National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 39015

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 39015
VAERS Form:
Age:85.0
Sex:Female
Location:Illinois
Vaccinated:1991-11-14
Onset:1991-12-14
Submitted:0000-00-00
Entered:1992-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1991-1992 / PARKE-DAVIS - / - A / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: SPEECH DIS, MYASTHENIA

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: EC ASA, NTG patch, Lasix, K-DUR, Ditropan,Tolinase, Cardizem, Hydergine
Current Illness:
Preexisting Conditions: no allergies; post hx of CVA,DMASHD, HTN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Approx 1 mo p/recvd flu vax, pt devel rt sided weakness w/inappropriate speech on 14DEC91; on 16DEC91 speech became appropriate but rt sided weakness continues w/rt hand weakness;


Changed on 12/8/2009

VAERS ID: 39015 Before After
VAERS Form:
Age:85.0
Sex:Female
Location:Illinois
Vaccinated:1991-11-14
Onset:1991-12-14
Submitted:0000-00-00
Entered:1992-01-24 1992-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1991-1992 INFLUENZA (SEASONAL) (FLUOGEN 91-92) / PARKE-DAVIS - / - A / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Myasthenic syndrome, Speech disorder, SPEECH DIS, MYASTHENIA

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: EC ASA, NTG patch, Lasix, K-DUR, Ditropan,Tolinase, Cardizem, Hydergine
Current Illness:
Preexisting Conditions: no allergies; post hx of CVA,DMASHD, HTN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Approx 1 mo p/recvd flu vax, pt devel rt sided weakness w/inappropriate speech on 14DEC91; on 16DEC91 speech became appropriate but rt sided weakness continues w/rt hand weakness;


Changed on 8/31/2010

VAERS ID: 39015 Before After
VAERS Form:
Age:85.0
Sex:Female
Location:Illinois
Vaccinated:1991-11-14
Onset:1991-12-14
Submitted:0000-00-00
Entered:1992-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 91-92) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - A / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Myasthenic syndrome, Speech disorder

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: EC ASA, NTG patch, Lasix, K-DUR, Ditropan,Tolinase, Cardizem, Hydergine
Current Illness:
Preexisting Conditions: no allergies; post hx of CVA,DMASHD, HTN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Approx 1 mo p/recvd flu vax, pt devel rt sided weakness w/inappropriate speech on 14DEC91; on 16DEC91 speech became appropriate but rt sided weakness continues w/rt hand weakness;


Changed on 7/7/2013

VAERS ID: 39015 Before After
VAERS Form:
Age:85.0
Sex:Female
Location:Illinois
Vaccinated:1991-11-14
Onset:1991-12-14
Submitted:0000-00-00
Entered:1992-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - A / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - A / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Myasthenic syndrome, Speech disorder

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: EC ASA, NTG patch, Lasix, K-DUR, Ditropan,Tolinase, Cardizem, Hydergine
Current Illness:
Preexisting Conditions: no allergies; post hx of CVA,DMASHD, HTN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Approx 1 mo p/recvd flu vax, pt devel rt sided weakness w/inappropriate speech on 14DEC91; on 16DEC91 speech became appropriate but rt sided weakness continues w/rt hand weakness;


Changed on 5/14/2017

VAERS ID: 39015 Before After
VAERS Form:
Age:85.0
Sex:Female
Location:Illinois
Vaccinated:1991-11-14
Onset:1991-12-14
Submitted:0000-00-00
Entered:1992-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - A - / IM IM A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Myasthenic syndrome, Speech disorder

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: EC ASA, NTG patch, Lasix, K-DUR, Ditropan,Tolinase, Cardizem, Hydergine
Current Illness:
Preexisting Conditions: no allergies; post hx of CVA,DMASHD, HTN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Approx 1 mo p/recvd flu vax, pt devel rt sided weakness w/inappropriate speech on 14DEC91; on 16DEC91 speech became appropriate but rt sided weakness continues w/rt hand weakness;


Changed on 9/14/2017

VAERS ID: 39015 Before After
VAERS Form:(blank) 1
Age:85.0
Sex:Female
Location:Illinois
Vaccinated:1991-11-14
Onset:1991-12-14
Submitted:0000-00-00
Entered:1992-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - UNK - / IM A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Myasthenic syndrome, Speech disorder

