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This is VAERS ID 35524

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 35524
VAERS Form:
Age:49.6
Sex:Male
Location:New Jersey
Vaccinated:1990-09-27
Onset:1990-10-07
Submitted:1990-10-15
Entered:1991-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH 4908201 / 0 RA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND, ASTHENIA, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NONE

Write-up: following vax pt devel GBS; sx included weakness & tingling in the legs; Hospitalization was required due to progressive weakness; pt improved p/an initial course of 5-6 plasmapheresis tx; 1 wk later, pt was retreated w/5-6 plasmapheresis;


Changed on 12/8/2009

VAERS ID: 35524 Before After
VAERS Form:
Age:49.6
Sex:Male
Location:New Jersey
Vaccinated:1990-09-27
Onset:1990-10-07
Submitted:1990-10-15
Entered:1991-10-22 1991-10-16
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 4908201 / 0 RA / IM

Administered by: Other      Purchased by: Unknown Private
Symptoms: Asthenia, Guillain-Barre syndrome, Paraesthesia, GUILLAIN BARRE SYND, ASTHENIA, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NONE 890312002B

Write-up: following vax pt devel GBS; sx included weakness & tingling in the legs; Hospitalization was required due to progressive weakness; pt improved p/an initial course of 5-6 plasmapheresis tx; 1 wk later, pt was retreated w/5-6 plasmapheresis;


Changed on 8/31/2010

VAERS ID: 35524 Before After
VAERS Form:
Age:49.6
Sex:Male
Location:New Jersey
Vaccinated:1990-09-27
Onset:1990-10-07
Submitted:1990-10-15
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4908201 / 0 RA / IM

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890312002B

Write-up: following vax pt devel GBS; sx included weakness & tingling in the legs; Hospitalization was required due to progressive weakness; pt improved p/an initial course of 5-6 plasmapheresis tx; 1 wk later, pt was retreated w/5-6 plasmapheresis;


Changed on 7/7/2013

VAERS ID: 35524 Before After
VAERS Form:
Age:49.6
Sex:Male
Location:New Jersey
Vaccinated:1990-09-27
Onset:1990-10-07
Submitted:1990-10-15
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / 0 RA / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / 0 RA / IM

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890312002B

Write-up: following vax pt devel GBS; sx included weakness & tingling in the legs; Hospitalization was required due to progressive weakness; pt improved p/an initial course of 5-6 plasmapheresis tx; 1 wk later, pt was retreated w/5-6 plasmapheresis;


Changed on 12/14/2016

VAERS ID: 35524 Before After
VAERS Form:
Age:49.6
Sex:Male
Location:New Jersey
Vaccinated:1990-09-27
Onset:1990-10-07
Submitted:1990-10-15
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / 0 RA / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / 0 RA / IM

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890312002B

Write-up: following vax pt devel GBS; sx included weakness & tingling in the legs; Hospitalization was required due to progressive weakness; pt improved p/an initial course of 5-6 plasmapheresis tx; 1 wk later, pt was retreated w/5-6 plasmapheresis;


Changed on 2/14/2017

VAERS ID: 35524 Before After
VAERS Form:
Age:49.6 49.0
Sex:Male
Location:New Jersey
Vaccinated:1990-09-27
Onset:1990-10-07
Submitted:1990-10-15
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / 0 RA / IM

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890312002B

Write-up: following vax pt devel GBS; sx included weakness & tingling in the legs; Hospitalization was required due to progressive weakness; pt improved p/an initial course of 5-6 plasmapheresis tx; 1 wk later, pt was retreated w/5-6 plasmapheresis;


Changed on 5/14/2017

VAERS ID: 35524 Before After
VAERS Form:
Age:49.0
Sex:Male
Location:New Jersey
Vaccinated:1990-09-27
Onset:1990-10-07
Submitted:1990-10-15
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / 0 RA / IM

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890312002B

Write-up: following vax pt devel GBS; sx included weakness & tingling in the legs; Hospitalization was required due to progressive weakness; pt improved p/an initial course of 5-6 plasmapheresis tx; 1 wk later, pt was retreated w/5-6 plasmapheresis;


Changed on 9/14/2017

VAERS ID: 35524 Before After
VAERS Form:(blank) 1
Age:49.0
Sex:Male
Location:New Jersey
Vaccinated:1990-09-27
Onset:1990-10-07
Submitted:1990-10-15
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / 0 1 RA / IM

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890312002B

Write-up: following vax pt devel GBS; sx included weakness & tingling in the legs; Hospitalization was required due to progressive weakness; pt improved p/an initial course of 5-6 plasmapheresis tx; 1 wk later, pt was retreated w/5-6 plasmapheresis;


Changed on 2/14/2018

VAERS ID: 35524 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:New Jersey
Vaccinated:1990-09-27
Onset:1990-10-07
Submitted:1990-10-15
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / 1 RA / IM

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890312002B

Write-up: following vax pt devel GBS; sx included weakness & tingling in the legs; Hospitalization was required due to progressive weakness; pt improved p/an initial course of 5-6 plasmapheresis tx; 1 wk later, pt was retreated w/5-6 plasmapheresis;


Changed on 6/14/2018

VAERS ID: 35524 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:New Jersey
Vaccinated:1990-09-27
Onset:1990-10-07
Submitted:1990-10-15
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / 1 RA / IM

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890312002B

Write-up: following vax pt devel GBS; sx included weakness & tingling in the legs; Hospitalization was required due to progressive weakness; pt improved p/an initial course of 5-6 plasmapheresis tx; 1 wk later, pt was retreated w/5-6 plasmapheresis;


Changed on 8/14/2018

VAERS ID: 35524 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:New Jersey
Vaccinated:1990-09-27
Onset:1990-10-07
Submitted:1990-10-15
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / 1 RA / IM

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890312002B

Write-up: following vax pt devel GBS; sx included weakness & tingling in the legs; Hospitalization was required due to progressive weakness; pt improved p/an initial course of 5-6 plasmapheresis tx; 1 wk later, pt was retreated w/5-6 plasmapheresis;


Changed on 9/14/2018

VAERS ID: 35524 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:New Jersey
Vaccinated:1990-09-27
Onset:1990-10-07
Submitted:1990-10-15
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / 1 RA / IM

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890312002B

Write-up: following vax pt devel GBS; sx included weakness & tingling in the legs; Hospitalization was required due to progressive weakness; pt improved p/an initial course of 5-6 plasmapheresis tx; 1 wk later, pt was retreated w/5-6 plasmapheresis;


Changed on 10/14/2018

VAERS ID: 35524 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:New Jersey
Vaccinated:1990-09-27
Onset:1990-10-07
Submitted:1990-10-15
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / 1 RA / IM

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890312002B

Write-up: following vax pt devel GBS; sx included weakness & tingling in the legs; Hospitalization was required due to progressive weakness; pt improved p/an initial course of 5-6 plasmapheresis tx; 1 wk later, pt was retreated w/5-6 plasmapheresis;

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