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This is VAERS ID 49045

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 49045
VAERS Form:
Age:69.0
Sex:Male
Location:Pennsylvania
Vaccinated:1992-11-06
Onset:1992-11-06
Submitted:0000-00-00
Entered:1993-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1992-1993 / WYETH 4928217 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: HEADACHE, GUILLAIN BARRE SYND, VISION ABNORM, DIPLOPIA, PTOSIS

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: Ecotrin, Tagamet
Current Illness:
Preexisting Conditions: Gastroesophageal reflux dis, hypercholesterolemia, hx of anxiety disorder, stable abdo aortic aneurysm;
Allergies:
Diagnostic Lab Data: CSF-appearance was transparent & acellular present material neg for malignant cells;
CDC 'Split Type':

Write-up: pt exp diplopia & frontal h/a 1 day p/receiving flu vax followed by diminished visual acuity in lt eye & lt ptosis; poss GBS;


Changed on 12/8/2009

VAERS ID: 49045 Before After
VAERS Form:
Age:69.0
Sex:Male
Location:Pennsylvania
Vaccinated:1992-11-06
Onset:1992-11-06
Submitted:0000-00-00
Entered:1993-01-19 1993-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1992-1993 INFLUENZA (SEASONAL) (NO BRAND NAME, 92-93) / WYETH WYETH PHARMACEUTICALS, INC 4928217 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diplopia, Eyelid ptosis, Guillain-Barre syndrome, Headache, Visual disturbance, HEADACHE, GUILLAIN BARRE SYND, VISION ABNORM, DIPLOPIA, PTOSIS

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: Ecotrin, Tagamet
Current Illness:
Preexisting Conditions: Gastroesophageal reflux dis, hypercholesterolemia, hx of anxiety disorder, stable abdo aortic aneurysm;
Allergies:
Diagnostic Lab Data: CSF-appearance was transparent & acellular present material neg for malignant cells;
CDC 'Split Type':

Write-up: pt exp diplopia & frontal h/a 1 day p/receiving flu vax followed by diminished visual acuity in lt eye & lt ptosis; poss GBS;


Changed on 8/31/2010

VAERS ID: 49045 Before After
VAERS Form:
Age:69.0
Sex:Male
Location:Pennsylvania
Vaccinated:1992-11-06
Onset:1992-11-06
Submitted:0000-00-00
Entered:1993-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 92-93) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4928217 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diplopia, Eyelid ptosis, Guillain-Barre syndrome, Headache, Visual disturbance

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: Ecotrin, Tagamet
Current Illness:
Preexisting Conditions: Gastroesophageal reflux dis, hypercholesterolemia, hx of anxiety disorder, stable abdo aortic aneurysm;
Allergies:
Diagnostic Lab Data: CSF-appearance was transparent & acellular present material neg for malignant cells;
CDC 'Split Type':

Write-up: pt exp diplopia & frontal h/a 1 day p/receiving flu vax followed by diminished visual acuity in lt eye & lt ptosis; poss GBS;


Changed on 7/7/2013

VAERS ID: 49045 Before After
VAERS Form:
Age:69.0
Sex:Male
Location:Pennsylvania
Vaccinated:1992-11-06
Onset:1992-11-06
Submitted:0000-00-00
Entered:1993-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / - - / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diplopia, Eyelid ptosis, Guillain-Barre syndrome, Headache, Visual disturbance

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: Ecotrin, Tagamet
Current Illness:
Preexisting Conditions: Gastroesophageal reflux dis, hypercholesterolemia, hx of anxiety disorder, stable abdo aortic aneurysm;
Allergies:
Diagnostic Lab Data: CSF-appearance was transparent & acellular present material neg for malignant cells;
CDC 'Split Type':

Write-up: pt exp diplopia & frontal h/a 1 day p/receiving flu vax followed by diminished visual acuity in lt eye & lt ptosis; poss GBS;


Changed on 12/14/2016

VAERS ID: 49045 Before After
VAERS Form:
Age:69.0
Sex:Male
Location:Pennsylvania
Vaccinated:1992-11-06
Onset:1992-11-06
Submitted:0000-00-00
Entered:1993-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / - - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diplopia, Eyelid ptosis, Guillain-Barre syndrome, Headache, Visual disturbance

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: Ecotrin, Tagamet
Current Illness:
Preexisting Conditions: Gastroesophageal reflux dis, hypercholesterolemia, hx of anxiety disorder, stable abdo aortic aneurysm;
Allergies:
Diagnostic Lab Data: CSF-appearance was transparent & acellular present material neg for malignant cells;
CDC 'Split Type':

Write-up: pt exp diplopia & frontal h/a 1 day p/receiving flu vax followed by diminished visual acuity in lt eye & lt ptosis; poss GBS;


Changed on 5/14/2017

VAERS ID: 49045 Before After
VAERS Form:
Age:69.0
Sex:Male
Location:Pennsylvania
Vaccinated:1992-11-06
Onset:1992-11-06
Submitted:0000-00-00
Entered:1993-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diplopia, Eyelid ptosis, Guillain-Barre syndrome, Headache, Visual disturbance

