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This is VAERS ID 434581

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/11/2011

VAERS ID: 434581
VAERS Form:
Age:59.0
Sex:Female
Location:California
Vaccinated:2010-09-29
Onset:2010-10-01
Submitted:2011-09-16
Entered:2011-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR U3082CA / - RA / UN

Administered by: Private      Purchased by: Other
Symptoms: Amyotrophic lateral sclerosis, Death, Electromyogram abnormal, Muscle contractions involuntary

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: LAMICTAL; Estradiol; Prometrium, IMITREX
Current Illness: Partial complex SZ
Preexisting Conditions: Partial complex SZ
Allergies:
Diagnostic Lab Data: Abnormal EMG; Exam
CDC 'Split Type':

Write-up: ADACEL vaccine administered 7/29/10 Occ Health. Fasiculations developed 2 weeks later. Diagnosed with ALS 11/10. Expired Sept 2011.


Changed on 6/14/2014

VAERS ID: 434581 Before After
VAERS Form:
Age:59.0
Sex:Female
Location:California
Vaccinated:2010-09-29
Onset:2010-10-01
Submitted:2011-09-16
Entered:2011-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR U3082CA / - RA / UN

Administered by: Private      Purchased by: Other
Symptoms: Amyotrophic lateral sclerosis, Death, Electromyogram abnormal, Muscle contractions involuntary

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: LAMICTAL; Estradiol; Prometrium, IMITREX
Current Illness: Partial complex SZ
Preexisting Conditions: Partial complex SZ
Allergies:
Diagnostic Lab Data: Abnormal EMG; Exam
CDC 'Split Type':

Write-up: ADACEL vaccine administered 7/29/10 Occ Health. Fasiculations developed 2 weeks later. Diagnosed with ALS 11/10. Expired Sept 2011.


Changed on 2/14/2017

VAERS ID: 434581 Before After
VAERS Form:
Age:59.0
Sex:Female
Location:California
Vaccinated:2010-09-29
Onset:2010-10-01
Submitted:2011-09-16
Entered:2011-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR U3082CA / - RA / UN

Administered by: Private      Purchased by: Other
Symptoms: Amyotrophic lateral sclerosis, Death, Electromyogram abnormal, Muscle contractions involuntary

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: LAMICTAL; Estradiol; Prometrium, IMITREX
Current Illness: Partial complex SZ
Preexisting Conditions: Partial complex SZ
Allergies:
Diagnostic Lab Data: Abnormal EMG; Exam
CDC 'Split Type':

Write-up: ADACEL vaccine administered 7/29/10 Occ Health. Fasiculations developed 2 weeks later. Diagnosed with ALS 11/10. Expired Sept 2011.


Changed on 9/14/2017

VAERS ID: 434581 Before After
VAERS Form:(blank) 1
Age:59.0
Sex:Female
Location:California
Vaccinated:2010-09-29
Onset:2010-10-01
Submitted:2011-09-16
Entered:2011-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR U3082CA / - UNK RA / UN

Administered by: Private      Purchased by: Other
Symptoms: Amyotrophic lateral sclerosis, Death, Electromyogram abnormal, Muscle contractions involuntary

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: LAMICTAL; Estradiol; Prometrium, IMITREX
Current Illness: Partial complex SZ
Preexisting Conditions: Partial complex SZ
Allergies:
Diagnostic Lab Data: Abnormal EMG; Exam
CDC 'Split Type':

Write-up: ADACEL vaccine administered 7/29/10 Occ Health. Fasiculations developed 2 weeks later. Diagnosed with ALS 11/10. Expired Sept 2011.


Changed on 2/14/2018

VAERS ID: 434581 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:California
Vaccinated:2010-09-29
Onset:2010-10-01
Submitted:2011-09-16
Entered:2011-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR U3082CA / UNK RA / UN

Administered by: Private      Purchased by: Other
Symptoms: Amyotrophic lateral sclerosis, Death, Electromyogram abnormal, Muscle contractions involuntary

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: LAMICTAL; Estradiol; Prometrium, IMITREX
Current Illness: Partial complex SZ
Preexisting Conditions: Partial complex SZ
Allergies:
Diagnostic Lab Data: Abnormal EMG; Exam
CDC 'Split Type':

Write-up: ADACEL vaccine administered 7/29/10 Occ Health. Fasiculations developed 2 weeks later. Diagnosed with ALS 11/10. Expired Sept 2011.


Changed on 6/14/2018

VAERS ID: 434581 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:California
Vaccinated:2010-09-29
Onset:2010-10-01
Submitted:2011-09-16
Entered:2011-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR U3082CA / UNK RA / UN

Administered by: Private      Purchased by: Other
Symptoms: Amyotrophic lateral sclerosis, Death, Electromyogram abnormal, Muscle contractions involuntary

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: LAMICTAL; Estradiol; Prometrium, IMITREX
Current Illness: Partial complex SZ
Preexisting Conditions: Partial complex SZ
Allergies:
Diagnostic Lab Data: Abnormal EMG; Exam
CDC 'Split Type':

Write-up: ADACEL vaccine administered 7/29/10 Occ Health. Fasiculations developed 2 weeks later. Diagnosed with ALS 11/10. Expired Sept 2011.


