulty swallowing&talking came to ER-hospitalized for 8 days Developed quadriplegia & resp difficulty,15Nov resp arrest. preliminary DX was Guillian Barre Synd.Final DX: GBS & resp failure


Changed on 5/14/2017

VAERS ID: 27204 Before After
VAERS Form:
Age:58.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-01
Submitted:0000-00-00
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Asthenia, Dysphagia, Dyspnoea, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900211201

Write-up: Following vax 62 yo male c/o weakness & difficulty swallowing&talking came to ER-hospitalized for 8 days Developed quadriplegia & resp difficulty,15Nov resp arrest. preliminary DX was Guillian Barre Synd.Final DX: GBS & resp failure


Changed on 9/14/2017

VAERS ID: 27204 Before After
VAERS Form:(blank) 1
Age:58.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-01
Submitted:0000-00-00
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Asthenia, Dysphagia, Dyspnoea, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900211201

Write-up: Following vax 62 yo male c/o weakness & difficulty swallowing&talking came to ER-hospitalized for 8 days Developed quadriplegia & resp difficulty,15Nov resp arrest. preliminary DX was Guillian Barre Synd.Final DX: GBS & resp failure


Changed on 2/14/2018

VAERS ID: 27204 Before After
VAERS Form:1
Age:58.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-01
Submitted:0000-00-00
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Asthenia, Dysphagia, Dyspnoea, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900211201

Write-up: Following vax 62 yo male c/o weakness & difficulty swallowing&talking came to ER-hospitalized for 8 days Developed quadriplegia & resp difficulty,15Nov resp arrest. preliminary DX was Guillian Barre Synd.Final DX: GBS & resp failure


Changed on 6/14/2018

VAERS ID: 27204 Before After
VAERS Form:1
Age:58.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-01
Submitted:0000-00-00
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Asthenia, Dysphagia, Dyspnoea, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900211201

Write-up: Following vax 62 yo male c/o weakness & difficulty swallowing&talking came to ER-hospitalized for 8 days Developed quadriplegia & resp difficulty,15Nov resp arrest. preliminary DX was Guillian Barre Synd.Final DX: GBS & resp failure


Changed on 8/14/2018

VAERS ID: 27204 Before After
VAERS Form:1
Age:58.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-01
Submitted:0000-00-00
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Asthenia, Dysphagia, Dyspnoea, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900211201

Write-up: Following vax 62 yo male c/o weakness & difficulty swallowing&talking came to ER-hospitalized for 8 days Developed quadriplegia & resp difficulty,15Nov resp arrest. preliminary DX was Guillian Barre Synd.Final DX: GBS & resp failure


Changed on 9/14/2018

VAERS ID: 27204 Before After
VAERS Form:1
Age:58.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-01
Submitted:0000-00-00
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Asthenia, Dysphagia, Dyspnoea, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900211201

Write-up: Following vax 62 yo male c/o weakness & difficulty swallowing&talking came to ER-hospitalized for 8 days Developed quadriplegia & resp difficulty,15Nov resp arrest. preliminary DX was Guillian Barre Synd.Final DX: GBS & resp failure


Changed on 10/14/2018

VAERS ID: 27204 Before After
VAERS Form:1
Age:58.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-01
Submitted:0000-00-00
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Asthenia, Dysphagia, Dyspnoea, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900211201

Write-up: Following vax 62 yo male c/o weakness & difficulty swallowing&talking came to ER-hospitalized for 8 days Developed quadriplegia & resp difficulty,15Nov resp arrest. preliminary DX was Guillian Barre Synd.Final DX: GBS & resp failure

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=27204&WAYBACKHISTORY=ON


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