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This is VAERS ID 43894

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 43894
VAERS Form:
Age:62.5
Sex:Male
Location:New York
Vaccinated:1988-11-25
Onset:1988-12-10
Submitted:1991-01-04
Entered:1992-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1989-1990 TRIVALENT TYPES A&B / WYETH - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND, ASTHENIA, CSF ABNORM, ECG ABNORM, HYPERTENS

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: Orudis Capsules
Current Illness: NONE
Preexisting Conditions: pt has known allergy to PCN; inc cholesterol in the past; pos for diabetes mellitus in mom & dad; father also had emphysema;
Allergies:
Diagnostic Lab Data: Spinal fluid analysis-inc spinal fluid protein, nl glucose & w/o leukocytes; Cholesterol 319; Triglycerides 276; EMG & Nerve conduction velocities showed mltifocal conduction abn;
CDC 'Split Type':

Write-up: Pt recvd flu vax & was admitted to hosp w/extremity weakness & numbness; approx 4-5 days prior to admission, pt had dorsal & epigastric pain assoc w/tingling in hands & feet;poss GBS; also areflexia; BP 190/100;


Changed on 12/8/2009

VAERS ID: 43894 Before After
VAERS Form:
Age:62.5
Sex:Male
Location:New York
Vaccinated:1988-11-25
Onset:1988-12-10
Submitted:1991-01-04
Entered:1992-08-05 1991-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1989-1990 TRIVALENT TYPES A&B INFLUENZA (SEASONAL) (NO BRAND NAME, 89-90) / WYETH WYETH PHARMACEUTICALS, INC - / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Asthenia, Back pain, Electrocardiogram abnormal, Guillain-Barre syndrome, Hypertension, Hyporeflexia, Paraesthesia, CSF test abnormal, GUILLAIN BARRE SYND, ASTHENIA, CSF ABNORM, ECG ABNORM, HYPERTENS

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: Orudis Capsules
Current Illness: NONE
Preexisting Conditions: pt has known allergy to PCN; inc cholesterol in the past; pos for diabetes mellitus in mom & dad; father also had emphysema;
Allergies:
Diagnostic Lab Data: Spinal fluid analysis-inc spinal fluid protein, nl glucose & w/o leukocytes; Cholesterol 319; Triglycerides 276; EMG & Nerve conduction velocities showed mltifocal conduction abn;
CDC 'Split Type': (blank) B073089012

Write-up: Pt recvd flu vax & was admitted to hosp w/extremity weakness & numbness; approx 4-5 days prior to admission, pt had dorsal & epigastric pain assoc w/tingling in hands & feet;poss GBS; also areflexia; BP 190/100;


Changed on 8/31/2010

VAERS ID: 43894 Before After
VAERS Form:
Age:62.5
Sex:Male
Location:New York
Vaccinated:1988-11-25
Onset:1988-12-10
Submitted:1991-01-04
Entered:1991-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 89-90) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Back pain, Electrocardiogram abnormal, Guillain-Barre syndrome, Hypertension, Hyporeflexia, Paraesthesia, CSF test abnormal

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: Orudis Capsules
Current Illness: NONE
Preexisting Conditions: pt has known allergy to PCN; inc cholesterol in the past; pos for diabetes mellitus in mom & dad; father also had emphysema;
Allergies:
Diagnostic Lab Data: Spinal fluid analysis-inc spinal fluid protein, nl glucose & w/o leukocytes; Cholesterol 319; Triglycerides 276; EMG & Nerve conduction velocities showed mltifocal conduction abn;
CDC 'Split Type': B073089012

Write-up: Pt recvd flu vax & was admitted to hosp w/extremity weakness & numbness; approx 4-5 days prior to admission, pt had dorsal & epigastric pain assoc w/tingling in hands & feet;poss GBS; also areflexia; BP 190/100;


Changed on 7/7/2013

VAERS ID: 43894 Before After
VAERS Form:
Age:62.5
Sex:Male
Location:New York
Vaccinated:1988-11-25
Onset:1988-12-10
Submitted:1991-01-04
Entered:1991-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Back pain, Electrocardiogram abnormal, Guillain-Barre syndrome, Hypertension, Hyporeflexia, Paraesthesia, CSF test abnormal

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: Orudis Capsules
Current Illness: NONE
Preexisting Conditions: pt has known allergy to PCN; inc cholesterol in the past; pos for diabetes mellitus in mom & dad; father also had emphysema;
Allergies:
Diagnostic Lab Data: Spinal fluid analysis-inc spinal fluid protein, nl glucose & w/o leukocytes; Cholesterol 319; Triglycerides 276; EMG & Nerve conduction velocities showed mltifocal conduction abn;
CDC 'Split Type': B073089012

