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This is VAERS ID 36479

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 36479
VAERS Form:
Age:55.0
Sex:Female
Location:California
Vaccinated:1990-10-31
Onset:1990-11-14
Submitted:1991-01-16
Entered:1991-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 11222 / 0 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: HYPOTENS, GUILLAIN BARRE SYND, MYALGIA, ASTHENIA, HYPERESTHESIA

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: 16     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: Premarin/Provera, Inderal
Current Illness: NONE
Preexisting Conditions: Hypertension, migraines, tremor in lt hand for 15 hrs controlled by inderal;
Allergies:
Diagnostic Lab Data: LP x 1 28NOV MRI head/neck in hosp; 23DEC MRI head, to be repeated in April, Blood test in hosp thinks Ca & K was low; pt doesn''t have results;
CDC 'Split Type': Hypertension, migraines, tremor in lt hand for 15 hrs controlled by inderal;

Write-up: 14NOV90 tingling & cold hands & feet; 16NOV90 Seen by MD tingling, hypersensitive to touch, no response to knee reflex, tired; 22NOV90 unable to eat much, trouble ambulating, slurred speech, vision problems; poss GBS, backache, low BP;


Changed on 12/8/2009

VAERS ID: 36479 Before After
VAERS Form:
Age:55.0
Sex:Female
Location:California
Vaccinated:1990-10-31
Onset:1990-11-14
Submitted:1991-01-16
Entered:1991-11-21 1991-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABS CONNAUGHT LABORATORIES 11222 / 0 LA / -

Administered by: Public      Purchased by: Unknown Public
Symptoms: Asthenia, Guillain-Barre syndrome, Hyperaesthesia, Hypotension, Myalgia, Paraesthesia, Speech disorder, Visual disturbance, HYPOTENS, GUILLAIN BARRE SYND, MYALGIA, ASTHENIA, HYPERESTHESIA

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: 16     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: Premarin/Provera, Inderal
Current Illness: NONE
Preexisting Conditions: Hypertension, migraines, tremor in lt hand for 15 hrs controlled by inderal;
Allergies:
Diagnostic Lab Data: LP x 1 28NOV MRI head/neck in hosp; 23DEC MRI head, to be repeated in April, Blood test in hosp thinks Ca & K was low; pt doesn''t have results;
CDC 'Split Type': Hypertension, migraines, tremor in lt hand for 15 hrs controlled by inderal; CA91126

Write-up: 14NOV90 tingling & cold hands & feet; 16NOV90 Seen by MD tingling, hypersensitive to touch, no response to knee reflex, tired; 22NOV90 unable to eat much, trouble ambulating, slurred speech, vision problems; poss GBS, backache, low BP;


Changed on 8/31/2010

VAERS ID: 36479 Before After
VAERS Form:
Age:55.0
Sex:Female
Location:California
Vaccinated:1990-10-31
Onset:1990-11-14
Submitted:1991-01-16
Entered:1991-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11222 / 0 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Guillain-Barre syndrome, Hyperaesthesia, Hypotension, Myalgia, Paraesthesia, Speech disorder, Visual disturbance

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: 16     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: Premarin/Provera, Inderal
Current Illness: NONE
Preexisting Conditions: Hypertension, migraines, tremor in lt hand for 15 hrs controlled by inderal;
Allergies:
Diagnostic Lab Data: LP x 1 28NOV MRI head/neck in hosp; 23DEC MRI head, to be repeated in April, Blood test in hosp thinks Ca & K was low; pt doesn''t have results;
CDC 'Split Type': CA91126

Write-up: 14NOV90 tingling & cold hands & feet; 16NOV90 Seen by MD tingling, hypersensitive to touch, no response to knee reflex, tired; 22NOV90 unable to eat much, trouble ambulating, slurred speech, vision problems; poss GBS, backache, low BP;


Changed on 7/7/2013

VAERS ID: 36479 Before After
VAERS Form:
Age:55.0
Sex:Female
Location:California
Vaccinated:1990-10-31
Onset:1990-11-14
Submitted:1991-01-16
Entered:1991-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11222 / 0 LA / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11222 / 0 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Guillain-Barre syndrome, Hyperaesthesia, Hypotension, Myalgia, Paraesthesia, Speech disorder, Visual disturbance

