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This is VAERS ID 31380

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 31380
VAERS Form:
Age:61.3
Sex:Male
Location:Connecticut
Vaccinated:1990-09-28
Onset:1990-10-10
Submitted:1991-06-12
Entered:1991-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH - / 0 LA / -

Administered by: Private      Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND, MYASTHENIA, CSF ABNORM

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Cardizem
Current Illness: HTN, ASHD
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: spinal tap showing elevated protein
CDC 'Split Type':

Write-up: Pt recvd vax 28SEP90. Pt developed progressive muscle weakness. Hospitalized 11OCT90 w/acute Guillian-Barre Synd. The pt required plasmapheresis & respirator support.


Changed on 12/8/2009

VAERS ID: 31380 Before After
VAERS Form:
Age:61.3
Sex:Male
Location:Connecticut
Vaccinated:1990-09-28
Onset:1990-10-10
Submitted:1991-06-12
Entered:1991-06-20 1991-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) / WYETH WYETH PHARMACEUTICALS, INC - / 0 LA / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome, CSF test abnormal, GUILLAIN BARRE SYND, MYASTHENIA, CSF ABNORM

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Cardizem
Current Illness: HTN, ASHD
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: spinal tap showing elevated protein
CDC 'Split Type':

Write-up: Pt recvd vax 28SEP90. Pt developed progressive muscle weakness. Hospitalized 11OCT90 w/acute Guillian-Barre Synd. The pt required plasmapheresis & respirator support.


Changed on 8/31/2010

VAERS ID: 31380 Before After
VAERS Form:
Age:61.3
Sex:Male
Location:Connecticut
Vaccinated:1990-09-28
Onset:1990-10-10
Submitted:1991-06-12
Entered:1991-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / 0 LA / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Cardizem
Current Illness: HTN, ASHD
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: spinal tap showing elevated protein
CDC 'Split Type':

Write-up: Pt recvd vax 28SEP90. Pt developed progressive muscle weakness. Hospitalized 11OCT90 w/acute Guillian-Barre Synd. The pt required plasmapheresis & respirator support.


Changed on 7/7/2013

VAERS ID: 31380 Before After
VAERS Form:
Age:61.3
Sex:Male
Location:Connecticut
Vaccinated:1990-09-28
Onset:1990-10-10
Submitted:1991-06-12
Entered:1991-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 LA / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 LA / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Cardizem
Current Illness: HTN, ASHD
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: spinal tap showing elevated protein
CDC 'Split Type':

Write-up: Pt recvd vax 28SEP90. Pt developed progressive muscle weakness. Hospitalized 11OCT90 w/acute Guillian-Barre Synd. The pt required plasmapheresis & respirator support.


Changed on 12/14/2016

VAERS ID: 31380 Before After
VAERS Form:
Age:61.3
Sex:Male
Location:Connecticut
Vaccinated:1990-09-28
Onset:1990-10-10
Submitted:1991-06-12
Entered:1991-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 LA / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 LA / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Cardizem
Current Illness: HTN, ASHD
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: spinal tap showing elevated protein
CDC 'Split Type':

Write-up: Pt recvd vax 28SEP90. Pt developed progressive muscle weakness. Hospitalized 11OCT90 w/acute Guillian-Barre Synd. The pt required plasmapheresis & respirator support.


Changed on 2/14/2017

VAERS ID: 31380 Before After
VAERS Form:
Age:61.3 61.0
Sex:Male
Location:Connecticut
Vaccinated:1990-09-28
Onset:1990-10-10
Submitted:1991-06-12
Entered:1991-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 LA / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Cardizem
Current Illness: HTN, ASHD
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: spinal tap showing elevated protein
CDC 'Split Type':

Write-up: Pt recvd vax 28SEP90. Pt developed progressive muscle weakness. Hospitalized 11OCT90 w/acute Guillian-Barre Synd. The pt required plasmapheresis & respirator support.


