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This is VAERS ID 46276

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 46276
VAERS Form:
Age:81.8
Sex:Female
Location:Texas
Vaccinated:1992-10-07
Onset:1992-10-08
Submitted:1992-10-14
Entered:1992-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLU-IMUNE 1992-1993 EVANS MED & LEDERLE / LEDERLE 338971 / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: CONVULS GRAND MAL, PARALYSIS, ENCEPHALOPATHY, APHASIA

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nasalide, Megace, Theophyllin, Digoxin, K Ce, Lasix, Coumadin, Iron, ALbuterol inhaler, Atrovent;
Current Illness: breast cancer w/metasitasis, CHF
Preexisting Conditions: organic brain synd, recurrent deep vein thrombosis & pulmonar-embolism;
Allergies:
Diagnostic Lab Data: neg head CT x 2; neg LP; THeophylline level + digoxin levels non toxic;
CDC 'Split Type':

Write-up: seizures, grand mal w/in 12 hrs of vax; diffuse encephalopathy w/bilateral lower extremities & rt upper extremities paresis, aphasia;


Changed on 12/8/2009

VAERS ID: 46276 Before After
VAERS Form:
Age:81.8
Sex:Female
Location:Texas
Vaccinated:1992-10-07
Onset:1992-10-08
Submitted:1992-10-14
Entered:1992-10-21 1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLU-IMUNE 1992-1993 EVANS MED & LEDERLE INFLUENZA (SEASONAL) (FLU-IMUNE 92-93) / LEDERLE LEDERLE LABORATORIES 338971 / 0 LA / IM

Administered by: Other      Purchased by: Unknown Private
Symptoms: Aphasia, Encephalopathy, Grand mal convulsion, Paralysis, CONVULS GRAND MAL, PARALYSIS, ENCEPHALOPATHY, APHASIA

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nasalide, Megace, Theophyllin, Digoxin, K Ce, Lasix, Coumadin, Iron, ALbuterol inhaler, Atrovent;
Current Illness: breast cancer w/metasitasis, CHF
Preexisting Conditions: organic brain synd, recurrent deep vein thrombosis & pulmonar-embolism;
Allergies:
Diagnostic Lab Data: neg head CT x 2; neg LP; THeophylline level + digoxin levels non toxic;
CDC 'Split Type':

Write-up: seizures, grand mal w/in 12 hrs of vax; diffuse encephalopathy w/bilateral lower extremities & rt upper extremities paresis, aphasia;


Changed on 8/31/2010

VAERS ID: 46276 Before After
VAERS Form:
Age:81.8
Sex:Female
Location:Texas
Vaccinated:1992-10-07
Onset:1992-10-08
Submitted:1992-10-14
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLU-IMUNE 92-93) INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 338971 / 0 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Aphasia, Encephalopathy, Grand mal convulsion, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nasalide, Megace, Theophyllin, Digoxin, K Ce, Lasix, Coumadin, Iron, ALbuterol inhaler, Atrovent;
Current Illness: breast cancer w/metasitasis, CHF
Preexisting Conditions: organic brain synd, recurrent deep vein thrombosis & pulmonar-embolism;
Allergies:
Diagnostic Lab Data: neg head CT x 2; neg LP; THeophylline level + digoxin levels non toxic;
CDC 'Split Type':

Write-up: seizures, grand mal w/in 12 hrs of vax; diffuse encephalopathy w/bilateral lower extremities & rt upper extremities paresis, aphasia;


Changed on 7/7/2013

VAERS ID: 46276 Before After
VAERS Form:
Age:81.8
Sex:Female
Location:Texas
Vaccinated:1992-10-07
Onset:1992-10-08
Submitted:1992-10-14
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 338971 / 0 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 338971 / 0 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Aphasia, Encephalopathy, Grand mal convulsion, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nasalide, Megace, Theophyllin, Digoxin, K Ce, Lasix, Coumadin, Iron, ALbuterol inhaler, Atrovent;
Current Illness: breast cancer w/metasitasis, CHF
Preexisting Conditions: organic brain synd, recurrent deep vein thrombosis & pulmonar-embolism;
Allergies:
Diagnostic Lab Data: neg head CT x 2; neg LP; THeophylline level + digoxin levels non toxic;
CDC 'Split Type':

