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This is VAERS ID 36611

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 36611
VAERS Form:
Age:56.7
Sex:Female
Location:Missouri
Vaccinated:1991-10-31
Onset:1991-11-09
Submitted:1991-11-15
Entered:1991-12-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1991-1992 / WYETH 4918146 / 0 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: HYPOKINESIA, GUILLAIN BARRE SYND, MYALGIA, MYASTHENIA, DYSPHAGIA

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Advil, Cardizem
Current Illness: NONE
Preexisting Conditions: arthritis; hyperderssion sinc 3; hypothyroidism, allergic to PCN
Allergies:
Diagnostic Lab Data: CBC-normal; p-3.6; otherwise chem normal; Electormogram; CSF; GM slain-neg; smear fangus-neg; glucose; protein, APT; electrolytes, SGPT, total CPK, sigmoid; LP revealed mild inc in portein in spinal fluid & GBS dx; CXR-normal
CDC 'Split Type':

Write-up: 9NOV91 numbness & tingling lower extremities; 10NOV91 could no longer stand; arms have movement but weak;grasp weak, vomiting, muscular pain, some difficulty swallowing;

Changed on 12/8/2009

VAERS ID: 36611 Before After
VAERS Form:
Age:56.7
Sex:Female
Location:Missouri
Vaccinated:1991-10-31
Onset:1991-11-09
Submitted:1991-11-15
Entered:1991-12-02 1991-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1991-1992 INFLUENZA (SEASONAL) (NO BRAND NAME, 91-92) / WYETH WYETH PHARMACEUTICALS, INC 4918146 / 0 LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Dysphagia, Guillain-Barre syndrome, Hypokinesia, Myalgia, Myasthenic syndrome, Paraesthesia, Vomiting, HYPOKINESIA, GUILLAIN BARRE SYND, MYALGIA, MYASTHENIA, DYSPHAGIA

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Advil, Cardizem
Current Illness: NONE
Preexisting Conditions: arthritis; hyperderssion sinc 3; hypothyroidism, allergic to PCN
Allergies:
Diagnostic Lab Data: CBC-normal; p-3.6; otherwise chem normal; Electormogram; CSF; GM slain-neg; smear fangus-neg; glucose; protein, APT; electrolytes, SGPT, total CPK, sigmoid; LP revealed mild inc in portein in spinal fluid & GBS dx; CXR-normal
CDC 'Split Type': (blank) MO9190

Write-up: 9NOV91 numbness & tingling lower extremities; 10NOV91 could no longer stand; arms have movement but weak;grasp weak, vomiting, muscular pain, some difficulty swallowing;

Changed on 8/31/2010

VAERS ID: 36611 Before After
VAERS Form:
Age:56.7
Sex:Female
Location:Missouri
Vaccinated:1991-10-31
Onset:1991-11-09
Submitted:1991-11-15
Entered:1991-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 91-92) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4918146 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dysphagia, Guillain-Barre syndrome, Hypokinesia, Myalgia, Myasthenic syndrome, Paraesthesia, Vomiting

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Advil, Cardizem
Current Illness: NONE
Preexisting Conditions: arthritis; hyperderssion sinc 3; hypothyroidism, allergic to PCN
Allergies:
Diagnostic Lab Data: CBC-normal; p-3.6; otherwise chem normal; Electormogram; CSF; GM slain-neg; smear fangus-neg; glucose; protein, APT; electrolytes, SGPT, total CPK, sigmoid; LP revealed mild inc in portein in spinal fluid & GBS dx; CXR-normal
CDC 'Split Type': MO9190

Write-up: 9NOV91 numbness & tingling lower extremities; 10NOV91 could no longer stand; arms have movement but weak;grasp weak, vomiting, muscular pain, some difficulty swallowing;

Changed on 7/7/2013

VAERS ID: 36611 Before After
VAERS Form:
Age:56.7
Sex:Female
Location:Missouri
Vaccinated:1991-10-31
Onset:1991-11-09
Submitted:1991-11-15
Entered:1991-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / 0 LA / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dysphagia, Guillain-Barre syndrome, Hypokinesia, Myalgia, Myasthenic syndrome, Paraesthesia, Vomiting

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Advil, Cardizem
Current Illness: NONE
Preexisting Conditions: arthritis; hyperderssion sinc 3; hypothyroidism, allergic to PCN
Allergies:
Diagnostic Lab Data: CBC-normal; p-3.6; otherwise chem normal; Electormogram; CSF; GM slain-neg; smear fangus-neg; glucose; protein, APT; electrolytes, SGPT, total CPK, sigmoid; LP revealed mild inc in portein in spinal fluid & GBS dx; CXR-normal
CDC 'Split Type': MO9190

Write-up: 9NOV91 numbness & tingling lower extremities; 10NOV91 could no longer stand; arms have movement but weak;grasp weak, vomiting, muscular pain, some difficulty swallowing;

