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This is VAERS ID 27752

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27752
VAERS Form:
Age:60.0
Sex:Male
Location:Florida
Vaccinated:1990-11-20
Onset:1990-11-27
Submitted:1991-01-25
Entered:1991-02-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS / PARKE-DAVIS 02780P / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: PAIN BACK, GUILLAIN BARRE SYND, PARESTHESIA

Life Threatening? No
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: 35     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approx 7d, pain lower back, tingling hands. Approx 14d, severe back pain & pain shooting up arms & legs & numbness in trunk & same area of pain. Hosp 5 wks-Therapy; Meds at home.unk when reflexs, nerves heal or numbness subsides. + GBS.


Changed on 12/8/2009

VAERS ID: 27752 Before After
VAERS Form:
Age:60.0
Sex:Male
Location:Florida
Vaccinated:1990-11-20
Onset:1990-11-27
Submitted:1991-01-25
Entered:1991-02-07 1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS INFLUENZA (SEASONAL) (FLUOGEN 90-91) / PARKE-DAVIS 02780P / - - / -

Administered by: Public      Purchased by: Unknown Private
Symptoms: Back pain, Guillain-Barre syndrome, Paraesthesia, PAIN BACK, GUILLAIN BARRE SYND, PARESTHESIA

Life Threatening? No
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: 35     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approx 7d, pain lower back, tingling hands. Approx 14d, severe back pain & pain shooting up arms & legs & numbness in trunk & same area of pain. Hosp 5 wks-Therapy; Meds at home.unk when reflexs, nerves heal or numbness subsides. + GBS.


Changed on 8/31/2010

VAERS ID: 27752 Before After
VAERS Form:
Age:60.0
Sex:Male
Location:Florida
Vaccinated:1990-11-20
Onset:1990-11-27
Submitted:1991-01-25
Entered:1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 90-91) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / - - / -

Administered by: Public      Purchased by: Private
Symptoms: Back pain, Guillain-Barre syndrome, Paraesthesia

Life Threatening? No
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: 35     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approx 7d, pain lower back, tingling hands. Approx 14d, severe back pain & pain shooting up arms & legs & numbness in trunk & same area of pain. Hosp 5 wks-Therapy; Meds at home.unk when reflexs, nerves heal or numbness subsides. + GBS.


Changed on 7/7/2013

VAERS ID: 27752 Before After
VAERS Form:
Age:60.0
Sex:Male
Location:Florida
Vaccinated:1990-11-20
Onset:1990-11-27
Submitted:1991-01-25
Entered:1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / - - / -

Administered by: Public      Purchased by: Private
Symptoms: Back pain, Guillain-Barre syndrome, Paraesthesia

Life Threatening? No
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: 35     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approx 7d, pain lower back, tingling hands. Approx 14d, severe back pain & pain shooting up arms & legs & numbness in trunk & same area of pain. Hosp 5 wks-Therapy; Meds at home.unk when reflexs, nerves heal or numbness subsides. + GBS.


Changed on 5/14/2017

VAERS ID: 27752 Before After
VAERS Form:
Age:60.0
Sex:Male
Location:Florida
Vaccinated:1990-11-20
Onset:1990-11-27
Submitted:1991-01-25
Entered:1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / - - / -

Administered by: Public      Purchased by: Private
Symptoms: Back pain, Guillain-Barre syndrome, Paraesthesia

Life Threatening? No
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: 35     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approx 7d, pain lower back, tingling hands. Approx 14d, severe back pain & pain shooting up arms & legs & numbness in trunk & same area of pain. Hosp 5 wks-Therapy; Meds at home.unk when reflexs, nerves heal or numbness subsides. + GBS.


Changed on 9/14/2017

VAERS ID: 27752 Before After
VAERS Form:(blank) 1
Age:60.0
Sex:Male
Location:Florida
Vaccinated:1990-11-20
Onset:1990-11-27
Submitted:1991-01-25
Entered:1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / - UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Back pain, Guillain-Barre syndrome, Paraesthesia

Life Threatening? No
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: 35     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approx 7d, pain lower back, tingling hands. Approx 14d, severe back pain & pain shooting up arms & legs & numbness in trunk & same area of pain. Hosp 5 wks-Therapy; Meds at home.unk when reflexs, nerves heal or numbness subsides. + GBS.


Changed on 2/14/2018

VAERS ID: 27752 Before After
VAERS Form:1
Age:60.0
Sex:Male
Location:Florida
Vaccinated:1990-11-20
Onset:1990-11-27
Submitted:1991-01-25
Entered:1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Back pain, Guillain-Barre syndrome, Paraesthesia

Life Threatening? No
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: 35     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approx 7d, pain lower back, tingling hands. Approx 14d, severe back pain & pain shooting up arms & legs & numbness in trunk & same area of pain. Hosp 5 wks-Therapy; Meds at home.unk when reflexs, nerves heal or numbness subsides. + GBS.


Changed on 6/14/2018

VAERS ID: 27752 Before After
VAERS Form:1
Age:60.0
Sex:Male
Location:Florida
Vaccinated:1990-11-20
Onset:1990-11-27
Submitted:1991-01-25
Entered:1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Back pain, Guillain-Barre syndrome, Paraesthesia

Life Threatening? No
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: 35     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approx 7d, pain lower back, tingling hands. Approx 14d, severe back pain & pain shooting up arms & legs & numbness in trunk & same area of pain. Hosp 5 wks-Therapy; Meds at home.unk when reflexs, nerves heal or numbness subsides. + GBS.


Changed on 8/14/2018

VAERS ID: 27752 Before After
VAERS Form:1
Age:60.0
Sex:Male
Location:Florida
Vaccinated:1990-11-20
Onset:1990-11-27
Submitted:1991-01-25
Entered:1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Back pain, Guillain-Barre syndrome, Paraesthesia

Life Threatening? No
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: 35     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approx 7d, pain lower back, tingling hands. Approx 14d, severe back pain & pain shooting up arms & legs & numbness in trunk & same area of pain. Hosp 5 wks-Therapy; Meds at home.unk when reflexs, nerves heal or numbness subsides. + GBS.


Changed on 9/14/2018

VAERS ID: 27752 Before After
VAERS Form:1
Age:60.0
Sex:Male
Location:Florida
Vaccinated:1990-11-20
Onset:1990-11-27
Submitted:1991-01-25
Entered:1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Back pain, Guillain-Barre syndrome, Paraesthesia

Life Threatening? No
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: 35     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approx 7d, pain lower back, tingling hands. Approx 14d, severe back pain & pain shooting up arms & legs & numbness in trunk & same area of pain. Hosp 5 wks-Therapy; Meds at home.unk when reflexs, nerves heal or numbness subsides. + GBS.


Changed on 10/14/2018

VAERS ID: 27752 Before After
VAERS Form:1
Age:60.0
Sex:Male
Location:Florida
Vaccinated:1990-11-20
Onset:1990-11-27
Submitted:1991-01-25
Entered:1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / UNK - / -

Administered by: Public      Purchased by: Private
Symptoms: Back pain, Guillain-Barre syndrome, Paraesthesia

Life Threatening? No
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: 35     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Approx 7d, pain lower back, tingling hands. Approx 14d, severe back pain & pain shooting up arms & legs & numbness in trunk & same area of pain. Hosp 5 wks-Therapy; Meds at home.unk when reflexs, nerves heal or numbness subsides. + GBS.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=27752&WAYBACKHISTORY=ON


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