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This is VAERS ID 476382

History of Changes from the VAERS Wayback Machine

First Appeared on 12/11/2012

VAERS ID: 476382
VAERS Form:
Age:73.0
Sex:Male
Location:Tennessee
Vaccinated:2012-10-09
Onset:2012-10-12
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4525AA / - LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Biopsy, Biopsy bone marrow, Computerised tomogram, Nuclear magnetic resonance imaging, Sensory loss, X-ray, Abasia, Blood test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 34     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vasodec, HTZ/lisinopril
Current Illness: None
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: CT, MRI, (multiple) biopsies, blood tests, bone marrow biopsy, multiple x rays
CDC 'Split Type':

Write-up: Started losing all feeling in arms and legs. Unable to walk unassisted.


Changed on 7/7/2013

VAERS ID: 476382 Before After
VAERS Form:
Age:73.0
Sex:Male
Location:Tennessee
Vaccinated:2012-10-09
Onset:2012-10-12
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4525AA / - LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4525AA / - LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Biopsy, Biopsy bone marrow, Computerised tomogram, Nuclear magnetic resonance imaging, Sensory loss, X-ray, Abasia, Blood test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 34     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vasodec, HTZ/lisinopril
Current Illness: None
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: CT, MRI, (multiple) biopsies, blood tests, bone marrow biopsy, multiple x rays
CDC 'Split Type':

Write-up: Started losing all feeling in arms and legs. Unable to walk unassisted.


Changed on 6/14/2014

VAERS ID: 476382 Before After
VAERS Form:
Age:73.0
Sex:Male
Location:Tennessee
Vaccinated:2012-10-09
Onset:2012-10-12
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4525AA / - LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Biopsy, Biopsy bone marrow, Computerised tomogram, Nuclear magnetic resonance imaging, Sensory loss, X-ray, Abasia, Blood test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 34     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vasodec, HTZ/lisinopril
Current Illness: None
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: CT, MRI, (multiple) biopsies, blood tests, bone marrow biopsy, multiple x rays
CDC 'Split Type':

Write-up: Started losing all feeling in arms and legs. Unable to walk unassisted.


Changed on 3/14/2015

VAERS ID: 476382 Before After
VAERS Form:
Age:73.0
Sex:Male
Location:Tennessee
Vaccinated:2012-10-09
Onset:2012-10-12
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4525AA / - LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Biopsy, Biopsy bone marrow, Computerised tomogram, Nuclear magnetic resonance imaging, Sensory loss, X-ray, Abasia, Blood test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 34     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vasodec, HTZ/lisinopril
Current Illness: None
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: CT, MRI, (multiple) biopsies, blood tests, bone marrow biopsy, multiple x rays
CDC 'Split Type':

Write-up: Started losing all feeling in arms and legs. Unable to walk unassisted.


Changed on 9/14/2017

VAERS ID: 476382 Before After
VAERS Form:(blank) 1
Age:73.0
Sex:Male
Location:Tennessee
Vaccinated:2012-10-09
Onset:2012-10-12
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4525AA / - UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Biopsy, Biopsy bone marrow, Computerised tomogram, Nuclear magnetic resonance imaging, Sensory loss, X-ray, Abasia, Blood test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 34     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vasodec, HTZ/lisinopril
Current Illness: None
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: CT, MRI, (multiple) biopsies, blood tests, bone marrow biopsy, multiple x rays
CDC 'Split Type':

Write-up: Started losing all feeling in arms and legs. Unable to walk unassisted.


Changed on 2/14/2018

VAERS ID: 476382 Before After
VAERS Form:1
Age:73.0
Sex:Male
Location:Tennessee
Vaccinated:2012-10-09
Onset:2012-10-12
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4525AA / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Biopsy, Biopsy bone marrow, Computerised tomogram, Nuclear magnetic resonance imaging, Sensory loss, X-ray, Abasia, Blood test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 34     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vasodec, HTZ/lisinopril
Current Illness: None
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: CT, MRI, (multiple) biopsies, blood tests, bone marrow biopsy, multiple x rays
CDC 'Split Type':

Write-up: Started losing all feeling in arms and legs. Unable to walk unassisted.


Changed on 6/14/2018

VAERS ID: 476382 Before After
VAERS Form:1
Age:73.0
Sex:Male
Location:Tennessee
Vaccinated:2012-10-09
Onset:2012-10-12
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4525AA / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Biopsy, Biopsy bone marrow, Computerised tomogram, Nuclear magnetic resonance imaging, Sensory loss, X-ray, Abasia, Blood test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 34     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vasodec, HTZ/lisinopril
Current Illness: None
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: CT, MRI, (multiple) biopsies, blood tests, bone marrow biopsy, multiple x rays
CDC 'Split Type':

Write-up: Started losing all feeling in arms and legs. Unable to walk unassisted.


Changed on 8/14/2018

VAERS ID: 476382 Before After
VAERS Form:1
Age:73.0
Sex:Male
Location:Tennessee
Vaccinated:2012-10-09
Onset:2012-10-12
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4525AA / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Biopsy, Biopsy bone marrow, Computerised tomogram, Nuclear magnetic resonance imaging, Sensory loss, X-ray, Abasia, Blood test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 34     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vasodec, HTZ/lisinopril
Current Illness: None
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: CT, MRI, (multiple) biopsies, blood tests, bone marrow biopsy, multiple x rays
CDC 'Split Type':

Write-up: Started losing all feeling in arms and legs. Unable to walk unassisted.


Changed on 9/14/2018

VAERS ID: 476382 Before After
VAERS Form:1
Age:73.0
Sex:Male
Location:Tennessee
Vaccinated:2012-10-09
Onset:2012-10-12
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4525AA / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Biopsy, Biopsy bone marrow, Computerised tomogram, Nuclear magnetic resonance imaging, Sensory loss, X-ray, Abasia, Blood test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 34     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vasodec, HTZ/lisinopril
Current Illness: None
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: CT, MRI, (multiple) biopsies, blood tests, bone marrow biopsy, multiple x rays
CDC 'Split Type':

Write-up: Started losing all feeling in arms and legs. Unable to walk unassisted.


Changed on 10/14/2018

VAERS ID: 476382 Before After
VAERS Form:1
Age:73.0
Sex:Male
Location:Tennessee
Vaccinated:2012-10-09
Onset:2012-10-12
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4525AA / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Biopsy, Biopsy bone marrow, Computerised tomogram, Nuclear magnetic resonance imaging, Sensory loss, X-ray, Abasia, Blood test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 34     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Vasodec, HTZ/lisinopril
Current Illness: None
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data: CT, MRI, (multiple) biopsies, blood tests, bone marrow biopsy, multiple x rays
CDC 'Split Type':

Write-up: Started losing all feeling in arms and legs. Unable to walk unassisted.

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