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This is VAERS ID 35646

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 35646
VAERS Form:
Age:62.0
Sex:Female
Location:Pennsylvania
Vaccinated:1991-09-24
Onset:1991-09-24
Submitted:1991-10-01
Entered:1991-10-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLU-IMUNE 1990-1991 LEDERLE / LEDERLE 312978 / - A / IM

Administered by: Private      Purchased by: Unknown
Symptoms: NEUROPATHY, MYELITIS, MYASTHENIA

Life Threatening? Yes
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? Yes, days: 30     Extended hospital stay? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: several medical problems-not specified
Allergies:
Diagnostic Lab Data: Cervical Myelogram-WBC 175; MRI-swelling C4-C6;
CDC 'Split Type': several medical problems-not specified

Write-up: 62 y/o pt immunized 24SEP91 & w/in 12 hrs post vax, pt exp weakness in the lt arm & leg; Hospitalized on 26SEP; dx w/transverse myelitis; tx w/high dose IV steroids; pt stable, still hospitalized as of 8OCT91;


Changed on 12/8/2009

VAERS ID: 35646 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:Pennsylvania
Vaccinated:1991-09-24
Onset:1991-09-24
Submitted:1991-10-01
Entered:1991-10-23 1991-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLU-IMUNE 1990-1991 LEDERLE INFLUENZA (SEASONAL) (FLU-IMUNE 90-91) / LEDERLE LEDERLE LABORATORIES 312978 / - A / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Myasthenic syndrome, Myelitis, Neuropathy, NEUROPATHY, MYELITIS, MYASTHENIA

Life Threatening? Yes
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? Yes, days: 30     Extended hospital stay? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: several medical problems-not specified
Allergies:
Diagnostic Lab Data: Cervical Myelogram-WBC 175; MRI-swelling C4-C6;
CDC 'Split Type': several medical problems-not specified 910183701

Write-up: 62 y/o pt immunized 24SEP91 & w/in 12 hrs post vax, pt exp weakness in the lt arm & leg; Hospitalized on 26SEP; dx w/transverse myelitis; tx w/high dose IV steroids; pt stable, still hospitalized as of 8OCT91;


Changed on 8/31/2010

VAERS ID: 35646 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:Pennsylvania
Vaccinated:1991-09-24
Onset:1991-09-24
Submitted:1991-10-01
Entered:1991-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLU-IMUNE 90-91) INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 312978 / - A / IM

Administered by: Private      Purchased by: Private
Symptoms: Myasthenic syndrome, Myelitis, Neuropathy

Life Threatening? Yes
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? Yes, days: 30     Extended hospital stay? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: several medical problems-not specified
Allergies:
Diagnostic Lab Data: Cervical Myelogram-WBC 175; MRI-swelling C4-C6;
CDC 'Split Type': 910183701

Write-up: 62 y/o pt immunized 24SEP91 & w/in 12 hrs post vax, pt exp weakness in the lt arm & leg; Hospitalized on 26SEP; dx w/transverse myelitis; tx w/high dose IV steroids; pt stable, still hospitalized as of 8OCT91;


Changed on 7/7/2013

VAERS ID: 35646 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:Pennsylvania
Vaccinated:1991-09-24
Onset:1991-09-24
Submitted:1991-10-01
Entered:1991-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 312978 / - A / IM
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 312978 / - A / IM

Administered by: Private      Purchased by: Private
Symptoms: Myasthenic syndrome, Myelitis, Neuropathy

Life Threatening? Yes
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? Yes, days: 30     Extended hospital stay? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: several medical problems-not specified
Allergies:
Diagnostic Lab Data: Cervical Myelogram-WBC 175; MRI-swelling C4-C6;
CDC 'Split Type': 910183701

Write-up: 62 y/o pt immunized 24SEP91 & w/in 12 hrs post vax, pt exp weakness in the lt arm & leg; Hospitalized on 26SEP; dx w/transverse myelitis; tx w/high dose IV steroids; pt stable, still hospitalized as of 8OCT91;


Changed on 5/14/2017

VAERS ID: 35646 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:Pennsylvania
Vaccinated:1991-09-24
Onset:1991-09-24
Submitted:1991-10-01
Entered:1991-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 312978 / - A - / IM IM A

Administered by: Private      Purchased by: Private
Symptoms: Myasthenic syndrome, Myelitis, Neuropathy

Life Threatening? Yes
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? Yes, days: 30     Extended hospital stay? No
Previous Vaccinations: UNK UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: several medical problems-not specified
Allergies:
Diagnostic Lab Data: Cervical Myelogram-WBC 175; MRI-swelling C4-C6;
CDC 'Split Type': 910183701

Write-up: 62 y/o pt immunized 24SEP91 & w/in 12 hrs post vax, pt exp weakness in the lt arm & leg; Hospitalized on 26SEP; dx w/transverse myelitis; tx w/high dose IV steroids; pt stable, still hospitalized as of 8OCT91;