Changed on 5/14/2017

VAERS ID: 31380 Before After
VAERS Form:
Age:61.0
Sex:Male
Location:Connecticut
Vaccinated:1990-09-28
Onset:1990-10-10
Submitted:1991-06-12
Entered:1991-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 LA / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Cardizem
Current Illness: HTN, ASHD
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: spinal tap showing elevated protein
CDC 'Split Type':

Write-up: Pt recvd vax 28SEP90. Pt developed progressive muscle weakness. Hospitalized 11OCT90 w/acute Guillian-Barre Synd. The pt required plasmapheresis & respirator support.


Changed on 9/14/2017

VAERS ID: 31380 Before After
VAERS Form:(blank) 1
Age:61.0
Sex:Male
Location:Connecticut
Vaccinated:1990-09-28
Onset:1990-10-10
Submitted:1991-06-12
Entered:1991-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 1 LA / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Cardizem
Current Illness: HTN, ASHD
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: spinal tap showing elevated protein
CDC 'Split Type':

Write-up: Pt recvd vax 28SEP90. Pt developed progressive muscle weakness. Hospitalized 11OCT90 w/acute Guillian-Barre Synd. The pt required plasmapheresis & respirator support.


Changed on 2/14/2018

VAERS ID: 31380 Before After
VAERS Form:1
Age:61.0
Sex:Male
Location:Connecticut
Vaccinated:1990-09-28
Onset:1990-10-10
Submitted:1991-06-12
Entered:1991-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 LA / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Cardizem
Current Illness: HTN, ASHD
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: spinal tap showing elevated protein
CDC 'Split Type':

Write-up: Pt recvd vax 28SEP90. Pt developed progressive muscle weakness. Hospitalized 11OCT90 w/acute Guillian-Barre Synd. The pt required plasmapheresis & respirator support.


Changed on 6/14/2018

VAERS ID: 31380 Before After
VAERS Form:1
Age:61.0
Sex:Male
Location:Connecticut
Vaccinated:1990-09-28
Onset:1990-10-10
Submitted:1991-06-12
Entered:1991-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 LA / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Cardizem
Current Illness: HTN, ASHD
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: spinal tap showing elevated protein
CDC 'Split Type':

Write-up: Pt recvd vax 28SEP90. Pt developed progressive muscle weakness. Hospitalized 11OCT90 w/acute Guillian-Barre Synd. The pt required plasmapheresis & respirator support.


Changed on 8/14/2018

VAERS ID: 31380 Before After
VAERS Form:1
Age:61.0
Sex:Male
Location:Connecticut
Vaccinated:1990-09-28
Onset:1990-10-10
Submitted:1991-06-12
Entered:1991-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 LA / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Cardizem
Current Illness: HTN, ASHD
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: spinal tap showing elevated protein
CDC 'Split Type':

Write-up: Pt recvd vax 28SEP90. Pt developed progressive muscle weakness. Hospitalized 11OCT90 w/acute Guillian-Barre Synd. The pt required plasmapheresis & respirator support.


Changed on 9/14/2018

VAERS ID: 31380 Before After
VAERS Form:1
Age:61.0
Sex:Male
Location:Connecticut
Vaccinated:1990-09-28
Onset:1990-10-10
Submitted:1991-06-12
Entered:1991-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 LA / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Cardizem
Current Illness: HTN, ASHD
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: spinal tap showing elevated protein
CDC 'Split Type':

Write-up: Pt recvd vax 28SEP90. Pt developed progressive muscle weakness. Hospitalized 11OCT90 w/acute Guillian-Barre Synd. The pt required plasmapheresis & respirator support.


Changed on 10/14/2018

VAERS ID: 31380 Before After
VAERS Form:1
Age:61.0
Sex:Male
Location:Connecticut
Vaccinated:1990-09-28
Onset:1990-10-10
Submitted:1991-06-12
Entered:1991-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 LA / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Cardizem
Current Illness: HTN, ASHD
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: spinal tap showing elevated protein
CDC 'Split Type':

Write-up: Pt recvd vax 28SEP90. Pt developed progressive muscle weakness. Hospitalized 11OCT90 w/acute Guillian-Barre Synd. The pt required plasmapheresis & respirator support.

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