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: 16     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: Premarin/Provera, Inderal
Current Illness: NONE
Preexisting Conditions: Hypertension, migraines, tremor in lt hand for 15 hrs controlled by inderal;
Allergies:
Diagnostic Lab Data: LP x 1 28NOV MRI head/neck in hosp; 23DEC MRI head, to be repeated in April, Blood test in hosp thinks Ca & K was low; pt doesn''t have results;
CDC 'Split Type': CA91126

Write-up: 14NOV90 tingling & cold hands & feet; 16NOV90 Seen by MD tingling, hypersensitive to touch, no response to knee reflex, tired; 22NOV90 unable to eat much, trouble ambulating, slurred speech, vision problems; poss GBS, backache, low BP;


Changed on 5/14/2017

VAERS ID: 36479 Before After
VAERS Form:
Age:55.0
Sex:Female
Location:California
Vaccinated:1990-10-31
Onset:1990-11-14
Submitted:1991-01-16
Entered:1991-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11222 / 0 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Guillain-Barre syndrome, Hyperaesthesia, Hypotension, Myalgia, Paraesthesia, Speech disorder, Visual disturbance

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: 16     Extended hospital stay? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: Premarin/Provera, Inderal
Current Illness: NONE
Preexisting Conditions: Hypertension, migraines, tremor in lt hand for 15 hrs controlled by inderal;
Allergies:
Diagnostic Lab Data: LP x 1 28NOV MRI head/neck in hosp; 23DEC MRI head, to be repeated in April, Blood test in hosp thinks Ca & K was low; pt doesn''t have results;
CDC 'Split Type': CA91126

Write-up: 14NOV90 tingling & cold hands & feet; 16NOV90 Seen by MD tingling, hypersensitive to touch, no response to knee reflex, tired; 22NOV90 unable to eat much, trouble ambulating, slurred speech, vision problems; poss GBS, backache, low BP;


Changed on 9/14/2017

VAERS ID: 36479 Before After
VAERS Form:(blank) 1
Age:55.0
Sex:Female
Location:California
Vaccinated:1990-10-31
Onset:1990-11-14
Submitted:1991-01-16
Entered:1991-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11222 / 0 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Guillain-Barre syndrome, Hyperaesthesia, Hypotension, Myalgia, Paraesthesia, Speech disorder, Visual disturbance

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: 16     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Premarin/Provera, Inderal
Current Illness: NONE
Preexisting Conditions: Hypertension, migraines, tremor in lt hand for 15 hrs controlled by inderal;
Allergies:
Diagnostic Lab Data: LP x 1 28NOV MRI head/neck in hosp; 23DEC MRI head, to be repeated in April, Blood test in hosp thinks Ca & K was low; pt doesn''t have results;
CDC 'Split Type': CA91126

Write-up: 14NOV90 tingling & cold hands & feet; 16NOV90 Seen by MD tingling, hypersensitive to touch, no response to knee reflex, tired; 22NOV90 unable to eat much, trouble ambulating, slurred speech, vision problems; poss GBS, backache, low BP;


Changed on 2/14/2018

VAERS ID: 36479 Before After
VAERS Form:1
Age:55.0
Sex:Female
Location:California
Vaccinated:1990-10-31
Onset:1990-11-14
Submitted:1991-01-16
Entered:1991-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11222 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Guillain-Barre syndrome, Hyperaesthesia, Hypotension, Myalgia, Paraesthesia, Speech disorder, Visual disturbance

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: 16     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Premarin/Provera, Inderal
Current Illness: NONE
Preexisting Conditions: Hypertension, migraines, tremor in lt hand for 15 hrs controlled by inderal;
Allergies:
Diagnostic Lab Data: LP x 1 28NOV MRI head/neck in hosp; 23DEC MRI head, to be repeated in April, Blood test in hosp thinks Ca & K was low; pt doesn''t have results;
CDC 'Split Type': CA91126

Write-up: 14NOV90 tingling & cold hands & feet; 16NOV90 Seen by MD tingling, hypersensitive to touch, no response to knee reflex, tired; 22NOV90 unable to eat much, trouble ambulating, slurred speech, vision problems; poss GBS, backache, low BP;