Write-up: Pt recvd flu vax & was admitted to hosp w/extremity weakness & numbness; approx 4-5 days prior to admission, pt had dorsal & epigastric pain assoc w/tingling in hands & feet;poss GBS; also areflexia; BP 190/100;


Changed on 12/14/2016

VAERS ID: 43894 Before After
VAERS Form:
Age:62.5
Sex:Male
Location:New York
Vaccinated:1988-11-25
Onset:1988-12-10
Submitted:1991-01-04
Entered:1991-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Back pain, Electrocardiogram abnormal, Guillain-Barre syndrome, Hypertension, Hyporeflexia, Paraesthesia, CSF test abnormal

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: Orudis Capsules
Current Illness: NONE
Preexisting Conditions: pt has known allergy to PCN; inc cholesterol in the past; pos for diabetes mellitus in mom & dad; father also had emphysema;
Allergies:
Diagnostic Lab Data: Spinal fluid analysis-inc spinal fluid protein, nl glucose & w/o leukocytes; Cholesterol 319; Triglycerides 276; EMG & Nerve conduction velocities showed mltifocal conduction abn;
CDC 'Split Type': B073089012

Write-up: Pt recvd flu vax & was admitted to hosp w/extremity weakness & numbness; approx 4-5 days prior to admission, pt had dorsal & epigastric pain assoc w/tingling in hands & feet;poss GBS; also areflexia; BP 190/100;


Changed on 2/14/2017

VAERS ID: 43894 Before After
VAERS Form:
Age:62.5 62.0
Sex:Male
Location:New York
Vaccinated:1988-11-25
Onset:1988-12-10
Submitted:1991-01-04
Entered:1991-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Back pain, Electrocardiogram abnormal, Guillain-Barre syndrome, Hypertension, Hyporeflexia, Paraesthesia, CSF test abnormal

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: Orudis Capsules
Current Illness: NONE
Preexisting Conditions: pt has known allergy to PCN; inc cholesterol in the past; pos for diabetes mellitus in mom & dad; father also had emphysema;
Allergies:
Diagnostic Lab Data: Spinal fluid analysis-inc spinal fluid protein, nl glucose & w/o leukocytes; Cholesterol 319; Triglycerides 276; EMG & Nerve conduction velocities showed mltifocal conduction abn;
CDC 'Split Type': B073089012

Write-up: Pt recvd flu vax & was admitted to hosp w/extremity weakness & numbness; approx 4-5 days prior to admission, pt had dorsal & epigastric pain assoc w/tingling in hands & feet;poss GBS; also areflexia; BP 190/100;


Changed on 9/14/2017

VAERS ID: 43894 Before After
VAERS Form:(blank) 1
Age:62.0
Sex:Male
Location:New York
Vaccinated:1988-11-25
Onset:1988-12-10
Submitted:1991-01-04
Entered:1991-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Back pain, Electrocardiogram abnormal, Guillain-Barre syndrome, Hypertension, Hyporeflexia, Paraesthesia, CSF test abnormal

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: Orudis Capsules
Current Illness: NONE
Preexisting Conditions: pt has known allergy to PCN; inc cholesterol in the past; pos for diabetes mellitus in mom & dad; father also had emphysema;
Allergies:
Diagnostic Lab Data: Spinal fluid analysis-inc spinal fluid protein, nl glucose & w/o leukocytes; Cholesterol 319; Triglycerides 276; EMG & Nerve conduction velocities showed mltifocal conduction abn;
CDC 'Split Type': B073089012

Write-up: Pt recvd flu vax & was admitted to hosp w/extremity weakness & numbness; approx 4-5 days prior to admission, pt had dorsal & epigastric pain assoc w/tingling in hands & feet;poss GBS; also areflexia; BP 190/100;


Changed on 2/14/2018

VAERS ID: 43894 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:New York
Vaccinated:1988-11-25
Onset:1988-12-10
Submitted:1991-01-04
Entered:1991-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Back pain, Electrocardiogram abnormal, Guillain-Barre syndrome, Hypertension, Hyporeflexia, Paraesthesia, CSF test abnormal

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: Orudis Capsules
Current Illness: NONE
Preexisting Conditions: pt has known allergy to PCN; inc cholesterol in the past; pos for diabetes mellitus in mom & dad; father also had emphysema;
Allergies:
Diagnostic Lab Data: Spinal fluid analysis-inc spinal fluid protein, nl glucose & w/o leukocytes; Cholesterol 319; Triglycerides 276; EMG & Nerve conduction velocities showed mltifocal conduction abn;
CDC 'Split Type': B073089012

