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This is VAERS ID 35525

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 35525
VAERS Form:
Age:74.5
Sex:Female
Location:Illinois
Vaccinated:1990-12-04
Onset:1990-12-19
Submitted:1991-06-11
Entered:1991-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH 4908195 / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND, PARALYSIS

Life Threatening? Yes
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: 21     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Regroton, Procardia
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS severe hosp care under MD;


Changed on 12/8/2009

VAERS ID: 35525 Before After
VAERS Form:
Age:74.5
Sex:Female
Location:Illinois
Vaccinated:1990-12-04
Onset:1990-12-19
Submitted:1991-06-11
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 4908195 / - - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Guillain-Barre syndrome, Paralysis, GUILLAIN BARRE SYND, PARALYSIS

Life Threatening? Yes
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: 21     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Regroton, Procardia
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 891198011B

Write-up: GBS severe hosp care under MD;


Changed on 8/31/2010

VAERS ID: 35525 Before After
VAERS Form:
Age:74.5
Sex:Female
Location:Illinois
Vaccinated:1990-12-04
Onset:1990-12-19
Submitted:1991-06-11
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 4908195 / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Paralysis

Life Threatening? Yes
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: 21     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Regroton, Procardia
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891198011B

Write-up: GBS severe hosp care under MD;


Changed on 7/7/2013

VAERS ID: 35525 Before After
VAERS Form:
Age:74.5
Sex:Female
Location:Illinois
Vaccinated:1990-12-04
Onset:1990-12-19
Submitted:1991-06-11
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908195 / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908195 / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Paralysis

Life Threatening? Yes
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: 21     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Regroton, Procardia
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891198011B

Write-up: GBS severe hosp care under MD;


Changed on 12/14/2016

VAERS ID: 35525 Before After
VAERS Form:
Age:74.5
Sex:Female
Location:Illinois
Vaccinated:1990-12-04
Onset:1990-12-19
Submitted:1991-06-11
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908195 / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908195 / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Paralysis

Life Threatening? Yes
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: 21     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Regroton, Procardia
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891198011B

Write-up: GBS severe hosp care under MD;


Changed on 2/14/2017

VAERS ID: 35525 Before After
VAERS Form:
Age:74.5 74.0
Sex:Female
Location:Illinois
Vaccinated:1990-12-04
Onset:1990-12-19
Submitted:1991-06-11
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908195 / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Paralysis

Life Threatening? Yes
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: 21     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Regroton, Procardia
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891198011B

Write-up: GBS severe hosp care under MD;


Changed on 5/14/2017

VAERS ID: 35525 Before After
VAERS Form:
Age:74.0
Sex:Female
Location:Illinois
Vaccinated:1990-12-04
Onset:1990-12-19
Submitted:1991-06-11
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908195 / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Paralysis

Life Threatening? Yes
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: 21     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Regroton, Procardia UNK
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': 891198011B

Write-up: Pt devel GBS severe hosp care under MD; w/paralysis approx 3 wks p/receiving influenza vax; pt believes the vax caused this problem;


Changed on 9/14/2017

VAERS ID: 35525 Before After
VAERS Form:(blank) 1
Age:74.0
Sex:Female
Location:Illinois
Vaccinated:1990-12-04
Onset:1990-12-19
Submitted:1991-06-11
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908195 / - UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Paralysis

Life Threatening? Yes
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: 21     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': 891198011B

Write-up: Pt devel GBS w/paralysis approx 3 wks p/receiving influenza vax; pt believes the vax caused this problem;


Changed on 2/14/2018

VAERS ID: 35525 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Illinois
Vaccinated:1990-12-04
Onset:1990-12-19
Submitted:1991-06-11
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908195 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Paralysis

Life Threatening? Yes
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: 21     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': 891198011B

Write-up: Pt devel GBS w/paralysis approx 3 wks p/receiving influenza vax; pt believes the vax caused this problem;


Changed on 6/14/2018

VAERS ID: 35525 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Illinois
Vaccinated:1990-12-04
Onset:1990-12-19
Submitted:1991-06-11
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908195 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Paralysis

Life Threatening? Yes
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: 21     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': 891198011B

Write-up: Pt devel GBS w/paralysis approx 3 wks p/receiving influenza vax; pt believes the vax caused this problem;


Changed on 8/14/2018

VAERS ID: 35525 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Illinois
Vaccinated:1990-12-04
Onset:1990-12-19
Submitted:1991-06-11
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908195 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Paralysis

Life Threatening? Yes
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: 21     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': 891198011B

Write-up: Pt devel GBS w/paralysis approx 3 wks p/receiving influenza vax; pt believes the vax caused this problem;


Changed on 9/14/2018

VAERS ID: 35525 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Illinois
Vaccinated:1990-12-04
Onset:1990-12-19
Submitted:1991-06-11
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908195 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Paralysis

Life Threatening? Yes
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: 21     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': 891198011B

Write-up: Pt devel GBS w/paralysis approx 3 wks p/receiving influenza vax; pt believes the vax caused this problem;


Changed on 10/14/2018

VAERS ID: 35525 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Illinois
Vaccinated:1990-12-04
Onset:1990-12-19
Submitted:1991-06-11
Entered:1991-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908195 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Guillain-Barre syndrome, Paralysis

Life Threatening? Yes
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: 21     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': 891198011B

Write-up: Pt devel GBS w/paralysis approx 3 wks p/receiving influenza vax; pt believes the vax caused this problem;

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