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This is VAERS ID 48724

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 48724
VAERS Form:
Age:65.1
Sex:Male
Location:Arizona
Vaccinated:1992-10-19
Onset:1992-10-19
Submitted:1992-12-02
Entered:1993-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1992-1993 / WYETH 4928228 / - LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: HYPOKINESIA, GUILLAIN BARRE SYND, MYALGIA, ATAXIA, ATROPHY MUSCLE

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? No
Previous Vaccinations: NONE
Other Medications: none specified;
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: EMG, nerve conduction velocities, MRI of brain; (specific results unknown);
CDC 'Split Type': NONE

Write-up: pt recvd flu vax; pt states inject was given directly into ax nerve; pt exp instant severe pain that has persisted over 8 wks; atrophy of the posterior deltoid & impaired function & persistent pain in the lt deltoid & trapezius; poss GBS;


Changed on 12/8/2009

VAERS ID: 48724 Before After
VAERS Form:
Age:65.1
Sex:Male
Location:Arizona
Vaccinated:1992-10-19
Onset:1992-10-19
Submitted:1992-12-02
Entered:1993-01-11 1993-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1992-1993 INFLUENZA (SEASONAL) (NO BRAND NAME, 92-93) / WYETH WYETH PHARMACEUTICALS, INC 4928228 / - LA / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Coordination abnormal, Guillain-Barre syndrome, Hypokinesia, Muscle atrophy, Myalgia, Neuritis, Pain, HYPOKINESIA, GUILLAIN BARRE SYND, MYALGIA, ATAXIA, ATROPHY MUSCLE

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? No
Previous Vaccinations: NONE
Other Medications: none specified;
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: EMG, nerve conduction velocities, MRI of brain; (specific results unknown);
CDC 'Split Type': NONE 892339002E

Write-up: pt recvd flu vax; pt states inject was given directly into ax nerve; pt exp instant severe pain that has persisted over 8 wks; atrophy of the posterior deltoid & impaired function & persistent pain in the lt deltoid & trapezius; poss GBS;


Changed on 8/31/2010

VAERS ID: 48724 Before After
VAERS Form:
Age:65.1
Sex:Male
Location:Arizona
Vaccinated:1992-10-19
Onset:1992-10-19
Submitted:1992-12-02
Entered:1993-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 92-93) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4928228 / - LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Coordination abnormal, Guillain-Barre syndrome, Hypokinesia, Muscle atrophy, Myalgia, Neuritis, Pain

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? No
Previous Vaccinations: NONE
Other Medications: none specified;
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: EMG, nerve conduction velocities, MRI of brain; (specific results unknown);
CDC 'Split Type': 892339002E

Write-up: pt recvd flu vax; pt states inject was given directly into ax nerve; pt exp instant severe pain that has persisted over 8 wks; atrophy of the posterior deltoid & impaired function & persistent pain in the lt deltoid & trapezius; poss GBS;


Changed on 7/7/2013

VAERS ID: 48724 Before After
VAERS Form:
Age:65.1
Sex:Male
Location:Arizona
Vaccinated:1992-10-19
Onset:1992-10-19
Submitted:1992-12-02
Entered:1993-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928228 / - LA / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928228 / - LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Coordination abnormal, Guillain-Barre syndrome, Hypokinesia, Muscle atrophy, Myalgia, Neuritis, Pain

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? No
Previous Vaccinations: NONE
Other Medications: none specified;
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: EMG, nerve conduction velocities, MRI of brain; (specific results unknown);
CDC 'Split Type': 892339002E

Write-up: pt recvd flu vax; pt states inject was given directly into ax nerve; pt exp instant severe pain that has persisted over 8 wks; atrophy of the posterior deltoid & impaired function & persistent pain in the lt deltoid & trapezius; poss GBS;


Changed on 12/14/2016

VAERS ID: 48724 Before After
VAERS Form:
Age:65.1
Sex:Male
Location:Arizona
Vaccinated:1992-10-19
Onset:1992-10-19
Submitted:1992-12-02
Entered:1993-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928228 / - LA / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928228 / - LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Coordination abnormal, Guillain-Barre syndrome, Hypokinesia, Muscle atrophy, Myalgia, Neuritis, Pain

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? No
Previous Vaccinations: NONE
Other Medications: none specified;
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: EMG, nerve conduction velocities, MRI of brain; (specific results unknown);
CDC 'Split Type': 892339002E

Write-up: pt recvd flu vax; pt states inject was given directly into ax nerve; pt exp instant severe pain that has persisted over 8 wks; atrophy of the posterior deltoid & impaired function & persistent pain in the lt deltoid & trapezius; poss GBS;


Changed on 2/14/2017

VAERS ID: 48724 Before After
VAERS Form:
Age:65.1 65.0
Sex:Male
Location:Arizona
Vaccinated:1992-10-19
Onset:1992-10-19
Submitted:1992-12-02
Entered:1993-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928228 / - LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Coordination abnormal, Guillain-Barre syndrome, Hypokinesia, Muscle atrophy, Myalgia, Neuritis, Pain

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? No
Previous Vaccinations: NONE
Other Medications: none specified;
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: EMG, nerve conduction velocities, MRI of brain; (specific results unknown);
CDC 'Split Type': 892339002E

Write-up: pt recvd flu vax; pt states inject was given directly into ax nerve; pt exp instant severe pain that has persisted over 8 wks; atrophy of the posterior deltoid & impaired function & persistent pain in the lt deltoid & trapezius; poss GBS;