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: EC ASA, NTG patch, Lasix, K-DUR, Ditropan,Tolinase, Cardizem, Hydergine
Current Illness:
Preexisting Conditions: no allergies; post hx of CVA,DMASHD, HTN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Approx 1 mo p/recvd flu vax, pt devel rt sided weakness w/inappropriate speech on 14DEC91; on 16DEC91 speech became appropriate but rt sided weakness continues w/rt hand weakness;


Changed on 2/14/2018

VAERS ID: 39015 Before After
VAERS Form:1
Age:85.0
Sex:Female
Location:Illinois
Vaccinated:1991-11-14
Onset:1991-12-14
Submitted:0000-00-00
Entered:1992-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Myasthenic syndrome, Speech disorder

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: EC ASA, NTG patch, Lasix, K-DUR, Ditropan,Tolinase, Cardizem, Hydergine
Current Illness:
Preexisting Conditions: no allergies; post hx of CVA,DMASHD, HTN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Approx 1 mo p/recvd flu vax, pt devel rt sided weakness w/inappropriate speech on 14DEC91; on 16DEC91 speech became appropriate but rt sided weakness continues w/rt hand weakness;


Changed on 6/14/2018

VAERS ID: 39015 Before After
VAERS Form:1
Age:85.0
Sex:Female
Location:Illinois
Vaccinated:1991-11-14
Onset:1991-12-14
Submitted:0000-00-00
Entered:1992-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Myasthenic syndrome, Speech disorder

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: EC ASA, NTG patch, Lasix, K-DUR, Ditropan,Tolinase, Cardizem, Hydergine
Current Illness:
Preexisting Conditions: no allergies; post hx of CVA,DMASHD, HTN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Approx 1 mo p/recvd flu vax, pt devel rt sided weakness w/inappropriate speech on 14DEC91; on 16DEC91 speech became appropriate but rt sided weakness continues w/rt hand weakness;


Changed on 8/14/2018

VAERS ID: 39015 Before After
VAERS Form:1
Age:85.0
Sex:Female
Location:Illinois
Vaccinated:1991-11-14
Onset:1991-12-14
Submitted:0000-00-00
Entered:1992-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Myasthenic syndrome, Speech disorder

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: EC ASA, NTG patch, Lasix, K-DUR, Ditropan,Tolinase, Cardizem, Hydergine
Current Illness:
Preexisting Conditions: no allergies; post hx of CVA,DMASHD, HTN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Approx 1 mo p/recvd flu vax, pt devel rt sided weakness w/inappropriate speech on 14DEC91; on 16DEC91 speech became appropriate but rt sided weakness continues w/rt hand weakness;


Changed on 9/14/2018

VAERS ID: 39015 Before After
VAERS Form:1
Age:85.0
Sex:Female
Location:Illinois
Vaccinated:1991-11-14
Onset:1991-12-14
Submitted:0000-00-00
Entered:1992-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Myasthenic syndrome, Speech disorder

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: EC ASA, NTG patch, Lasix, K-DUR, Ditropan,Tolinase, Cardizem, Hydergine
Current Illness:
Preexisting Conditions: no allergies; post hx of CVA,DMASHD, HTN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Approx 1 mo p/recvd flu vax, pt devel rt sided weakness w/inappropriate speech on 14DEC91; on 16DEC91 speech became appropriate but rt sided weakness continues w/rt hand weakness;


Changed on 10/14/2018

VAERS ID: 39015 Before After
VAERS Form:1
Age:85.0
Sex:Female
Location:Illinois
Vaccinated:1991-11-14
Onset:1991-12-14
Submitted:0000-00-00
Entered:1992-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Myasthenic syndrome, Speech disorder

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: EC ASA, NTG patch, Lasix, K-DUR, Ditropan,Tolinase, Cardizem, Hydergine
Current Illness:
Preexisting Conditions: no allergies; post hx of CVA,DMASHD, HTN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Approx 1 mo p/recvd flu vax, pt devel rt sided weakness w/inappropriate speech on 14DEC91; on 16DEC91 speech became appropriate but rt sided weakness continues w/rt hand weakness;

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=39015&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166