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This is VAERS ID 27304

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27304
VAERS Form:
Age:82.0
Sex:Female
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS / PARKE-DAVIS - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: ASTHENIA, DYSPHAGIA, HYPERTENS, BRAIN STEM DIS, HYPERGLYCEM

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: Catapres, Tambocor, Digoxin, ASA, Clonidine
Current Illness:
Preexisting Conditions: A CVA & Myasthenia gravis have been ruled out.
Allergies:
Diagnostic Lab Data: Spinal Tap & Ct head Scan WNL; Tensilon test - Negative. CSF = wnl, EMG - planned.
CDC 'Split Type':

Write-up: Pt vac w/FLUOGEN developed brain stem disorder, weakness of extremities & hypertension, bilat ptosis, difficulty speaking & swallowing. Admitted to Hosp BP 217/87, P 70min, R 20min, BS 225 mg/DL. Botulism suspected. Tensilon test neg.


Changed on 12/8/2009

VAERS ID: 27304 Before After
VAERS Form:
Age:82.0
Sex:Female
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-08 1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS INFLUENZA (SEASONAL) (FLUOGEN 90-91) / PARKE-DAVIS - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dysphagia, Eyelid ptosis, Hyperglycaemia, Hypertension, Speech disorder, Brain stem syndrome, ASTHENIA, DYSPHAGIA, HYPERTENS, BRAIN STEM DIS, HYPERGLYCEM

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: Catapres, Tambocor, Digoxin, ASA, Clonidine
Current Illness:
Preexisting Conditions: A CVA & Myasthenia gravis have been ruled out.
Allergies:
Diagnostic Lab Data: Spinal Tap & Ct head Scan WNL; Tensilon test - Negative. CSF = wnl, EMG - planned.
CDC 'Split Type': (blank) 904090014

Write-up: Pt vac w/FLUOGEN developed brain stem disorder, weakness of extremities & hypertension, bilat ptosis, difficulty speaking & swallowing. Admitted to Hosp BP 217/87, P 70min, R 20min, BS 225 mg/DL. Botulism suspected. Tensilon test neg.


Changed on 8/31/2010

VAERS ID: 27304 Before After
VAERS Form:
Age:82.0
Sex:Female
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 90-91) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dysphagia, Eyelid ptosis, Hyperglycaemia, Hypertension, Speech disorder, Brain stem 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: Catapres, Tambocor, Digoxin, ASA, Clonidine
Current Illness:
Preexisting Conditions: A CVA & Myasthenia gravis have been ruled out.
Allergies:
Diagnostic Lab Data: Spinal Tap & Ct head Scan WNL; Tensilon test - Negative. CSF = wnl, EMG - planned.
CDC 'Split Type': 904090014

Write-up: Pt vac w/FLUOGEN developed brain stem disorder, weakness of extremities & hypertension, bilat ptosis, difficulty speaking & swallowing. Admitted to Hosp BP 217/87, P 70min, R 20min, BS 225 mg/DL. Botulism suspected. Tensilon test neg.


Changed on 7/7/2013

VAERS ID: 27304 Before After
VAERS Form:
Age:82.0
Sex:Female
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dysphagia, Eyelid ptosis, Hyperglycaemia, Hypertension, Speech disorder, Brain stem 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: Catapres, Tambocor, Digoxin, ASA, Clonidine
Current Illness:
Preexisting Conditions: A CVA & Myasthenia gravis have been ruled out.
Allergies:
Diagnostic Lab Data: Spinal Tap & Ct head Scan WNL; Tensilon test - Negative. CSF = wnl, EMG - planned.
CDC 'Split Type': 904090014

Write-up: Pt vac w/FLUOGEN developed brain stem disorder, weakness of extremities & hypertension, bilat ptosis, difficulty speaking & swallowing. Admitted to Hosp BP 217/87, P 70min, R 20min, BS 225 mg/DL. Botulism suspected. Tensilon test neg.


Changed on 5/14/2017

VAERS ID: 27304 Before After
VAERS Form:
Age:82.0
Sex:Female
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dysphagia, Eyelid ptosis, Hyperglycaemia, Hypertension, Speech disorder, Brain stem 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: Catapres, Tambocor, Digoxin, ASA, Clonidine
Current Illness:
Preexisting Conditions: A CVA & Myasthenia gravis have been ruled out.
Allergies:
Diagnostic Lab Data: Spinal Tap & Ct head Scan WNL; Tensilon test - Negative. CSF = wnl, EMG - planned.
CDC 'Split Type': 904090014

Write-up: Pt vac w/FLUOGEN developed brain stem disorder, weakness of extremities & hypertension, bilat ptosis, difficulty speaking & swallowing. Admitted to Hosp BP 217/87, P 70min, R 20min, BS 225 mg/DL. Botulism suspected. Tensilon test neg.


