National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 42912

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 42912
VAERS Form:
Age:
Sex:Female
Location:Florida
Vaccinated:1990-11-05
Onset:0000-00-00
Submitted:1992-06-01
Entered:1992-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: MYELITIS, QUADRIPLEGIA

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:
CDC 'Split Type':

Write-up: pt recvd flu vax & devel transverse myelitis coincident w/its administration; pt is an incomplete quadriplegic as a result of the transverse myelitis; Wyeth-Ayerst is awaiting further info;


Changed on 12/8/2009

VAERS ID: 42912 Before After
VAERS Form:
Age:
Sex:Female
Location:Florida
Vaccinated:1990-11-05
Onset:0000-00-00
Submitted:1992-06-01
Entered:1992-06-22 1992-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) / WYETH WYETH PHARMACEUTICALS, INC - / - - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Myelitis, Quadriplegia, MYELITIS, QUADRIPLEGIA

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:
CDC 'Split Type': (blank) 892160001E

Write-up: pt recvd flu vax & devel transverse myelitis coincident w/its administration; pt is an incomplete quadriplegic as a result of the transverse myelitis; Wyeth-Ayerst is awaiting further info;


Changed on 8/31/2010

VAERS ID: 42912 Before After
VAERS Form:
Age:
Sex:Female
Location:Florida
Vaccinated:1990-11-05
Onset:0000-00-00
Submitted:1992-06-01
Entered:1992-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Myelitis, Quadriplegia

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:
CDC 'Split Type': 892160001E

Write-up: pt recvd flu vax & devel transverse myelitis coincident w/its administration; pt is an incomplete quadriplegic as a result of the transverse myelitis; Wyeth-Ayerst is awaiting further info;


Changed on 7/7/2013

VAERS ID: 42912 Before After
VAERS Form:
Age:
Sex:Female
Location:Florida
Vaccinated:1990-11-05
Onset:0000-00-00
Submitted:1992-06-01
Entered:1992-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Myelitis, Quadriplegia

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:
CDC 'Split Type': 892160001E

Write-up: pt recvd flu vax & devel transverse myelitis coincident w/its administration; pt is an incomplete quadriplegic as a result of the transverse myelitis; Wyeth-Ayerst is awaiting further info;


Changed on 12/14/2016

VAERS ID: 42912 Before After
VAERS Form:
Age:
Sex:Female
Location:Florida
Vaccinated:1990-11-05
Onset:0000-00-00
Submitted:1992-06-01
Entered:1992-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Myelitis, Quadriplegia

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:
CDC 'Split Type': 892160001E

Write-up: pt recvd flu vax & devel transverse myelitis coincident w/its administration; pt is an incomplete quadriplegic as a result of the transverse myelitis; Wyeth-Ayerst is awaiting further info;


Changed on 5/14/2017

VAERS ID: 42912 Before After
VAERS Form:
Age:
Sex:Female
Location:Florida
Vaccinated:1990-11-05
Onset:0000-00-00
Submitted:1992-06-01
Entered:1992-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Myelitis, Quadriplegia

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:
CDC 'Split Type': 892160001E

Write-up: pt recvd flu vax & devel transverse myelitis coincident w/its administration; pt is an incomplete quadriplegic as a result of the transverse myelitis; Wyeth-Ayerst is awaiting further info;


Changed on 9/14/2017

VAERS ID: 42912 Before After
VAERS Form:(blank) 1
Age:
Sex:Female
Location:Florida
Vaccinated:1990-11-05
Onset:0000-00-00
Submitted:1992-06-01
Entered:1992-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Myelitis, Quadriplegia

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:
CDC 'Split Type': 892160001E

Write-up: pt recvd flu vax & devel transverse myelitis coincident w/its administration; pt is an incomplete quadriplegic as a result of the transverse myelitis; Wyeth-Ayerst is awaiting further info;


Changed on 2/14/2018

VAERS ID: 42912 Before After
VAERS Form:1
Age:
Sex:Female
Location:Florida
Vaccinated:1990-11-05
Onset:0000-00-00
Submitted:1992-06-01
Entered:1992-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Myelitis, Quadriplegia

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:
CDC 'Split Type': 892160001E

Write-up: pt recvd flu vax & devel transverse myelitis coincident w/its administration; pt is an incomplete quadriplegic as a result of the transverse myelitis; Wyeth-Ayerst is awaiting further info;


Changed on 6/14/2018

VAERS ID: 42912 Before After
VAERS Form:1
Age:
Sex:Female
Location:Florida
Vaccinated:1990-11-05
Onset:0000-00-00
Submitted:1992-06-01
Entered:1992-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Myelitis, Quadriplegia

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:
CDC 'Split Type': 892160001E

Write-up: pt recvd flu vax & devel transverse myelitis coincident w/its administration; pt is an incomplete quadriplegic as a result of the transverse myelitis; Wyeth-Ayerst is awaiting further info;


Changed on 8/14/2018

VAERS ID: 42912 Before After
VAERS Form:1
Age:
Sex:Female
Location:Florida
Vaccinated:1990-11-05
Onset:0000-00-00
Submitted:1992-06-01
Entered:1992-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Myelitis, Quadriplegia

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:
CDC 'Split Type': 892160001E

Write-up: pt recvd flu vax & devel transverse myelitis coincident w/its administration; pt is an incomplete quadriplegic as a result of the transverse myelitis; Wyeth-Ayerst is awaiting further info;


Changed on 9/14/2018

VAERS ID: 42912 Before After
VAERS Form:1
Age:
Sex:Female
Location:Florida
Vaccinated:1990-11-05
Onset:0000-00-00
Submitted:1992-06-01
Entered:1992-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Myelitis, Quadriplegia

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:
CDC 'Split Type': 892160001E

Write-up: pt recvd flu vax & devel transverse myelitis coincident w/its administration; pt is an incomplete quadriplegic as a result of the transverse myelitis; Wyeth-Ayerst is awaiting further info;


Changed on 10/14/2018

VAERS ID: 42912 Before After
VAERS Form:1
Age:
Sex:Female
Location:Florida
Vaccinated:1990-11-05
Onset:0000-00-00
Submitted:1992-06-01
Entered:1992-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Myelitis, Quadriplegia

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:
CDC 'Split Type': 892160001E

Write-up: pt recvd flu vax & devel transverse myelitis coincident w/its administration; pt is an incomplete quadriplegic as a result of the transverse myelitis; Wyeth-Ayerst is awaiting further info;

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=42912&WAYBACKHISTORY=ON


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