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This is VAERS ID 407287

History of Changes from the VAERS Wayback Machine

First Appeared on 12/7/2010

VAERS ID: 407287
VAERS Form:
Age:85.0
Sex:Male
Location:Massachusetts
Vaccinated:2010-10-22
Onset:2010-10-25
Submitted:2010-11-08
Entered:2010-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(10-11): INFLUENZA (SEASONAL) (FLULAVAL 10-11) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Back pain, Muscular weakness

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-11
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: 16     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccinated on 10/22/10. Reports back pain and muscle weakness increasing through weekend. Admitted on 10/27/10.


Changed on 4/13/2011

VAERS ID: 407287 Before After
VAERS Form:
Age:85.0
Sex:Male
Location:Massachusetts
Vaccinated:2010-10-22
Onset:2010-10-25
Submitted:2010-11-08
Entered:2010-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(10-11): INFLUENZA (SEASONAL) (FLULAVAL 10-11) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Acidosis, Back pain, Chest X-ray abnormal, Clostridium difficile colitis, Colitis, Colitis ischaemic, Computerised tomogram abnormal, Death, Electromyogram abnormal, Gastrointestinal haemorrhage, Guillain-Barre syndrome, Haematocrit decreased, Haemodialysis, Haemoglobin decreased, Hypothermia, Intensive care, International normalised ratio increased, Muscular weakness, Nuclear magnetic resonance imaging abnormal, Plasmapheresis, Pneumonia, Polyneuropathy, Prothrombin time prolonged, Red blood cell count decreased, Renal failure, Respiratory failure, Shock, White blood cell count normal, Abasia, Explorative laparotomy, Computerised tomogram abdomen abnormal, Colectomy, Procedural hypotension, Endotracheal intubation, Immunoglobulin therapy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-11
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: 16     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccinated on 10/22/10. Reports back pain and muscle weakness increasing through weekend. Admitted on 10/27/10.


Changed on 5/13/2011

VAERS ID: 407287 Before After
VAERS Form:
Age:85.0
Sex:Male
Location:Massachusetts
Vaccinated:2010-10-22
Onset:2010-10-25
Submitted:2010-11-08
Entered:2010-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(10-11): INFLUENZA (SEASONAL) (FLULAVAL 10-11) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Acidosis, Back pain, Chest X-ray abnormal, Clostridium difficile colitis, Colitis, Colitis ischaemic, Computerised tomogram abnormal, Death, Electromyogram abnormal, Gastrointestinal haemorrhage, Guillain-Barre syndrome, Haematocrit decreased, Haemodialysis, Haemoglobin decreased, Hypothermia, Intensive care, International normalised ratio increased, Muscular weakness, Nuclear magnetic resonance imaging abnormal, Plasmapheresis, Pneumonia, Polyneuropathy, Prothrombin time prolonged, Red blood cell count decreased, Renal failure, Respiratory failure, Shock, White blood cell count normal, Abasia, Explorative laparotomy, Computerised tomogram abdomen abnormal, Colectomy, Procedural hypotension, Endotracheal intubation, Immunoglobulin therapy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-11
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: 16     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccinated on 10/22/10. Reports back pain and muscle weakness increasing through weekend. Admitted on 10/27/10.


Changed on 7/12/2011

VAERS ID: 407287 Before After
VAERS Form:
Age:85.0
Sex:Male
Location:Massachusetts
Vaccinated:2010-10-22
Onset:2010-10-25
Submitted:2010-11-08
Entered:2010-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLULAVAL) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / - LA / IM
FLU(10-11): INFLUENZA (SEASONAL) (FLULAVAL 10-11) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Back pain, Muscular weakness

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-11
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: 16     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccinated on 10/22/10. Reports back pain and muscle weakness increasing through weekend. Admitted on 10/27/10.


Changed on 7/7/2013

VAERS ID: 407287 Before After
VAERS Form:
Age:85.0
Sex:Male
Location:Massachusetts
Vaccinated:2010-10-22
Onset:2010-10-25
Submitted:2010-11-08
Entered:2010-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLULAVAL) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / - LA / IM
FLU3: INFLUENZA (SEASONAL) (FLULAVAL) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Back pain, Muscular weakness

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-11
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: 16     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccinated on 10/22/10. Reports back pain and muscle weakness increasing through weekend. Admitted on 10/27/10.