Write-up: Pt recvd flu vax & was admitted to hosp w/extremity weakness & numbness; approx 4-5 days prior to admission, pt had dorsal & epigastric pain assoc w/tingling in hands & feet;poss GBS; also areflexia; BP 190/100;


Changed on 6/14/2018

VAERS ID: 43894 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:New York
Vaccinated:1988-11-25
Onset:1988-12-10
Submitted:1991-01-04
Entered:1991-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Back pain, Electrocardiogram abnormal, Guillain-Barre syndrome, Hypertension, Hyporeflexia, Paraesthesia, CSF test abnormal

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: Orudis Capsules
Current Illness: NONE
Preexisting Conditions: pt has known allergy to PCN; inc cholesterol in the past; pos for diabetes mellitus in mom & dad; father also had emphysema;
Allergies:
Diagnostic Lab Data: Spinal fluid analysis-inc spinal fluid protein, nl glucose & w/o leukocytes; Cholesterol 319; Triglycerides 276; EMG & Nerve conduction velocities showed mltifocal conduction abn;
CDC 'Split Type': B073089012

Write-up: Pt recvd flu vax & was admitted to hosp w/extremity weakness & numbness; approx 4-5 days prior to admission, pt had dorsal & epigastric pain assoc w/tingling in hands & feet;poss GBS; also areflexia; BP 190/100;


Changed on 8/14/2018

VAERS ID: 43894 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:New York
Vaccinated:1988-11-25
Onset:1988-12-10
Submitted:1991-01-04
Entered:1991-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Back pain, Electrocardiogram abnormal, Guillain-Barre syndrome, Hypertension, Hyporeflexia, Paraesthesia, CSF test abnormal

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: Orudis Capsules
Current Illness: NONE
Preexisting Conditions: pt has known allergy to PCN; inc cholesterol in the past; pos for diabetes mellitus in mom & dad; father also had emphysema;
Allergies:
Diagnostic Lab Data: Spinal fluid analysis-inc spinal fluid protein, nl glucose & w/o leukocytes; Cholesterol 319; Triglycerides 276; EMG & Nerve conduction velocities showed mltifocal conduction abn;
CDC 'Split Type': B073089012

Write-up: Pt recvd flu vax & was admitted to hosp w/extremity weakness & numbness; approx 4-5 days prior to admission, pt had dorsal & epigastric pain assoc w/tingling in hands & feet;poss GBS; also areflexia; BP 190/100;


Changed on 9/14/2018

VAERS ID: 43894 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:New York
Vaccinated:1988-11-25
Onset:1988-12-10
Submitted:1991-01-04
Entered:1991-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Back pain, Electrocardiogram abnormal, Guillain-Barre syndrome, Hypertension, Hyporeflexia, Paraesthesia, CSF test abnormal

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: Orudis Capsules
Current Illness: NONE
Preexisting Conditions: pt has known allergy to PCN; inc cholesterol in the past; pos for diabetes mellitus in mom & dad; father also had emphysema;
Allergies:
Diagnostic Lab Data: Spinal fluid analysis-inc spinal fluid protein, nl glucose & w/o leukocytes; Cholesterol 319; Triglycerides 276; EMG & Nerve conduction velocities showed mltifocal conduction abn;
CDC 'Split Type': B073089012

Write-up: Pt recvd flu vax & was admitted to hosp w/extremity weakness & numbness; approx 4-5 days prior to admission, pt had dorsal & epigastric pain assoc w/tingling in hands & feet;poss GBS; also areflexia; BP 190/100;


Changed on 10/14/2018

VAERS ID: 43894 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:New York
Vaccinated:1988-11-25
Onset:1988-12-10
Submitted:1991-01-04
Entered:1991-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Back pain, Electrocardiogram abnormal, Guillain-Barre syndrome, Hypertension, Hyporeflexia, Paraesthesia, CSF test abnormal

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: Orudis Capsules
Current Illness: NONE
Preexisting Conditions: pt has known allergy to PCN; inc cholesterol in the past; pos for diabetes mellitus in mom & dad; father also had emphysema;
Allergies:
Diagnostic Lab Data: Spinal fluid analysis-inc spinal fluid protein, nl glucose & w/o leukocytes; Cholesterol 319; Triglycerides 276; EMG & Nerve conduction velocities showed mltifocal conduction abn;
CDC 'Split Type': B073089012

Write-up: Pt recvd flu vax & was admitted to hosp w/extremity weakness & numbness; approx 4-5 days prior to admission, pt had dorsal & epigastric pain assoc w/tingling in hands & feet;poss GBS; also areflexia; BP 190/100;

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