Changed on 9/14/2017

VAERS ID: 35646 Before After
VAERS Form:(blank) 1
Age:62.0
Sex:Female
Location:Pennsylvania
Vaccinated:1991-09-24
Onset:1991-09-24
Submitted:1991-10-01
Entered:1991-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 312978 / - UNK - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Myasthenic syndrome, Myelitis, Neuropathy

Life Threatening? Yes
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? Yes, days: 30     Extended hospital stay? No
Previous Vaccinations: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: several medical problems-not specified
Allergies:
Diagnostic Lab Data: Cervical Myelogram-WBC 175; MRI-swelling C4-C6;
CDC 'Split Type': 910183701

Write-up: 62 y/o pt immunized 24SEP91 & w/in 12 hrs post vax, pt exp weakness in the lt arm & leg; Hospitalized on 26SEP; dx w/transverse myelitis; tx w/high dose IV steroids; pt stable, still hospitalized as of 8OCT91;


Changed on 2/14/2018

VAERS ID: 35646 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Pennsylvania
Vaccinated:1991-09-24
Onset:1991-09-24
Submitted:1991-10-01
Entered:1991-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 312978 / UNK - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Myasthenic syndrome, Myelitis, Neuropathy

Life Threatening? Yes
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? Yes, days: 30     Extended hospital stay? No
Previous Vaccinations: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: several medical problems-not specified
Allergies:
Diagnostic Lab Data: Cervical Myelogram-WBC 175; MRI-swelling C4-C6;
CDC 'Split Type': 910183701

Write-up: 62 y/o pt immunized 24SEP91 & w/in 12 hrs post vax, pt exp weakness in the lt arm & leg; Hospitalized on 26SEP; dx w/transverse myelitis; tx w/high dose IV steroids; pt stable, still hospitalized as of 8OCT91;


Changed on 6/14/2018

VAERS ID: 35646 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Pennsylvania
Vaccinated:1991-09-24
Onset:1991-09-24
Submitted:1991-10-01
Entered:1991-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 312978 / UNK - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Myasthenic syndrome, Myelitis, Neuropathy

Life Threatening? Yes
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? Yes, days: 30     Extended hospital stay? No
Previous Vaccinations: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: several medical problems-not specified
Allergies:
Diagnostic Lab Data: Cervical Myelogram-WBC 175; MRI-swelling C4-C6;
CDC 'Split Type': 910183701

Write-up: 62 y/o pt immunized 24SEP91 & w/in 12 hrs post vax, pt exp weakness in the lt arm & leg; Hospitalized on 26SEP; dx w/transverse myelitis; tx w/high dose IV steroids; pt stable, still hospitalized as of 8OCT91;


Changed on 8/14/2018

VAERS ID: 35646 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Pennsylvania
Vaccinated:1991-09-24
Onset:1991-09-24
Submitted:1991-10-01
Entered:1991-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 312978 / UNK - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Myasthenic syndrome, Myelitis, Neuropathy

Life Threatening? Yes
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? Yes, days: 30     Extended hospital stay? No
Previous Vaccinations: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: several medical problems-not specified
Allergies:
Diagnostic Lab Data: Cervical Myelogram-WBC 175; MRI-swelling C4-C6;
CDC 'Split Type': 910183701

Write-up: 62 y/o pt immunized 24SEP91 & w/in 12 hrs post vax, pt exp weakness in the lt arm & leg; Hospitalized on 26SEP; dx w/transverse myelitis; tx w/high dose IV steroids; pt stable, still hospitalized as of 8OCT91;


Changed on 9/14/2018

VAERS ID: 35646 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Pennsylvania
Vaccinated:1991-09-24
Onset:1991-09-24
Submitted:1991-10-01
Entered:1991-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 312978 / UNK - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Myasthenic syndrome, Myelitis, Neuropathy

Life Threatening? Yes
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? Yes, days: 30     Extended hospital stay? No
Previous Vaccinations: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: several medical problems-not specified
Allergies:
Diagnostic Lab Data: Cervical Myelogram-WBC 175; MRI-swelling C4-C6;
CDC 'Split Type': 910183701

Write-up: 62 y/o pt immunized 24SEP91 & w/in 12 hrs post vax, pt exp weakness in the lt arm & leg; Hospitalized on 26SEP; dx w/transverse myelitis; tx w/high dose IV steroids; pt stable, still hospitalized as of 8OCT91;


Changed on 10/14/2018

VAERS ID: 35646 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Pennsylvania
Vaccinated:1991-09-24
Onset:1991-09-24
Submitted:1991-10-01
Entered:1991-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 312978 / UNK - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Myasthenic syndrome, Myelitis, Neuropathy

Life Threatening? Yes
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? Yes, days: 30     Extended hospital stay? No
Previous Vaccinations: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: several medical problems-not specified
Allergies:
Diagnostic Lab Data: Cervical Myelogram-WBC 175; MRI-swelling C4-C6;
CDC 'Split Type': 910183701

Write-up: 62 y/o pt immunized 24SEP91 & w/in 12 hrs post vax, pt exp weakness in the lt arm & leg; Hospitalized on 26SEP; dx w/transverse myelitis; tx w/high dose IV steroids; pt stable, still hospitalized as of 8OCT91;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=35646&WAYBACKHISTORY=ON


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