Write-up: seizures, grand mal w/in 12 hrs of vax; diffuse encephalopathy w/bilateral lower extremities & rt upper extremities paresis, aphasia;


Changed on 2/14/2017

VAERS ID: 46276 Before After
VAERS Form:
Age:81.8 81.0
Sex:Female
Location:Texas
Vaccinated:1992-10-07
Onset:1992-10-08
Submitted:1992-10-14
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 338971 / 0 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Aphasia, Encephalopathy, Grand mal convulsion, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nasalide, Megace, Theophyllin, Digoxin, K Ce, Lasix, Coumadin, Iron, ALbuterol inhaler, Atrovent;
Current Illness: breast cancer w/metasitasis, CHF
Preexisting Conditions: organic brain synd, recurrent deep vein thrombosis & pulmonar-embolism;
Allergies:
Diagnostic Lab Data: neg head CT x 2; neg LP; THeophylline level + digoxin levels non toxic;
CDC 'Split Type':

Write-up: seizures, grand mal w/in 12 hrs of vax; diffuse encephalopathy w/bilateral lower extremities & rt upper extremities paresis, aphasia;


Changed on 5/14/2017

VAERS ID: 46276 Before After
VAERS Form:
Age:81.0
Sex:Female
Location:Texas
Vaccinated:1992-10-07
Onset:1992-10-08
Submitted:1992-10-14
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 338971 / 0 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Aphasia, Encephalopathy, Grand mal convulsion, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Nasalide, Megace, Theophyllin, Digoxin, K Ce, Lasix, Coumadin, Iron, ALbuterol inhaler, Atrovent;
Current Illness: breast cancer w/metasitasis, CHF
Preexisting Conditions: organic brain synd, recurrent deep vein thrombosis & pulmonar-embolism;
Allergies:
Diagnostic Lab Data: neg head CT x 2; neg LP; THeophylline level + digoxin levels non toxic;
CDC 'Split Type':

Write-up: seizures, grand mal w/in 12 hrs of vax; diffuse encephalopathy w/bilateral lower extremities & rt upper extremities paresis, aphasia;


Changed on 9/14/2017

VAERS ID: 46276 Before After
VAERS Form:(blank) 1
Age:81.0
Sex:Female
Location:Texas
Vaccinated:1992-10-07
Onset:1992-10-08
Submitted:1992-10-14
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 338971 / 0 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Aphasia, Encephalopathy, Grand mal convulsion, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Nasalide, Megace, Theophyllin, Digoxin, K Ce, Lasix, Coumadin, Iron, ALbuterol inhaler, Atrovent;
Current Illness: breast cancer w/metasitasis, CHF
Preexisting Conditions: organic brain synd, recurrent deep vein thrombosis & pulmonar-embolism;
Allergies:
Diagnostic Lab Data: neg head CT x 2; neg LP; THeophylline level + digoxin levels non toxic;
CDC 'Split Type':

Write-up: seizures, grand mal w/in 12 hrs of vax; diffuse encephalopathy w/bilateral lower extremities & rt upper extremities paresis, aphasia;


Changed on 2/14/2018

VAERS ID: 46276 Before After
VAERS Form:1
Age:81.0
Sex:Female
Location:Texas
Vaccinated:1992-10-07
Onset:1992-10-08
Submitted:1992-10-14
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 338971 / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Aphasia, Encephalopathy, Grand mal convulsion, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Nasalide, Megace, Theophyllin, Digoxin, K Ce, Lasix, Coumadin, Iron, ALbuterol inhaler, Atrovent;
Current Illness: breast cancer w/metasitasis, CHF
Preexisting Conditions: organic brain synd, recurrent deep vein thrombosis & pulmonar-embolism;
Allergies:
Diagnostic Lab Data: neg head CT x 2; neg LP; THeophylline level + digoxin levels non toxic;
CDC 'Split Type':