Changed on 12/14/2016

VAERS ID: 36611 Before After
VAERS Form:
Age:56.7
Sex:Female
Location:Missouri
Vaccinated:1991-10-31
Onset:1991-11-09
Submitted:1991-11-15
Entered:1991-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / 0 LA / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dysphagia, Guillain-Barre syndrome, Hypokinesia, Myalgia, Myasthenic syndrome, Paraesthesia, Vomiting

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Advil, Cardizem
Current Illness: NONE
Preexisting Conditions: arthritis; hyperderssion sinc 3; hypothyroidism, allergic to PCN
Allergies:
Diagnostic Lab Data: CBC-normal; p-3.6; otherwise chem normal; Electormogram; CSF; GM slain-neg; smear fangus-neg; glucose; protein, APT; electrolytes, SGPT, total CPK, sigmoid; LP revealed mild inc in portein in spinal fluid & GBS dx; CXR-normal
CDC 'Split Type': MO9190

Write-up: 9NOV91 numbness & tingling lower extremities; 10NOV91 could no longer stand; arms have movement but weak;grasp weak, vomiting, muscular pain, some difficulty swallowing;

Changed on 2/14/2017

VAERS ID: 36611 Before After
VAERS Form:
Age:56.7 56.0
Sex:Female
Location:Missouri
Vaccinated:1991-10-31
Onset:1991-11-09
Submitted:1991-11-15
Entered:1991-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dysphagia, Guillain-Barre syndrome, Hypokinesia, Myalgia, Myasthenic syndrome, Paraesthesia, Vomiting

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Advil, Cardizem
Current Illness: NONE
Preexisting Conditions: arthritis; hyperderssion sinc 3; hypothyroidism, allergic to PCN
Allergies:
Diagnostic Lab Data: CBC-normal; p-3.6; otherwise chem normal; Electormogram; CSF; GM slain-neg; smear fangus-neg; glucose; protein, APT; electrolytes, SGPT, total CPK, sigmoid; LP revealed mild inc in portein in spinal fluid & GBS dx; CXR-normal
CDC 'Split Type': MO9190

Write-up: 9NOV91 numbness & tingling lower extremities; 10NOV91 could no longer stand; arms have movement but weak;grasp weak, vomiting, muscular pain, some difficulty swallowing;

Changed on 5/14/2017

VAERS ID: 36611 Before After
VAERS Form:
Age:56.0
Sex:Female
Location:Missouri
Vaccinated:1991-10-31
Onset:1991-11-09
Submitted:1991-11-15
Entered:1991-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dysphagia, Guillain-Barre syndrome, Hypokinesia, Myalgia, Myasthenic syndrome, Paraesthesia, Vomiting

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: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Advil, Cardizem
Current Illness: NONE
Preexisting Conditions: arthritis; hyperderssion sinc 3; hypothyroidism, allergic to PCN
Allergies:
Diagnostic Lab Data: CBC-normal; p-3.6; otherwise chem normal; Electormogram; CSF; GM slain-neg; smear fangus-neg; glucose; protein, APT; electrolytes, SGPT, total CPK, sigmoid; LP revealed mild inc in portein in spinal fluid & GBS dx; CXR-normal
CDC 'Split Type': MO9190

Write-up: 9NOV91 numbness & tingling lower extremities; 10NOV91 could no longer stand; arms have movement but weak;grasp weak, vomiting, muscular pain, some difficulty swallowing;

Changed on 9/14/2017

VAERS ID: 36611 Before After
VAERS Form:(blank) 1
Age:56.0
Sex:Female
Location:Missouri
Vaccinated:1991-10-31
Onset:1991-11-09
Submitted:1991-11-15
Entered:1991-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / 0 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dysphagia, Guillain-Barre syndrome, Hypokinesia, Myalgia, Myasthenic syndrome, Paraesthesia, Vomiting

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: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Advil, Cardizem
Current Illness: NONE
Preexisting Conditions: arthritis; hyperderssion sinc 3; hypothyroidism, allergic to PCN
Allergies:
Diagnostic Lab Data: CBC-normal; p-3.6; otherwise chem normal; Electormogram; CSF; GM slain-neg; smear fangus-neg; glucose; protein, APT; electrolytes, SGPT, total CPK, sigmoid; LP revealed mild inc in portein in spinal fluid & GBS dx; CXR-normal
CDC 'Split Type': MO9190

Write-up: 9NOV91 numbness & tingling lower extremities; 10NOV91 could no longer stand; arms have movement but weak;grasp weak, vomiting, muscular pain, some difficulty swallowing;

Changed on 2/14/2018

VAERS ID: 36611 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:Missouri
Vaccinated:1991-10-31
Onset:1991-11-09
Submitted:1991-11-15
Entered:1991-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dysphagia, Guillain-Barre syndrome, Hypokinesia, Myalgia, Myasthenic syndrome, Paraesthesia, Vomiting