Changed on 9/14/2017

VAERS ID: 27304 Before After
VAERS Form:(blank) 1
Age:82.0
Sex:Female
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dysphagia, Eyelid ptosis, Hyperglycaemia, Hypertension, Speech disorder, Brain stem 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: Catapres, Tambocor, Digoxin, ASA, Clonidine
Current Illness:
Preexisting Conditions: A CVA & Myasthenia gravis have been ruled out.
Allergies:
Diagnostic Lab Data: Spinal Tap & Ct head Scan WNL; Tensilon test - Negative. CSF = wnl, EMG - planned.
CDC 'Split Type': 904090014

Write-up: Pt vac w/FLUOGEN developed brain stem disorder, weakness of extremities & hypertension, bilat ptosis, difficulty speaking & swallowing. Admitted to Hosp BP 217/87, P 70min, R 20min, BS 225 mg/DL. Botulism suspected. Tensilon test neg.


Changed on 2/14/2018

VAERS ID: 27304 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dysphagia, Eyelid ptosis, Hyperglycaemia, Hypertension, Speech disorder, Brain stem 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: Catapres, Tambocor, Digoxin, ASA, Clonidine
Current Illness:
Preexisting Conditions: A CVA & Myasthenia gravis have been ruled out.
Allergies:
Diagnostic Lab Data: Spinal Tap & Ct head Scan WNL; Tensilon test - Negative. CSF = wnl, EMG - planned.
CDC 'Split Type': 904090014

Write-up: Pt vac w/FLUOGEN developed brain stem disorder, weakness of extremities & hypertension, bilat ptosis, difficulty speaking & swallowing. Admitted to Hosp BP 217/87, P 70min, R 20min, BS 225 mg/DL. Botulism suspected. Tensilon test neg.


Changed on 6/14/2018

VAERS ID: 27304 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dysphagia, Eyelid ptosis, Hyperglycaemia, Hypertension, Speech disorder, Brain stem 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: Catapres, Tambocor, Digoxin, ASA, Clonidine
Current Illness:
Preexisting Conditions: A CVA & Myasthenia gravis have been ruled out.
Allergies:
Diagnostic Lab Data: Spinal Tap & Ct head Scan WNL; Tensilon test - Negative. CSF = wnl, EMG - planned.
CDC 'Split Type': 904090014

Write-up: Pt vac w/FLUOGEN developed brain stem disorder, weakness of extremities & hypertension, bilat ptosis, difficulty speaking & swallowing. Admitted to Hosp BP 217/87, P 70min, R 20min, BS 225 mg/DL. Botulism suspected. Tensilon test neg.


Changed on 8/14/2018

VAERS ID: 27304 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dysphagia, Eyelid ptosis, Hyperglycaemia, Hypertension, Speech disorder, Brain stem 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: Catapres, Tambocor, Digoxin, ASA, Clonidine
Current Illness:
Preexisting Conditions: A CVA & Myasthenia gravis have been ruled out.
Allergies:
Diagnostic Lab Data: Spinal Tap & Ct head Scan WNL; Tensilon test - Negative. CSF = wnl, EMG - planned.
CDC 'Split Type': 904090014

Write-up: Pt vac w/FLUOGEN developed brain stem disorder, weakness of extremities & hypertension, bilat ptosis, difficulty speaking & swallowing. Admitted to Hosp BP 217/87, P 70min, R 20min, BS 225 mg/DL. Botulism suspected. Tensilon test neg.


Changed on 9/14/2018

VAERS ID: 27304 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dysphagia, Eyelid ptosis, Hyperglycaemia, Hypertension, Speech disorder, Brain stem 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: Catapres, Tambocor, Digoxin, ASA, Clonidine
Current Illness:
Preexisting Conditions: A CVA & Myasthenia gravis have been ruled out.
Allergies:
Diagnostic Lab Data: Spinal Tap & Ct head Scan WNL; Tensilon test - Negative. CSF = wnl, EMG - planned.
CDC 'Split Type': 904090014

Write-up: Pt vac w/FLUOGEN developed brain stem disorder, weakness of extremities & hypertension, bilat ptosis, difficulty speaking & swallowing. Admitted to Hosp BP 217/87, P 70min, R 20min, BS 225 mg/DL. Botulism suspected. Tensilon test neg.


Changed on 10/14/2018

VAERS ID: 27304 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dysphagia, Eyelid ptosis, Hyperglycaemia, Hypertension, Speech disorder, Brain stem 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: Catapres, Tambocor, Digoxin, ASA, Clonidine
Current Illness:
Preexisting Conditions: A CVA & Myasthenia gravis have been ruled out.
Allergies:
Diagnostic Lab Data: Spinal Tap & Ct head Scan WNL; Tensilon test - Negative. CSF = wnl, EMG - planned.
CDC 'Split Type': 904090014

Write-up: Pt vac w/FLUOGEN developed brain stem disorder, weakness of extremities & hypertension, bilat ptosis, difficulty speaking & swallowing. Admitted to Hosp BP 217/87, P 70min, R 20min, BS 225 mg/DL. Botulism suspected. Tensilon test neg.

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