Changed on 5/14/2017

VAERS ID: 48724 Before After
VAERS Form:
Age:65.0
Sex:Male
Location:Arizona
Vaccinated:1992-10-19
Onset:1992-10-19
Submitted:1992-12-02
Entered:1993-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928228 / - LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Coordination abnormal, Guillain-Barre syndrome, Hypokinesia, Muscle atrophy, Myalgia, Neuritis, Pain

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? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: none specified;
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: EMG, nerve conduction velocities, MRI of brain; (specific results unknown);
CDC 'Split Type': 892339002E

Write-up: pt recvd flu vax; pt states inject was given directly into ax nerve; pt exp instant severe pain that has persisted over 8 wks; atrophy of the posterior deltoid & impaired function & persistent pain in the lt deltoid & trapezius; poss GBS;


Changed on 9/14/2017

VAERS ID: 48724 Before After
VAERS Form:(blank) 1
Age:65.0
Sex:Male
Location:Arizona
Vaccinated:1992-10-19
Onset:1992-10-19
Submitted:1992-12-02
Entered:1993-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928228 / - UNK LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Coordination abnormal, Guillain-Barre syndrome, Hypokinesia, Muscle atrophy, Myalgia, Neuritis, Pain

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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: none specified;
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: EMG, nerve conduction velocities, MRI of brain; (specific results unknown);
CDC 'Split Type': 892339002E

Write-up: pt recvd flu vax; pt states inject was given directly into ax nerve; pt exp instant severe pain that has persisted over 8 wks; atrophy of the posterior deltoid & impaired function & persistent pain in the lt deltoid & trapezius; poss GBS;


Changed on 2/14/2018

VAERS ID: 48724 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:Arizona
Vaccinated:1992-10-19
Onset:1992-10-19
Submitted:1992-12-02
Entered:1993-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928228 / UNK LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Coordination abnormal, Guillain-Barre syndrome, Hypokinesia, Muscle atrophy, Myalgia, Neuritis, Pain

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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: none specified;
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: EMG, nerve conduction velocities, MRI of brain; (specific results unknown);
CDC 'Split Type': 892339002E

Write-up: pt recvd flu vax; pt states inject was given directly into ax nerve; pt exp instant severe pain that has persisted over 8 wks; atrophy of the posterior deltoid & impaired function & persistent pain in the lt deltoid & trapezius; poss GBS;


Changed on 6/14/2018

VAERS ID: 48724 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:Arizona
Vaccinated:1992-10-19
Onset:1992-10-19
Submitted:1992-12-02
Entered:1993-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928228 / UNK LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Coordination abnormal, Guillain-Barre syndrome, Hypokinesia, Muscle atrophy, Myalgia, Neuritis, Pain

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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: none specified;
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: EMG, nerve conduction velocities, MRI of brain; (specific results unknown);
CDC 'Split Type': 892339002E

Write-up: pt recvd flu vax; pt states inject was given directly into ax nerve; pt exp instant severe pain that has persisted over 8 wks; atrophy of the posterior deltoid & impaired function & persistent pain in the lt deltoid & trapezius; poss GBS;


Changed on 8/14/2018

VAERS ID: 48724 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:Arizona
Vaccinated:1992-10-19
Onset:1992-10-19
Submitted:1992-12-02
Entered:1993-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928228 / UNK LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Coordination abnormal, Guillain-Barre syndrome, Hypokinesia, Muscle atrophy, Myalgia, Neuritis, Pain

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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: none specified;
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: EMG, nerve conduction velocities, MRI of brain; (specific results unknown);
CDC 'Split Type': 892339002E

Write-up: pt recvd flu vax; pt states inject was given directly into ax nerve; pt exp instant severe pain that has persisted over 8 wks; atrophy of the posterior deltoid & impaired function & persistent pain in the lt deltoid & trapezius; poss GBS;


Changed on 9/14/2018

VAERS ID: 48724 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:Arizona
Vaccinated:1992-10-19
Onset:1992-10-19
Submitted:1992-12-02
Entered:1993-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928228 / UNK LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Coordination abnormal, Guillain-Barre syndrome, Hypokinesia, Muscle atrophy, Myalgia, Neuritis, Pain

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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: none specified;
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: EMG, nerve conduction velocities, MRI of brain; (specific results unknown);
CDC 'Split Type': 892339002E

Write-up: pt recvd flu vax; pt states inject was given directly into ax nerve; pt exp instant severe pain that has persisted over 8 wks; atrophy of the posterior deltoid & impaired function & persistent pain in the lt deltoid & trapezius; poss GBS;


Changed on 10/14/2018

VAERS ID: 48724 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:Arizona
Vaccinated:1992-10-19
Onset:1992-10-19
Submitted:1992-12-02
Entered:1993-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928228 / UNK LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Coordination abnormal, Guillain-Barre syndrome, Hypokinesia, Muscle atrophy, Myalgia, Neuritis, Pain

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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: none specified;
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: EMG, nerve conduction velocities, MRI of brain; (specific results unknown);
CDC 'Split Type': 892339002E

Write-up: pt recvd flu vax; pt states inject was given directly into ax nerve; pt exp instant severe pain that has persisted over 8 wks; atrophy of the posterior deltoid & impaired function & persistent pain in the lt deltoid & trapezius; poss GBS;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=48724&WAYBACKHISTORY=ON


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