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This is VAERS ID 35494

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 35494
VAERS Form:
Age:57.3
Sex:Male
Location:Mississippi
Vaccinated:1991-09-25
Onset:1991-09-26
Submitted:1991-10-10
Entered:1991-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH - / 0 A / IM

Administered by: Private      Purchased by: Unknown
Symptoms: PARALYSIS FACIAL

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Lasix, Hybin
Current Illness: HBP, Prostate Hypertrophy
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NONE

Write-up: Bells Palsy devel 2 days p/receiving vax;


Changed on 12/8/2009

VAERS ID: 35494 Before After
VAERS Form:
Age:57.3
Sex:Male
Location:Mississippi
Vaccinated:1991-09-25
Onset:1991-09-26
Submitted:1991-10-10
Entered:1991-10-17 1991-10-15
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 A / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Facial palsy, PARALYSIS FACIAL

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Lasix, Hybin
Current Illness: HBP, Prostate Hypertrophy
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NONE (blank)

Write-up: Bells Palsy devel 2 days p/receiving vax;


Changed on 8/31/2010

VAERS ID: 35494 Before After
VAERS Form:
Age:57.3
Sex:Male
Location:Mississippi
Vaccinated:1991-09-25
Onset:1991-09-26
Submitted:1991-10-10
Entered:1991-10-15
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 A / IM

Administered by: Private      Purchased by: Private
Symptoms: Facial palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Lasix, Hybin
Current Illness: HBP, Prostate Hypertrophy
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Bells Palsy devel 2 days p/receiving vax;


Changed on 7/7/2013

VAERS ID: 35494 Before After
VAERS Form:
Age:57.3
Sex:Male
Location:Mississippi
Vaccinated:1991-09-25
Onset:1991-09-26
Submitted:1991-10-10
Entered:1991-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 A / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 A / IM

Administered by: Private      Purchased by: Private
Symptoms: Facial palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Lasix, Hybin
Current Illness: HBP, Prostate Hypertrophy
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Bells Palsy devel 2 days p/receiving vax;


Changed on 12/14/2016

VAERS ID: 35494 Before After
VAERS Form:
Age:57.3
Sex:Male
Location:Mississippi
Vaccinated:1991-09-25
Onset:1991-09-26
Submitted:1991-10-10
Entered:1991-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 A / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 A / IM

Administered by: Private      Purchased by: Private
Symptoms: Facial palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Lasix, Hybin
Current Illness: HBP, Prostate Hypertrophy
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Bells Palsy devel 2 days p/receiving vax;


Changed on 2/14/2017

VAERS ID: 35494 Before After
VAERS Form:
Age:57.3 57.0
Sex:Male
Location:Mississippi
Vaccinated:1991-09-25
Onset:1991-09-26
Submitted:1991-10-10
Entered:1991-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 A / IM

Administered by: Private      Purchased by: Private
Symptoms: Facial palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Lasix, Hybin
Current Illness: HBP, Prostate Hypertrophy
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Bells Palsy devel 2 days p/receiving vax;


Changed on 5/14/2017

VAERS ID: 35494 Before After
VAERS Form:
Age:57.0
Sex:Male
Location:Mississippi
Vaccinated:1991-09-25
Onset:1991-09-26
Submitted:1991-10-10
Entered:1991-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 A - / IM IM A

Administered by: Private      Purchased by: Private
Symptoms: Facial palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: Lasix, Hybin
Current Illness: HBP, Prostate Hypertrophy
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Bells Palsy devel 2 days p/receiving vax;


Changed on 9/14/2017

VAERS ID: 35494 Before After
VAERS Form:(blank) 1
Age:57.0
Sex:Male
Location:Mississippi
Vaccinated:1991-09-25
Onset:1991-09-26
Submitted:1991-10-10
Entered:1991-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 1 - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Facial palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Lasix, Hybin
Current Illness: HBP, Prostate Hypertrophy
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Bells Palsy devel 2 days p/receiving vax;


Changed on 2/14/2018

VAERS ID: 35494 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Mississippi
Vaccinated:1991-09-25
Onset:1991-09-26
Submitted:1991-10-10
Entered:1991-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Facial palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Lasix, Hybin
Current Illness: HBP, Prostate Hypertrophy
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Bells Palsy devel 2 days p/receiving vax;


Changed on 6/14/2018

VAERS ID: 35494 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Mississippi
Vaccinated:1991-09-25
Onset:1991-09-26
Submitted:1991-10-10
Entered:1991-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Facial palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Lasix, Hybin
Current Illness: HBP, Prostate Hypertrophy
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Bells Palsy devel 2 days p/receiving vax;


Changed on 8/14/2018

VAERS ID: 35494 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Mississippi
Vaccinated:1991-09-25
Onset:1991-09-26
Submitted:1991-10-10
Entered:1991-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Facial palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Lasix, Hybin
Current Illness: HBP, Prostate Hypertrophy
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Bells Palsy devel 2 days p/receiving vax;


Changed on 9/14/2018

VAERS ID: 35494 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Mississippi
Vaccinated:1991-09-25
Onset:1991-09-26
Submitted:1991-10-10
Entered:1991-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Facial palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Lasix, Hybin
Current Illness: HBP, Prostate Hypertrophy
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Bells Palsy devel 2 days p/receiving vax;


Changed on 10/14/2018

VAERS ID: 35494 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Mississippi
Vaccinated:1991-09-25
Onset:1991-09-26
Submitted:1991-10-10
Entered:1991-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Facial palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Lasix, Hybin
Current Illness: HBP, Prostate Hypertrophy
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Bells Palsy devel 2 days p/receiving vax;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=35494&WAYBACKHISTORY=ON


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