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: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Advil, Cardizem
Current Illness: NONE
Preexisting Conditions: arthritis; hyperderssion sinc 3; hypothyroidism, allergic to PCN
Allergies:
Diagnostic Lab Data: CBC-normal; p-3.6; otherwise chem normal; Electormogram; CSF; GM slain-neg; smear fangus-neg; glucose; protein, APT; electrolytes, SGPT, total CPK, sigmoid; LP revealed mild inc in portein in spinal fluid & GBS dx; CXR-normal
CDC 'Split Type': MO9190

Write-up: 9NOV91 numbness & tingling lower extremities; 10NOV91 could no longer stand; arms have movement but weak;grasp weak, vomiting, muscular pain, some difficulty swallowing;

Changed on 6/14/2018

VAERS ID: 36611 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:Missouri
Vaccinated:1991-10-31
Onset:1991-11-09
Submitted:1991-11-15
Entered:1991-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dysphagia, Guillain-Barre syndrome, Hypokinesia, Myalgia, Myasthenic syndrome, Paraesthesia, Vomiting

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: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Advil, Cardizem
Current Illness: NONE
Preexisting Conditions: arthritis; hyperderssion sinc 3; hypothyroidism, allergic to PCN
Allergies:
Diagnostic Lab Data: CBC-normal; p-3.6; otherwise chem normal; Electormogram; CSF; GM slain-neg; smear fangus-neg; glucose; protein, APT; electrolytes, SGPT, total CPK, sigmoid; LP revealed mild inc in portein in spinal fluid & GBS dx; CXR-normal
CDC 'Split Type': MO9190

Write-up: 9NOV91 numbness & tingling lower extremities; 10NOV91 could no longer stand; arms have movement but weak;grasp weak, vomiting, muscular pain, some difficulty swallowing;

Changed on 8/14/2018

VAERS ID: 36611 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:Missouri
Vaccinated:1991-10-31
Onset:1991-11-09
Submitted:1991-11-15
Entered:1991-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dysphagia, Guillain-Barre syndrome, Hypokinesia, Myalgia, Myasthenic syndrome, Paraesthesia, Vomiting

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: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Advil, Cardizem
Current Illness: NONE
Preexisting Conditions: arthritis; hyperderssion sinc 3; hypothyroidism, allergic to PCN
Allergies:
Diagnostic Lab Data: CBC-normal; p-3.6; otherwise chem normal; Electormogram; CSF; GM slain-neg; smear fangus-neg; glucose; protein, APT; electrolytes, SGPT, total CPK, sigmoid; LP revealed mild inc in portein in spinal fluid & GBS dx; CXR-normal
CDC 'Split Type': MO9190

Write-up: 9NOV91 numbness & tingling lower extremities; 10NOV91 could no longer stand; arms have movement but weak;grasp weak, vomiting, muscular pain, some difficulty swallowing;

Changed on 9/14/2018

VAERS ID: 36611 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:Missouri
Vaccinated:1991-10-31
Onset:1991-11-09
Submitted:1991-11-15
Entered:1991-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dysphagia, Guillain-Barre syndrome, Hypokinesia, Myalgia, Myasthenic syndrome, Paraesthesia, Vomiting

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: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Advil, Cardizem
Current Illness: NONE
Preexisting Conditions: arthritis; hyperderssion sinc 3; hypothyroidism, allergic to PCN
Allergies:
Diagnostic Lab Data: CBC-normal; p-3.6; otherwise chem normal; Electormogram; CSF; GM slain-neg; smear fangus-neg; glucose; protein, APT; electrolytes, SGPT, total CPK, sigmoid; LP revealed mild inc in portein in spinal fluid & GBS dx; CXR-normal
CDC 'Split Type': MO9190

Write-up: 9NOV91 numbness & tingling lower extremities; 10NOV91 could no longer stand; arms have movement but weak;grasp weak, vomiting, muscular pain, some difficulty swallowing;

Changed on 10/14/2018

VAERS ID: 36611 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:Missouri
Vaccinated:1991-10-31
Onset:1991-11-09
Submitted:1991-11-15
Entered:1991-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dysphagia, Guillain-Barre syndrome, Hypokinesia, Myalgia, Myasthenic syndrome, Paraesthesia, Vomiting

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: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Advil, Cardizem
Current Illness: NONE
Preexisting Conditions: arthritis; hyperderssion sinc 3; hypothyroidism, allergic to PCN
Allergies:
Diagnostic Lab Data: CBC-normal; p-3.6; otherwise chem normal; Electormogram; CSF; GM slain-neg; smear fangus-neg; glucose; protein, APT; electrolytes, SGPT, total CPK, sigmoid; LP revealed mild inc in portein in spinal fluid & GBS dx; CXR-normal
CDC 'Split Type': MO9190

Write-up: 9NOV91 numbness & tingling lower extremities; 10NOV91 could no longer stand; arms have movement but weak;grasp weak, vomiting, muscular pain, some difficulty swallowing;

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