National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 39899

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 39899
VAERS Form:
Age:50.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-15
Onset:1989-10-25
Submitted:0000-00-00
Entered:1992-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1989-1990 / PARKE-DAVIS 01209P / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: HYPERTONIA, GUILLAIN BARRE SYND, ASTHENIA

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Calan, Zantac, Zestril, & HCTZ & KCL;
Current Illness:
Preexisting Conditions: Diet controlled NIDDM prior to GBS, now on insulin; flu shot in past w/out sequelae;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS reported in pt who recvd flu vax & 10 days p/flu shot pt was hospitalized for rapid progression of weakness; CT scan suggested surgical etiology for GBS; pt still exp muscle spasms;


Changed on 12/8/2009

VAERS ID: 39899 Before After
VAERS Form:
Age:50.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-15
Onset:1989-10-25
Submitted:0000-00-00
Entered:1992-03-11 1992-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1989-1990 INFLUENZA (SEASONAL) (FLUOGEN 89-90) / PARKE-DAVIS 01209P / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypertonia, HYPERTONIA, GUILLAIN BARRE SYND, ASTHENIA

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Calan, Zantac, Zestril, & HCTZ & KCL;
Current Illness:
Preexisting Conditions: Diet controlled NIDDM prior to GBS, now on insulin; flu shot in past w/out sequelae;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 914090006

Write-up: GBS reported in pt who recvd flu vax & 10 days p/flu shot pt was hospitalized for rapid progression of weakness; CT scan suggested surgical etiology for GBS; pt still exp muscle spasms;


Changed on 8/31/2010

VAERS ID: 39899 Before After
VAERS Form:
Age:50.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-15
Onset:1989-10-25
Submitted:0000-00-00
Entered:1992-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 89-90) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01209P / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypertonia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Calan, Zantac, Zestril, & HCTZ & KCL;
Current Illness:
Preexisting Conditions: Diet controlled NIDDM prior to GBS, now on insulin; flu shot in past w/out sequelae;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914090006

Write-up: GBS reported in pt who recvd flu vax & 10 days p/flu shot pt was hospitalized for rapid progression of weakness; CT scan suggested surgical etiology for GBS; pt still exp muscle spasms;


Changed on 7/7/2013

VAERS ID: 39899 Before After
VAERS Form:
Age:50.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-15
Onset:1989-10-25
Submitted:0000-00-00
Entered:1992-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01209P / - - / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01209P / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypertonia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Calan, Zantac, Zestril, & HCTZ & KCL;
Current Illness:
Preexisting Conditions: Diet controlled NIDDM prior to GBS, now on insulin; flu shot in past w/out sequelae;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914090006

Write-up: GBS reported in pt who recvd flu vax & 10 days p/flu shot pt was hospitalized for rapid progression of weakness; CT scan suggested surgical etiology for GBS; pt still exp muscle spasms;


Changed on 5/14/2017

VAERS ID: 39899 Before After
VAERS Form:
Age:50.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-15
Onset:1989-10-25
Submitted:0000-00-00
Entered:1992-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01209P / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypertonia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Calan, Zantac, Zestril, & HCTZ & KCL;
Current Illness:
Preexisting Conditions: Diet controlled NIDDM prior to GBS, now on insulin; flu shot in past w/out sequelae;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914090006

Write-up: GBS reported in pt who recvd flu vax & 10 days p/flu shot pt was hospitalized for rapid progression of weakness; CT scan suggested surgical etiology for GBS; pt still exp muscle spasms;


Changed on 9/14/2017

VAERS ID: 39899 Before After
VAERS Form:(blank) 1
Age:50.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-15
Onset:1989-10-25
Submitted:0000-00-00
Entered:1992-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01209P / - UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypertonia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Calan, Zantac, Zestril, & HCTZ & KCL;
Current Illness:
Preexisting Conditions: Diet controlled NIDDM prior to GBS, now on insulin; flu shot in past w/out sequelae;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914090006

Write-up: GBS reported in pt who recvd flu vax & 10 days p/flu shot pt was hospitalized for rapid progression of weakness; CT scan suggested surgical etiology for GBS; pt still exp muscle spasms;


Changed on 2/14/2018

VAERS ID: 39899 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-15
Onset:1989-10-25
Submitted:0000-00-00
Entered:1992-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01209P / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypertonia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Calan, Zantac, Zestril, & HCTZ & KCL;
Current Illness:
Preexisting Conditions: Diet controlled NIDDM prior to GBS, now on insulin; flu shot in past w/out sequelae;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914090006

Write-up: GBS reported in pt who recvd flu vax & 10 days p/flu shot pt was hospitalized for rapid progression of weakness; CT scan suggested surgical etiology for GBS; pt still exp muscle spasms;


Changed on 6/14/2018

VAERS ID: 39899 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-15
Onset:1989-10-25
Submitted:0000-00-00
Entered:1992-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01209P / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypertonia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Calan, Zantac, Zestril, & HCTZ & KCL;
Current Illness:
Preexisting Conditions: Diet controlled NIDDM prior to GBS, now on insulin; flu shot in past w/out sequelae;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914090006

Write-up: GBS reported in pt who recvd flu vax & 10 days p/flu shot pt was hospitalized for rapid progression of weakness; CT scan suggested surgical etiology for GBS; pt still exp muscle spasms;


Changed on 8/14/2018

VAERS ID: 39899 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-15
Onset:1989-10-25
Submitted:0000-00-00
Entered:1992-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01209P / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypertonia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Calan, Zantac, Zestril, & HCTZ & KCL;
Current Illness:
Preexisting Conditions: Diet controlled NIDDM prior to GBS, now on insulin; flu shot in past w/out sequelae;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914090006

Write-up: GBS reported in pt who recvd flu vax & 10 days p/flu shot pt was hospitalized for rapid progression of weakness; CT scan suggested surgical etiology for GBS; pt still exp muscle spasms;


Changed on 9/14/2018

VAERS ID: 39899 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-15
Onset:1989-10-25
Submitted:0000-00-00
Entered:1992-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01209P / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypertonia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Calan, Zantac, Zestril, & HCTZ & KCL;
Current Illness:
Preexisting Conditions: Diet controlled NIDDM prior to GBS, now on insulin; flu shot in past w/out sequelae;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914090006

Write-up: GBS reported in pt who recvd flu vax & 10 days p/flu shot pt was hospitalized for rapid progression of weakness; CT scan suggested surgical etiology for GBS; pt still exp muscle spasms;


Changed on 10/14/2018

VAERS ID: 39899 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-15
Onset:1989-10-25
Submitted:0000-00-00
Entered:1992-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01209P / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypertonia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Calan, Zantac, Zestril, & HCTZ & KCL;
Current Illness:
Preexisting Conditions: Diet controlled NIDDM prior to GBS, now on insulin; flu shot in past w/out sequelae;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914090006

Write-up: GBS reported in pt who recvd flu vax & 10 days p/flu shot pt was hospitalized for rapid progression of weakness; CT scan suggested surgical etiology for GBS; pt still exp muscle spasms;

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=39899&WAYBACKHISTORY=ON


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