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This is VAERS ID 38984

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 38984
VAERS Form:
Age:49.1
Sex:Male
Location:California
Vaccinated:1991-11-08
Onset:1991-11-15
Submitted:1992-01-17
Entered:1992-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1991-1992 / WYETH 4918147 / - A / -

Administered by: Public      Purchased by: Unknown
Symptoms: FEVER, APNEA, NEUROPATHY, GUILLAIN BARRE SYND, MYASTHENIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-01-04
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? No
Previous Vaccinations:
Other Medications: ATB for pneumonia p/hosp
Current Illness: UNK
Preexisting Conditions: heart murmmer, takes Naprosyn
Allergies:
Diagnostic Lab Data: CSF nl, ABG''s nl; CBC-WBC 9,200, HGB 16.1, HCT 44.9; plat 218,000; ESR-6; IgG 421 dec; Drug screen neg; nerve conduction velocity study; suggests GBS, acute polyneuropathy;
CDC 'Split Type':

Write-up: 15NOV91 tingling fingers & toes lt side numbness rt hand & foot; fatigue & muscular weakness; inc temp speech became more difficult; 19NOV91 placed on ventilator, only able to move lips shrug shoulder (tracheotomy); pneumonia;


Changed on 12/8/2009

VAERS ID: 38984 Before After
VAERS Form:
Age:49.1
Sex:Male
Location:California
Vaccinated:1991-11-08
Onset:1991-11-15
Submitted:1992-01-17
Entered:1992-01-23 1992-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1991-1992 INFLUENZA (SEASONAL) (NO BRAND NAME, 91-92) / WYETH WYETH PHARMACEUTICALS, INC 4918147 / - A / -

Administered by: Public      Purchased by: Unknown Private
Symptoms: Apnoea, Guillain-Barre syndrome, Myasthenic syndrome, Neuropathy, Paraesthesia, Pneumonia, Pyrexia, Speech disorder, FEVER, APNEA, NEUROPATHY, GUILLAIN BARRE SYND, MYASTHENIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-01-04
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? No
Previous Vaccinations:
Other Medications: ATB for pneumonia p/hosp
Current Illness: UNK
Preexisting Conditions: heart murmmer, takes Naprosyn
Allergies:
Diagnostic Lab Data: CSF nl, ABG''s nl; CBC-WBC 9,200, HGB 16.1, HCT 44.9; plat 218,000; ESR-6; IgG 421 dec; Drug screen neg; nerve conduction velocity study; suggests GBS, acute polyneuropathy;
CDC 'Split Type':

Write-up: 15NOV91 tingling fingers & toes lt side numbness rt hand & foot; fatigue & muscular weakness; inc temp speech became more difficult; 19NOV91 placed on ventilator, only able to move lips shrug shoulder (tracheotomy); pneumonia;


Changed on 8/31/2010

VAERS ID: 38984 Before After
VAERS Form:
Age:49.1
Sex:Male
Location:California
Vaccinated:1991-11-08
Onset:1991-11-15
Submitted:1992-01-17
Entered:1992-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 91-92) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4918147 / - A / -

Administered by: Public      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Myasthenic syndrome, Neuropathy, Paraesthesia, Pneumonia, Pyrexia, Speech disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-01-04
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? No
Previous Vaccinations:
Other Medications: ATB for pneumonia p/hosp
Current Illness: UNK
Preexisting Conditions: heart murmmer, takes Naprosyn
Allergies:
Diagnostic Lab Data: CSF nl, ABG''s nl; CBC-WBC 9,200, HGB 16.1, HCT 44.9; plat 218,000; ESR-6; IgG 421 dec; Drug screen neg; nerve conduction velocity study; suggests GBS, acute polyneuropathy;
CDC 'Split Type':

Write-up: 15NOV91 tingling fingers & toes lt side numbness rt hand & foot; fatigue & muscular weakness; inc temp speech became more difficult; 19NOV91 placed on ventilator, only able to move lips shrug shoulder (tracheotomy); pneumonia;


Changed on 7/7/2013

VAERS ID: 38984 Before After
VAERS Form:
Age:49.1
Sex:Male
Location:California
Vaccinated:1991-11-08
Onset:1991-11-15
Submitted:1992-01-17
Entered:1992-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918147 / - A / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918147 / - A / -

Administered by: Public      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Myasthenic syndrome, Neuropathy, Paraesthesia, Pneumonia, Pyrexia, Speech disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-01-04
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? No
Previous Vaccinations:
Other Medications: ATB for pneumonia p/hosp
Current Illness: UNK
Preexisting Conditions: heart murmmer, takes Naprosyn
Allergies:
Diagnostic Lab Data: CSF nl, ABG''s nl; CBC-WBC 9,200, HGB 16.1, HCT 44.9; plat 218,000; ESR-6; IgG 421 dec; Drug screen neg; nerve conduction velocity study; suggests GBS, acute polyneuropathy;
CDC 'Split Type':

Write-up: 15NOV91 tingling fingers & toes lt side numbness rt hand & foot; fatigue & muscular weakness; inc temp speech became more difficult; 19NOV91 placed on ventilator, only able to move lips shrug shoulder (tracheotomy); pneumonia;


