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This is VAERS ID 43970

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 43970
VAERS Form:
Age:78.1
Sex:Female
Location:North Carolina
Vaccinated:1990-10-11
Onset:1990-11-15
Submitted:0000-00-00
Entered:1992-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1991-1992 / CONNAUGHT LABS 0F11208 / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND, MYASTHENIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-16
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:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: many, including LP, EMG;
CDC 'Split Type':

Write-up: progressive LE weakness, GBS;


Changed on 12/8/2009

VAERS ID: 43970 Before After
VAERS Form:
Age:78.1
Sex:Female
Location:North Carolina
Vaccinated:1990-10-11
Onset:1990-11-15
Submitted:0000-00-00
Entered:1992-08-11 1992-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1991-1992 INFLUENZA (SEASONAL) (FLUZONE 91-92) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0F11208 / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome, GUILLAIN BARRE SYND, MYASTHENIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-16
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:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: many, including LP, EMG;
CDC 'Split Type':

Write-up: progressive LE weakness, GBS;


Changed on 8/31/2010

VAERS ID: 43970 Before After
VAERS Form:
Age:78.1
Sex:Female
Location:North Carolina
Vaccinated:1990-10-11
Onset:1990-11-15
Submitted:0000-00-00
Entered:1992-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 91-92) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11208 / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-16
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:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: many, including LP, EMG;
CDC 'Split Type':

Write-up: progressive LE weakness, GBS;


Changed on 7/7/2013

VAERS ID: 43970 Before After
VAERS Form:
Age:78.1
Sex:Female
Location:North Carolina
Vaccinated:1990-10-11
Onset:1990-11-15
Submitted:0000-00-00
Entered:1992-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11208 / 1 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11208 / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-16
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:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: many, including LP, EMG;
CDC 'Split Type':

Write-up: progressive LE weakness, GBS;


Changed on 2/14/2017

VAERS ID: 43970 Before After
VAERS Form:
Age:78.1 78.0
Sex:Female
Location:North Carolina
Vaccinated:1990-10-11
Onset:1990-11-15
Submitted:0000-00-00
Entered:1992-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11208 / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-16
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:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: many, including LP, EMG;
CDC 'Split Type':

Write-up: progressive LE weakness, GBS;


Changed on 5/14/2017

VAERS ID: 43970 Before After
VAERS Form:
Age:78.0
Sex:Female
Location:North Carolina
Vaccinated:1990-10-11
Onset:1990-11-15
Submitted:0000-00-00
Entered:1992-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11208 / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-16
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: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: many, including LP, EMG;
CDC 'Split Type':

Write-up: progressive LE weakness, GBS;


Changed on 9/14/2017

VAERS ID: 43970 Before After
VAERS Form:(blank) 1
Age:78.0
Sex:Female
Location:North Carolina
Vaccinated:1990-10-11
Onset:1990-11-15
Submitted:0000-00-00
Entered:1992-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11208 / 1 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-16
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: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: many, including LP, EMG;
CDC 'Split Type':

Write-up: progressive LE weakness, GBS;


Changed on 2/14/2018

VAERS ID: 43970 Before After
VAERS Form:1
Age:78.0
Sex:Female
Location:North Carolina
Vaccinated:1990-10-11
Onset:1990-11-15
Submitted:0000-00-00
Entered:1992-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11208 / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-16
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: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: many, including LP, EMG;
CDC 'Split Type':

Write-up: progressive LE weakness, GBS;


Changed on 6/14/2018

VAERS ID: 43970 Before After
VAERS Form:1
Age:78.0
Sex:Female
Location:North Carolina
Vaccinated:1990-10-11
Onset:1990-11-15
Submitted:0000-00-00
Entered:1992-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11208 / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-16
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: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: many, including LP, EMG;
CDC 'Split Type':

Write-up: progressive LE weakness, GBS;


Changed on 8/14/2018

VAERS ID: 43970 Before After
VAERS Form:1
Age:78.0
Sex:Female
Location:North Carolina
Vaccinated:1990-10-11
Onset:1990-11-15
Submitted:0000-00-00
Entered:1992-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11208 / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-16
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: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: many, including LP, EMG;
CDC 'Split Type':

Write-up: progressive LE weakness, GBS;


Changed on 9/14/2018

VAERS ID: 43970 Before After
VAERS Form:1
Age:78.0
Sex:Female
Location:North Carolina
Vaccinated:1990-10-11
Onset:1990-11-15
Submitted:0000-00-00
Entered:1992-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11208 / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-16
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: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: many, including LP, EMG;
CDC 'Split Type':

Write-up: progressive LE weakness, GBS;


Changed on 10/14/2018

VAERS ID: 43970 Before After
VAERS Form:1
Age:78.0
Sex:Female
Location:North Carolina
Vaccinated:1990-10-11
Onset:1990-11-15
Submitted:0000-00-00
Entered:1992-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11208 / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Myasthenic syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-16
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: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: many, including LP, EMG;
CDC 'Split Type':

Write-up: progressive LE weakness, GBS;

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