National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 27816

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27816
VAERS Form:
Age:62.2
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-12
Submitted:1991-01-28
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLU-IMUNE 1990-1991 LEDERLE / LEDERLE 287973 / 0 A / IM

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, APNEA, PARALYSIS, ATROPHY MUSCLE

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: neck & back sprain (auto accident)
Allergies:
Diagnostic Lab Data: See hospital records; See treating physicians (Stuart or Barreda)
CDC 'Split Type':

Write-up: Fever, respiratory paralysis, etc. Admitted for about 2 wks. Under care of neurologists including automatic respirator.


Changed on 12/8/2009

VAERS ID: 27816 Before After
VAERS Form:
Age:62.2
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-12
Submitted:1991-01-28
Entered:1991-02-12 1991-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLU-IMUNE 1990-1991 LEDERLE INFLUENZA (SEASONAL) (FLU-IMUNE 90-91) / LEDERLE LEDERLE LABORATORIES 287973 / 0 A / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Apnoea, Muscle atrophy, Paralysis, Pyrexia, FEVER, APNEA, PARALYSIS, ATROPHY MUSCLE

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: neck & back sprain (auto accident)
Allergies:
Diagnostic Lab Data: See hospital records; See treating physicians (Stuart or Barreda)
CDC 'Split Type':

Write-up: Fever, respiratory paralysis, etc. Admitted for about 2 wks. Under care of neurologists including automatic respirator.


Changed on 8/31/2010

VAERS ID: 27816 Before After
VAERS Form:
Age:62.2
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-12
Submitted:1991-01-28
Entered:1991-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLU-IMUNE 90-91) INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / 0 A / IM

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Muscle atrophy, Paralysis, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: neck & back sprain (auto accident)
Allergies:
Diagnostic Lab Data: See hospital records; See treating physicians (Stuart or Barreda)
CDC 'Split Type':

Write-up: Fever, respiratory paralysis, etc. Admitted for about 2 wks. Under care of neurologists including automatic respirator.


Changed on 2/13/2013

VAERS ID: 27816 Before After
VAERS Form:
Age:62.2 62.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-12
Submitted:1991-01-28
Entered:1991-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / 0 A - / IM -

Administered by: Private Unknown      Purchased by: Private Unknown
Symptoms: Apnoea, Muscle atrophy, Paralysis, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: neck & back sprain (auto accident)
Allergies:
Diagnostic Lab Data: See hospital records; See treating physicians (Stuart or Barreda) physicians.
CDC 'Split Type':

Write-up: Fever, respiratory paralysis, etc. Admitted for about 2 wks. Under care of neurologists including automatic respirator.


Changed on 7/7/2013

VAERS ID: 27816 Before After
VAERS Form:
Age:62.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-12
Submitted:1991-01-28
Entered:1991-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / 0 - / -
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / 0 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Muscle atrophy, Paralysis, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: neck & back sprain (auto accident)
Allergies:
Diagnostic Lab Data: See hospital records; See treating physicians.
CDC 'Split Type':

Write-up: Fever, respiratory paralysis, etc. Admitted for about 2 wks. Under care of neurologists including automatic respirator.


Changed on 9/14/2017

VAERS ID: 27816 Before After
VAERS Form:(blank) 1
Age:62.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-12
Submitted:1991-01-28
Entered:1991-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / 0 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Muscle atrophy, Paralysis, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: neck & back sprain (auto accident)
Allergies:
Diagnostic Lab Data: See hospital records; See treating physicians.
CDC 'Split Type':

Write-up: Fever, respiratory paralysis, etc. Admitted for about 2 wks. Under care of neurologists including automatic respirator.


Changed on 2/14/2018

VAERS ID: 27816 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-12
Submitted:1991-01-28
Entered:1991-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Muscle atrophy, Paralysis, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: neck & back sprain (auto accident)
Allergies:
Diagnostic Lab Data: See hospital records; See treating physicians.
CDC 'Split Type':

Write-up: Fever, respiratory paralysis, etc. Admitted for about 2 wks. Under care of neurologists including automatic respirator.


Changed on 6/14/2018

VAERS ID: 27816 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-12
Submitted:1991-01-28
Entered:1991-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Muscle atrophy, Paralysis, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: neck & back sprain (auto accident)
Allergies:
Diagnostic Lab Data: See hospital records; See treating physicians.
CDC 'Split Type':

Write-up: Fever, respiratory paralysis, etc. Admitted for about 2 wks. Under care of neurologists including automatic respirator.


Changed on 8/14/2018

VAERS ID: 27816 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-12
Submitted:1991-01-28
Entered:1991-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Muscle atrophy, Paralysis, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: neck & back sprain (auto accident)
Allergies:
Diagnostic Lab Data: See hospital records; See treating physicians.
CDC 'Split Type':

Write-up: Fever, respiratory paralysis, etc. Admitted for about 2 wks. Under care of neurologists including automatic respirator.


Changed on 9/14/2018

VAERS ID: 27816 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-12
Submitted:1991-01-28
Entered:1991-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Muscle atrophy, Paralysis, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: neck & back sprain (auto accident)
Allergies:
Diagnostic Lab Data: See hospital records; See treating physicians.
CDC 'Split Type':

Write-up: Fever, respiratory paralysis, etc. Admitted for about 2 wks. Under care of neurologists including automatic respirator.


Changed on 10/14/2018

VAERS ID: 27816 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:Florida
Vaccinated:1990-10-30
Onset:1990-11-12
Submitted:1991-01-28
Entered:1991-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Muscle atrophy, Paralysis, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: neck & back sprain (auto accident)
Allergies:
Diagnostic Lab Data: See hospital records; See treating physicians.
CDC 'Split Type':

Write-up: Fever, respiratory paralysis, etc. Admitted for about 2 wks. Under care of neurologists including automatic respirator.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=27816&WAYBACKHISTORY=ON


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166