Changed on 12/14/2016

VAERS ID: 38984 Before After
VAERS Form:
Age:49.1
Sex:Male
Location:California
Vaccinated:1991-11-08
Onset:1991-11-15
Submitted:1992-01-17
Entered:1992-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918147 / - A / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918147 / - A / -

Administered by: Public      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Myasthenic syndrome, Neuropathy, Paraesthesia, Pneumonia, Pyrexia, Speech disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-01-04
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? No
Previous Vaccinations:
Other Medications: ATB for pneumonia p/hosp
Current Illness: UNK
Preexisting Conditions: heart murmmer, takes Naprosyn
Allergies:
Diagnostic Lab Data: CSF nl, ABG''s nl; CBC-WBC 9,200, HGB 16.1, HCT 44.9; plat 218,000; ESR-6; IgG 421 dec; Drug screen neg; nerve conduction velocity study; suggests GBS, acute polyneuropathy;
CDC 'Split Type':

Write-up: 15NOV91 tingling fingers & toes lt side numbness rt hand & foot; fatigue & muscular weakness; inc temp speech became more difficult; 19NOV91 placed on ventilator, only able to move lips shrug shoulder (tracheotomy); pneumonia;


Changed on 2/14/2017

VAERS ID: 38984 Before After
VAERS Form:
Age:49.1 49.0
Sex:Male
Location:California
Vaccinated:1991-11-08
Onset:1991-11-15
Submitted:1992-01-17
Entered:1992-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918147 / - A / -

Administered by: Public      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Myasthenic syndrome, Neuropathy, Paraesthesia, Pneumonia, Pyrexia, Speech disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-01-04
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? No
Previous Vaccinations:
Other Medications: ATB for pneumonia p/hosp
Current Illness: UNK
Preexisting Conditions: heart murmmer, takes Naprosyn
Allergies:
Diagnostic Lab Data: CSF nl, ABG''s nl; CBC-WBC 9,200, HGB 16.1, HCT 44.9; plat 218,000; ESR-6; IgG 421 dec; Drug screen neg; nerve conduction velocity study; suggests GBS, acute polyneuropathy;
CDC 'Split Type':

Write-up: 15NOV91 tingling fingers & toes lt side numbness rt hand & foot; fatigue & muscular weakness; inc temp speech became more difficult; 19NOV91 placed on ventilator, only able to move lips shrug shoulder (tracheotomy); pneumonia;


Changed on 5/14/2017

VAERS ID: 38984 Before After
VAERS Form:
Age:49.0
Sex:Male
Location:California
Vaccinated:1991-11-08
Onset:1991-11-15
Submitted:1992-01-17
Entered:1992-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918147 / - A - / - A

Administered by: Public      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Myasthenic syndrome, Neuropathy, Paraesthesia, Pneumonia, Pyrexia, Speech disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-01-04
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: ATB for pneumonia p/hosp
Current Illness: UNK
Preexisting Conditions: heart murmmer, takes Naprosyn
Allergies:
Diagnostic Lab Data: CSF nl, ABG''s nl; CBC-WBC 9,200, HGB 16.1, HCT 44.9; plat 218,000; ESR-6; IgG 421 dec; Drug screen neg; nerve conduction velocity study; suggests GBS, acute polyneuropathy;
CDC 'Split Type':

Write-up: 15NOV91 tingling fingers & toes lt side numbness rt hand & foot; fatigue & muscular weakness; inc temp speech became more difficult; 19NOV91 placed on ventilator, only able to move lips shrug shoulder (tracheotomy); pneumonia;


Changed on 9/14/2017

VAERS ID: 38984 Before After
VAERS Form:(blank) 1
Age:49.0
Sex:Male
Location:California
Vaccinated:1991-11-08
Onset:1991-11-15
Submitted:1992-01-17
Entered:1992-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918147 / - UNK - / A

Administered by: Public      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Myasthenic syndrome, Neuropathy, Paraesthesia, Pneumonia, Pyrexia, Speech disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-01-04
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: ATB for pneumonia p/hosp
Current Illness: UNK
Preexisting Conditions: heart murmmer, takes Naprosyn
Allergies:
Diagnostic Lab Data: CSF nl, ABG''s nl; CBC-WBC 9,200, HGB 16.1, HCT 44.9; plat 218,000; ESR-6; IgG 421 dec; Drug screen neg; nerve conduction velocity study; suggests GBS, acute polyneuropathy;
CDC 'Split Type':

Write-up: 15NOV91 tingling fingers & toes lt side numbness rt hand & foot; fatigue & muscular weakness; inc temp speech became more difficult; 19NOV91 placed on ventilator, only able to move lips shrug shoulder (tracheotomy); pneumonia;


Changed on 2/14/2018

VAERS ID: 38984 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:California
Vaccinated:1991-11-08
Onset:1991-11-15
Submitted:1992-01-17
Entered:1992-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918147 / UNK - / A