Changed on 9/14/2017

VAERS ID: 407287 Before After
VAERS Form:(blank) 1
Age:85.0
Sex:Male
Location:Massachusetts
Vaccinated:2010-10-22
Onset:2010-10-25
Submitted:2010-11-08
Entered:2010-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLULAVAL) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / - UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Back pain, Muscular weakness

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-11
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: 16     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccinated on 10/22/10. Reports back pain and muscle weakness increasing through weekend. Admitted on 10/27/10.


Changed on 2/14/2018

VAERS ID: 407287 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Massachusetts
Vaccinated:2010-10-22
Onset:2010-10-25
Submitted:2010-11-08
Entered:2010-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLULAVAL) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Back pain, Muscular weakness

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-11
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: 16     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccinated on 10/22/10. Reports back pain and muscle weakness increasing through weekend. Admitted on 10/27/10.


Changed on 6/14/2018

VAERS ID: 407287 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Massachusetts
Vaccinated:2010-10-22
Onset:2010-10-25
Submitted:2010-11-08
Entered:2010-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLULAVAL) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Back pain, Muscular weakness

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-11
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: 16     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccinated on 10/22/10. Reports back pain and muscle weakness increasing through weekend. Admitted on 10/27/10.


Changed on 8/14/2018

VAERS ID: 407287 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Massachusetts
Vaccinated:2010-10-22
Onset:2010-10-25
Submitted:2010-11-08
Entered:2010-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLULAVAL) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Back pain, Muscular weakness

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-11
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: 16     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccinated on 10/22/10. Reports back pain and muscle weakness increasing through weekend. Admitted on 10/27/10.


Changed on 9/14/2018

VAERS ID: 407287 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Massachusetts
Vaccinated:2010-10-22
Onset:2010-10-25
Submitted:2010-11-08
Entered:2010-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLULAVAL) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Back pain, Muscular weakness

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-11
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: 16     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccinated on 10/22/10. Reports back pain and muscle weakness increasing through weekend. Admitted on 10/27/10.


Changed on 10/14/2018

VAERS ID: 407287 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Massachusetts
Vaccinated:2010-10-22
Onset:2010-10-25
Submitted:2010-11-08
Entered:2010-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLULAVAL) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Back pain, Muscular weakness

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-11
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: 16     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccinated on 10/22/10. Reports back pain and muscle weakness increasing through weekend. Admitted on 10/27/10.


Changed on 12/24/2020

VAERS ID: 407287 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Massachusetts
Vaccinated:2010-10-22
Onset:2010-10-25
Submitted:2010-11-08
Entered:2010-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLULAVAL) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Back pain, Muscular weakness

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-11
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: 16     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccinated on 10/22/10. Reports back pain and muscle weakness increasing through weekend. Admitted on 10/27/10.


Changed on 12/30/2020

VAERS ID: 407287 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Massachusetts
Vaccinated:2010-10-22
Onset:2010-10-25
Submitted:2010-11-08
Entered:2010-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLULAVAL) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Back pain, Muscular weakness

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-11
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: 16     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccinated on 10/22/10. Reports back pain and muscle weakness increasing through weekend. Admitted on 10/27/10.


Changed on 5/7/2021

VAERS ID: 407287 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Massachusetts
Vaccinated:2010-10-22
Onset:2010-10-25
Submitted:2010-11-08
Entered:2010-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLULAVAL) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Back pain, Muscular weakness

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-11
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: 16     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccinated on 10/22/10. Reports back pain and muscle weakness increasing through weekend. Admitted on 10/27/10.


Changed on 5/14/2021

VAERS ID: 407287 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Massachusetts
Vaccinated:2010-10-22
Onset:2010-10-25
Submitted:2010-11-08
Entered:2010-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLULAVAL) / GLAXOSMITHKLINE BIOLOGICALS AFUA602AB / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Back pain, Muscular weakness

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-11
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: 16     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Vaccinated on 10/22/10. Reports back pain and muscle weakness increasing through weekend. Admitted on 10/27/10.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=407287&WAYBACKHISTORY=ON


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