Write-up: seizures, grand mal w/in 12 hrs of vax; diffuse encephalopathy w/bilateral lower extremities & rt upper extremities paresis, aphasia;


Changed on 6/14/2018

VAERS ID: 46276 Before After
VAERS Form:1
Age:81.0
Sex:Female
Location:Texas
Vaccinated:1992-10-07
Onset:1992-10-08
Submitted:1992-10-14
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 338971 / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Aphasia, Encephalopathy, Grand mal convulsion, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Nasalide, Megace, Theophyllin, Digoxin, K Ce, Lasix, Coumadin, Iron, ALbuterol inhaler, Atrovent;
Current Illness: breast cancer w/metasitasis, CHF
Preexisting Conditions: organic brain synd, recurrent deep vein thrombosis & pulmonar-embolism;
Allergies:
Diagnostic Lab Data: neg head CT x 2; neg LP; THeophylline level + digoxin levels non toxic;
CDC 'Split Type':

Write-up: seizures, grand mal w/in 12 hrs of vax; diffuse encephalopathy w/bilateral lower extremities & rt upper extremities paresis, aphasia;


Changed on 8/14/2018

VAERS ID: 46276 Before After
VAERS Form:1
Age:81.0
Sex:Female
Location:Texas
Vaccinated:1992-10-07
Onset:1992-10-08
Submitted:1992-10-14
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 338971 / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Aphasia, Encephalopathy, Grand mal convulsion, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Nasalide, Megace, Theophyllin, Digoxin, K Ce, Lasix, Coumadin, Iron, ALbuterol inhaler, Atrovent;
Current Illness: breast cancer w/metasitasis, CHF
Preexisting Conditions: organic brain synd, recurrent deep vein thrombosis & pulmonar-embolism;
Allergies:
Diagnostic Lab Data: neg head CT x 2; neg LP; THeophylline level + digoxin levels non toxic;
CDC 'Split Type':

Write-up: seizures, grand mal w/in 12 hrs of vax; diffuse encephalopathy w/bilateral lower extremities & rt upper extremities paresis, aphasia;


Changed on 9/14/2018

VAERS ID: 46276 Before After
VAERS Form:1
Age:81.0
Sex:Female
Location:Texas
Vaccinated:1992-10-07
Onset:1992-10-08
Submitted:1992-10-14
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 338971 / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Aphasia, Encephalopathy, Grand mal convulsion, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Nasalide, Megace, Theophyllin, Digoxin, K Ce, Lasix, Coumadin, Iron, ALbuterol inhaler, Atrovent;
Current Illness: breast cancer w/metasitasis, CHF
Preexisting Conditions: organic brain synd, recurrent deep vein thrombosis & pulmonar-embolism;
Allergies:
Diagnostic Lab Data: neg head CT x 2; neg LP; THeophylline level + digoxin levels non toxic;
CDC 'Split Type':

Write-up: seizures, grand mal w/in 12 hrs of vax; diffuse encephalopathy w/bilateral lower extremities & rt upper extremities paresis, aphasia;


Changed on 10/14/2018

VAERS ID: 46276 Before After
VAERS Form:1
Age:81.0
Sex:Female
Location:Texas
Vaccinated:1992-10-07
Onset:1992-10-08
Submitted:1992-10-14
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 338971 / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Aphasia, Encephalopathy, Grand mal convulsion, Paralysis

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Nasalide, Megace, Theophyllin, Digoxin, K Ce, Lasix, Coumadin, Iron, ALbuterol inhaler, Atrovent;
Current Illness: breast cancer w/metasitasis, CHF
Preexisting Conditions: organic brain synd, recurrent deep vein thrombosis & pulmonar-embolism;
Allergies:
Diagnostic Lab Data: neg head CT x 2; neg LP; THeophylline level + digoxin levels non toxic;
CDC 'Split Type':

Write-up: seizures, grand mal w/in 12 hrs of vax; diffuse encephalopathy w/bilateral lower extremities & rt upper extremities paresis, aphasia;

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