Administered by: Public      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Myasthenic syndrome, Neuropathy, Paraesthesia, Pneumonia, Pyrexia, Speech disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-01-04
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: ATB for pneumonia p/hosp
Current Illness: UNK
Preexisting Conditions: heart murmmer, takes Naprosyn
Allergies:
Diagnostic Lab Data: CSF nl, ABG''s nl; CBC-WBC 9,200, HGB 16.1, HCT 44.9; plat 218,000; ESR-6; IgG 421 dec; Drug screen neg; nerve conduction velocity study; suggests GBS, acute polyneuropathy;
CDC 'Split Type':

Write-up: 15NOV91 tingling fingers & toes lt side numbness rt hand & foot; fatigue & muscular weakness; inc temp speech became more difficult; 19NOV91 placed on ventilator, only able to move lips shrug shoulder (tracheotomy); pneumonia;


Changed on 6/14/2018

VAERS ID: 38984 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:California
Vaccinated:1991-11-08
Onset:1991-11-15
Submitted:1992-01-17
Entered:1992-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918147 / UNK - / A

Administered by: Public      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Myasthenic syndrome, Neuropathy, Paraesthesia, Pneumonia, Pyrexia, Speech disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-01-04
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: ATB for pneumonia p/hosp
Current Illness: UNK
Preexisting Conditions: heart murmmer, takes Naprosyn
Allergies:
Diagnostic Lab Data: CSF nl, ABG''s nl; CBC-WBC 9,200, HGB 16.1, HCT 44.9; plat 218,000; ESR-6; IgG 421 dec; Drug screen neg; nerve conduction velocity study; suggests GBS, acute polyneuropathy;
CDC 'Split Type':

Write-up: 15NOV91 tingling fingers & toes lt side numbness rt hand & foot; fatigue & muscular weakness; inc temp speech became more difficult; 19NOV91 placed on ventilator, only able to move lips shrug shoulder (tracheotomy); pneumonia;


Changed on 8/14/2018

VAERS ID: 38984 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:California
Vaccinated:1991-11-08
Onset:1991-11-15
Submitted:1992-01-17
Entered:1992-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918147 / UNK - / A

Administered by: Public      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Myasthenic syndrome, Neuropathy, Paraesthesia, Pneumonia, Pyrexia, Speech disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-01-04
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: ATB for pneumonia p/hosp
Current Illness: UNK
Preexisting Conditions: heart murmmer, takes Naprosyn
Allergies:
Diagnostic Lab Data: CSF nl, ABG''s nl; CBC-WBC 9,200, HGB 16.1, HCT 44.9; plat 218,000; ESR-6; IgG 421 dec; Drug screen neg; nerve conduction velocity study; suggests GBS, acute polyneuropathy;
CDC 'Split Type':

Write-up: 15NOV91 tingling fingers & toes lt side numbness rt hand & foot; fatigue & muscular weakness; inc temp speech became more difficult; 19NOV91 placed on ventilator, only able to move lips shrug shoulder (tracheotomy); pneumonia;


Changed on 9/14/2018

VAERS ID: 38984 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:California
Vaccinated:1991-11-08
Onset:1991-11-15
Submitted:1992-01-17
Entered:1992-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918147 / UNK - / A

Administered by: Public      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Myasthenic syndrome, Neuropathy, Paraesthesia, Pneumonia, Pyrexia, Speech disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-01-04
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: ATB for pneumonia p/hosp
Current Illness: UNK
Preexisting Conditions: heart murmmer, takes Naprosyn
Allergies:
Diagnostic Lab Data: CSF nl, ABG''s nl; CBC-WBC 9,200, HGB 16.1, HCT 44.9; plat 218,000; ESR-6; IgG 421 dec; Drug screen neg; nerve conduction velocity study; suggests GBS, acute polyneuropathy;
CDC 'Split Type':

Write-up: 15NOV91 tingling fingers & toes lt side numbness rt hand & foot; fatigue & muscular weakness; inc temp speech became more difficult; 19NOV91 placed on ventilator, only able to move lips shrug shoulder (tracheotomy); pneumonia;


Changed on 10/14/2018

VAERS ID: 38984 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:California
Vaccinated:1991-11-08
Onset:1991-11-15
Submitted:1992-01-17
Entered:1992-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918147 / UNK - / A

Administered by: Public      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Myasthenic syndrome, Neuropathy, Paraesthesia, Pneumonia, Pyrexia, Speech disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-01-04
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: ATB for pneumonia p/hosp
Current Illness: UNK
Preexisting Conditions: heart murmmer, takes Naprosyn
Allergies:
Diagnostic Lab Data: CSF nl, ABG''s nl; CBC-WBC 9,200, HGB 16.1, HCT 44.9; plat 218,000; ESR-6; IgG 421 dec; Drug screen neg; nerve conduction velocity study; suggests GBS, acute polyneuropathy;
CDC 'Split Type':

Write-up: 15NOV91 tingling fingers & toes lt side numbness rt hand & foot; fatigue & muscular weakness; inc temp speech became more difficult; 19NOV91 placed on ventilator, only able to move lips shrug shoulder (tracheotomy); pneumonia;

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