Changed on 6/14/2018

VAERS ID: 36479 Before After
VAERS Form:1
Age:55.0
Sex:Female
Location:California
Vaccinated:1990-10-31
Onset:1990-11-14
Submitted:1991-01-16
Entered:1991-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11222 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Guillain-Barre syndrome, Hyperaesthesia, Hypotension, Myalgia, Paraesthesia, Speech disorder, Visual disturbance

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: 16     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Premarin/Provera, Inderal
Current Illness: NONE
Preexisting Conditions: Hypertension, migraines, tremor in lt hand for 15 hrs controlled by inderal;
Allergies:
Diagnostic Lab Data: LP x 1 28NOV MRI head/neck in hosp; 23DEC MRI head, to be repeated in April, Blood test in hosp thinks Ca & K was low; pt doesn''t have results;
CDC 'Split Type': CA91126

Write-up: 14NOV90 tingling & cold hands & feet; 16NOV90 Seen by MD tingling, hypersensitive to touch, no response to knee reflex, tired; 22NOV90 unable to eat much, trouble ambulating, slurred speech, vision problems; poss GBS, backache, low BP;


Changed on 8/14/2018

VAERS ID: 36479 Before After
VAERS Form:1
Age:55.0
Sex:Female
Location:California
Vaccinated:1990-10-31
Onset:1990-11-14
Submitted:1991-01-16
Entered:1991-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11222 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Guillain-Barre syndrome, Hyperaesthesia, Hypotension, Myalgia, Paraesthesia, Speech disorder, Visual disturbance

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: 16     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Premarin/Provera, Inderal
Current Illness: NONE
Preexisting Conditions: Hypertension, migraines, tremor in lt hand for 15 hrs controlled by inderal;
Allergies:
Diagnostic Lab Data: LP x 1 28NOV MRI head/neck in hosp; 23DEC MRI head, to be repeated in April, Blood test in hosp thinks Ca & K was low; pt doesn''t have results;
CDC 'Split Type': CA91126

Write-up: 14NOV90 tingling & cold hands & feet; 16NOV90 Seen by MD tingling, hypersensitive to touch, no response to knee reflex, tired; 22NOV90 unable to eat much, trouble ambulating, slurred speech, vision problems; poss GBS, backache, low BP;


Changed on 9/14/2018

VAERS ID: 36479 Before After
VAERS Form:1
Age:55.0
Sex:Female
Location:California
Vaccinated:1990-10-31
Onset:1990-11-14
Submitted:1991-01-16
Entered:1991-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11222 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Guillain-Barre syndrome, Hyperaesthesia, Hypotension, Myalgia, Paraesthesia, Speech disorder, Visual disturbance

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: 16     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Premarin/Provera, Inderal
Current Illness: NONE
Preexisting Conditions: Hypertension, migraines, tremor in lt hand for 15 hrs controlled by inderal;
Allergies:
Diagnostic Lab Data: LP x 1 28NOV MRI head/neck in hosp; 23DEC MRI head, to be repeated in April, Blood test in hosp thinks Ca & K was low; pt doesn''t have results;
CDC 'Split Type': CA91126

Write-up: 14NOV90 tingling & cold hands & feet; 16NOV90 Seen by MD tingling, hypersensitive to touch, no response to knee reflex, tired; 22NOV90 unable to eat much, trouble ambulating, slurred speech, vision problems; poss GBS, backache, low BP;


Changed on 10/14/2018

VAERS ID: 36479 Before After
VAERS Form:1
Age:55.0
Sex:Female
Location:California
Vaccinated:1990-10-31
Onset:1990-11-14
Submitted:1991-01-16
Entered:1991-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11222 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Guillain-Barre syndrome, Hyperaesthesia, Hypotension, Myalgia, Paraesthesia, Speech disorder, Visual disturbance

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: 16     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Premarin/Provera, Inderal
Current Illness: NONE
Preexisting Conditions: Hypertension, migraines, tremor in lt hand for 15 hrs controlled by inderal;
Allergies:
Diagnostic Lab Data: LP x 1 28NOV MRI head/neck in hosp; 23DEC MRI head, to be repeated in April, Blood test in hosp thinks Ca & K was low; pt doesn''t have results;
CDC 'Split Type': CA91126

Write-up: 14NOV90 tingling & cold hands & feet; 16NOV90 Seen by MD tingling, hypersensitive to touch, no response to knee reflex, tired; 22NOV90 unable to eat much, trouble ambulating, slurred speech, vision problems; poss GBS, backache, low BP;

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