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This is VAERS ID 38080

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 38080
VAERS Form:
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:1991-12-01
Submitted:0000-00-00
Entered:1991-12-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1991-1992 / CONNAUGHT LABS - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: BLIND

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up: Pt exp blindness p/receiving an influenza vax; This case is in litigation; No other info is now available; Add''l info will be requested from the MD;


Changed on 12/8/2009

VAERS ID: 38080 Before After
VAERS Form:
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:1991-12-01
Submitted:0000-00-00
Entered:1991-12-24 1991-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1991-1992 INFLUENZA (SEASONAL) (FLUZONE 91-92) / CONNAUGHT LABS CONNAUGHT LABORATORIES - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness, BLIND

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) 1291017

Write-up: Pt exp blindness p/receiving an influenza vax; This case is in litigation; No other info is now available; Add''l info will be requested from the MD;


Changed on 8/31/2010

VAERS ID: 38080 Before After
VAERS Form:
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:1991-12-01
Submitted:0000-00-00
Entered:1991-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 91-92) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': 1291017

Write-up: Pt exp blindness p/receiving an influenza vax; This case is in litigation; No other info is now available; Add''l info will be requested from the MD;


Changed on 7/7/2013

VAERS ID: 38080 Before After
VAERS Form:
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:1991-12-01
Submitted:0000-00-00
Entered:1991-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': 1291017

Write-up: Pt exp blindness p/receiving an influenza vax; This case is in litigation; No other info is now available; Add''l info will be requested from the MD;


Changed on 5/14/2017

VAERS ID: 38080 Before After
VAERS Form:
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:1991-12-01
Submitted:0000-00-00
Entered:1991-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': 1291017

Write-up: Pt exp blindness p/receiving an influenza vax; This case is in litigation; No other info is now available; Add''l info will be requested from the MD;


Changed on 9/14/2017

VAERS ID: 38080 Before After
VAERS Form:(blank) 1
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:1991-12-01
Submitted:0000-00-00
Entered:1991-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': 1291017

Write-up: Pt exp blindness p/receiving an influenza vax; This case is in litigation; No other info is now available; Add''l info will be requested from the MD;


Changed on 2/14/2018

VAERS ID: 38080 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:1991-12-01
Submitted:0000-00-00
Entered:1991-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': 1291017

Write-up: Pt exp blindness p/receiving an influenza vax; This case is in litigation; No other info is now available; Add''l info will be requested from the MD;


Changed on 6/14/2018

VAERS ID: 38080 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:1991-12-01
Submitted:0000-00-00
Entered:1991-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': 1291017

Write-up: Pt exp blindness p/receiving an influenza vax; This case is in litigation; No other info is now available; Add''l info will be requested from the MD;


Changed on 8/14/2018

VAERS ID: 38080 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:1991-12-01
Submitted:0000-00-00
Entered:1991-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': 1291017

Write-up: Pt exp blindness p/receiving an influenza vax; This case is in litigation; No other info is now available; Add''l info will be requested from the MD;


Changed on 9/14/2018

VAERS ID: 38080 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:1991-12-01
Submitted:0000-00-00
Entered:1991-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': 1291017

Write-up: Pt exp blindness p/receiving an influenza vax; This case is in litigation; No other info is now available; Add''l info will be requested from the MD;


Changed on 10/14/2018

VAERS ID: 38080 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:New York
Vaccinated:0000-00-00
Onset:1991-12-01
Submitted:0000-00-00
Entered:1991-12-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': 1291017

Write-up: Pt exp blindness p/receiving an influenza vax; This case is in litigation; No other info is now available; Add''l info will be requested from the MD;

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