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: Ecotrin, Tagamet
Current Illness:
Preexisting Conditions: Gastroesophageal reflux dis, hypercholesterolemia, hx of anxiety disorder, stable abdo aortic aneurysm;
Allergies:
Diagnostic Lab Data: CSF-appearance was transparent & acellular present material neg for malignant cells;
CDC 'Split Type':

Write-up: pt exp diplopia & frontal h/a 1 day p/receiving flu vax followed by diminished visual acuity in lt eye & lt ptosis; poss GBS;


Changed on 9/14/2017

VAERS ID: 49045 Before After
VAERS Form:(blank) 1
Age:69.0
Sex:Male
Location:Pennsylvania
Vaccinated:1992-11-06
Onset:1992-11-06
Submitted:0000-00-00
Entered:1993-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / - UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diplopia, Eyelid ptosis, Guillain-Barre syndrome, Headache, Visual disturbance

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: Ecotrin, Tagamet
Current Illness:
Preexisting Conditions: Gastroesophageal reflux dis, hypercholesterolemia, hx of anxiety disorder, stable abdo aortic aneurysm;
Allergies:
Diagnostic Lab Data: CSF-appearance was transparent & acellular present material neg for malignant cells;
CDC 'Split Type':

Write-up: pt exp diplopia & frontal h/a 1 day p/receiving flu vax followed by diminished visual acuity in lt eye & lt ptosis; poss GBS;


Changed on 2/14/2018

VAERS ID: 49045 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Pennsylvania
Vaccinated:1992-11-06
Onset:1992-11-06
Submitted:0000-00-00
Entered:1993-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diplopia, Eyelid ptosis, Guillain-Barre syndrome, Headache, Visual disturbance

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: Ecotrin, Tagamet
Current Illness:
Preexisting Conditions: Gastroesophageal reflux dis, hypercholesterolemia, hx of anxiety disorder, stable abdo aortic aneurysm;
Allergies:
Diagnostic Lab Data: CSF-appearance was transparent & acellular present material neg for malignant cells;
CDC 'Split Type':

Write-up: pt exp diplopia & frontal h/a 1 day p/receiving flu vax followed by diminished visual acuity in lt eye & lt ptosis; poss GBS;


Changed on 6/14/2018

VAERS ID: 49045 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Pennsylvania
Vaccinated:1992-11-06
Onset:1992-11-06
Submitted:0000-00-00
Entered:1993-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diplopia, Eyelid ptosis, Guillain-Barre syndrome, Headache, Visual disturbance

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: Ecotrin, Tagamet
Current Illness:
Preexisting Conditions: Gastroesophageal reflux dis, hypercholesterolemia, hx of anxiety disorder, stable abdo aortic aneurysm;
Allergies:
Diagnostic Lab Data: CSF-appearance was transparent & acellular present material neg for malignant cells;
CDC 'Split Type':

Write-up: pt exp diplopia & frontal h/a 1 day p/receiving flu vax followed by diminished visual acuity in lt eye & lt ptosis; poss GBS;


Changed on 8/14/2018

VAERS ID: 49045 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Pennsylvania
Vaccinated:1992-11-06
Onset:1992-11-06
Submitted:0000-00-00
Entered:1993-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diplopia, Eyelid ptosis, Guillain-Barre syndrome, Headache, Visual disturbance

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: Ecotrin, Tagamet
Current Illness:
Preexisting Conditions: Gastroesophageal reflux dis, hypercholesterolemia, hx of anxiety disorder, stable abdo aortic aneurysm;
Allergies:
Diagnostic Lab Data: CSF-appearance was transparent & acellular present material neg for malignant cells;
CDC 'Split Type':

Write-up: pt exp diplopia & frontal h/a 1 day p/receiving flu vax followed by diminished visual acuity in lt eye & lt ptosis; poss GBS;


Changed on 9/14/2018

VAERS ID: 49045 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Pennsylvania
Vaccinated:1992-11-06
Onset:1992-11-06
Submitted:0000-00-00
Entered:1993-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diplopia, Eyelid ptosis, Guillain-Barre syndrome, Headache, Visual disturbance

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: Ecotrin, Tagamet
Current Illness:
Preexisting Conditions: Gastroesophageal reflux dis, hypercholesterolemia, hx of anxiety disorder, stable abdo aortic aneurysm;
Allergies:
Diagnostic Lab Data: CSF-appearance was transparent & acellular present material neg for malignant cells;
CDC 'Split Type':

Write-up: pt exp diplopia & frontal h/a 1 day p/receiving flu vax followed by diminished visual acuity in lt eye & lt ptosis; poss GBS;


Changed on 10/14/2018

VAERS ID: 49045 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Pennsylvania
Vaccinated:1992-11-06
Onset:1992-11-06
Submitted:0000-00-00
Entered:1993-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diplopia, Eyelid ptosis, Guillain-Barre syndrome, Headache, Visual disturbance

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: Ecotrin, Tagamet
Current Illness:
Preexisting Conditions: Gastroesophageal reflux dis, hypercholesterolemia, hx of anxiety disorder, stable abdo aortic aneurysm;
Allergies:
Diagnostic Lab Data: CSF-appearance was transparent & acellular present material neg for malignant cells;
CDC 'Split Type':

Write-up: pt exp diplopia & frontal h/a 1 day p/receiving flu vax followed by diminished visual acuity in lt eye & lt ptosis; poss GBS;

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=49045&WAYBACKHISTORY=ON


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