Changed on 8/14/2018

VAERS ID: 434581 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:California
Vaccinated:2010-09-29
Onset:2010-10-01
Submitted:2011-09-16
Entered:2011-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR U3082CA / UNK RA / UN

Administered by: Private      Purchased by: Other
Symptoms: Amyotrophic lateral sclerosis, Death, Electromyogram abnormal, Muscle contractions involuntary

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: LAMICTAL; Estradiol; Prometrium, IMITREX
Current Illness: Partial complex SZ
Preexisting Conditions: Partial complex SZ
Allergies:
Diagnostic Lab Data: Abnormal EMG; Exam
CDC 'Split Type':

Write-up: ADACEL vaccine administered 7/29/10 Occ Health. Fasiculations developed 2 weeks later. Diagnosed with ALS 11/10. Expired Sept 2011.


Changed on 9/14/2018

VAERS ID: 434581 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:California
Vaccinated:2010-09-29
Onset:2010-10-01
Submitted:2011-09-16
Entered:2011-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR U3082CA / UNK RA / UN

Administered by: Private      Purchased by: Other
Symptoms: Amyotrophic lateral sclerosis, Death, Electromyogram abnormal, Muscle contractions involuntary

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: LAMICTAL; Estradiol; Prometrium, IMITREX
Current Illness: Partial complex SZ
Preexisting Conditions: Partial complex SZ
Allergies:
Diagnostic Lab Data: Abnormal EMG; Exam
CDC 'Split Type':

Write-up: ADACEL vaccine administered 7/29/10 Occ Health. Fasiculations developed 2 weeks later. Diagnosed with ALS 11/10. Expired Sept 2011.


Changed on 10/14/2018

VAERS ID: 434581 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:California
Vaccinated:2010-09-29
Onset:2010-10-01
Submitted:2011-09-16
Entered:2011-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR U3082CA / UNK RA / UN

Administered by: Private      Purchased by: Other
Symptoms: Amyotrophic lateral sclerosis, Death, Electromyogram abnormal, Muscle contractions involuntary

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: LAMICTAL; Estradiol; Prometrium, IMITREX
Current Illness: Partial complex SZ
Preexisting Conditions: Partial complex SZ
Allergies:
Diagnostic Lab Data: Abnormal EMG; Exam
CDC 'Split Type':

Write-up: ADACEL vaccine administered 7/29/10 Occ Health. Fasiculations developed 2 weeks later. Diagnosed with ALS 11/10. Expired Sept 2011.


Changed on 12/24/2020

VAERS ID: 434581 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:California
Vaccinated:2010-09-29
Onset:2010-10-01
Submitted:2011-09-16
Entered:2011-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR U3082CA / UNK RA / UN

Administered by: Private      Purchased by: Other
Symptoms: Amyotrophic lateral sclerosis, Death, Electromyogram abnormal, Muscle contractions involuntary

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: LAMICTAL; Estradiol; Prometrium, IMITREX
Current Illness: Partial complex SZ
Preexisting Conditions: Partial complex SZ
Allergies:
Diagnostic Lab Data: Abnormal EMG; Exam
CDC 'Split Type':

Write-up: ADACEL vaccine administered 7/29/10 Occ Health. Fasiculations developed 2 weeks later. Diagnosed with ALS 11/10. Expired Sept 2011.


Changed on 12/30/2020

VAERS ID: 434581 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:California
Vaccinated:2010-09-29
Onset:2010-10-01
Submitted:2011-09-16
Entered:2011-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR U3082CA / UNK RA / UN

Administered by: Private      Purchased by: Other
Symptoms: Amyotrophic lateral sclerosis, Death, Electromyogram abnormal, Muscle contractions involuntary

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: LAMICTAL; Estradiol; Prometrium, IMITREX
Current Illness: Partial complex SZ
Preexisting Conditions: Partial complex SZ
Allergies:
Diagnostic Lab Data: Abnormal EMG; Exam
CDC 'Split Type':

Write-up: ADACEL vaccine administered 7/29/10 Occ Health. Fasiculations developed 2 weeks later. Diagnosed with ALS 11/10. Expired Sept 2011.


Changed on 5/7/2021

VAERS ID: 434581 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:California
Vaccinated:2010-09-29
Onset:2010-10-01
Submitted:2011-09-16
Entered:2011-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR U3082CA / UNK RA / UN

Administered by: Private      Purchased by: Other
Symptoms: Amyotrophic lateral sclerosis, Death, Electromyogram abnormal, Muscle contractions involuntary

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: LAMICTAL; Estradiol; Prometrium, IMITREX
Current Illness: Partial complex SZ
Preexisting Conditions: Partial complex SZ
Allergies:
Diagnostic Lab Data: Abnormal EMG; Exam
CDC 'Split Type':

Write-up: ADACEL vaccine administered 7/29/10 Occ Health. Fasiculations developed 2 weeks later. Diagnosed with ALS 11/10. Expired Sept 2011.


Changed on 5/14/2021

VAERS ID: 434581 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:California
Vaccinated:2010-09-29
Onset:2010-10-01
Submitted:2011-09-16
Entered:2011-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR U3082CA / UNK RA / UN

Administered by: Private      Purchased by: Other
Symptoms: Amyotrophic lateral sclerosis, Death, Electromyogram abnormal, Muscle contractions involuntary

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: LAMICTAL; Estradiol; Prometrium, IMITREX
Current Illness: Partial complex SZ
Preexisting Conditions: Partial complex SZ
Allergies:
Diagnostic Lab Data: Abnormal EMG; Exam
CDC 'Split Type':

Write-up: ADACEL vaccine administered 7/29/10 Occ Health. Fasiculations developed 2 weeks later. Diagnosed with ALS 11/10. Expired Sept 2011.

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