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This is VAERS ID 51272

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 51272
VAERS Form:
Age:67.0
Sex:Male
Location:Unknown
Vaccinated:1992-10-12
Onset:1992-10-22
Submitted:0000-00-00
Entered:1993-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE / UNCLASSIFIED - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: ENCEPHALITIS, MYELITIS, PARALYSIS

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? Yes
Previous Vaccinations:
Other Medications: Voltaren, Vasotec & Vicodin
Current Illness:
Preexisting Conditions: hypertension, arthritis
Allergies:
Diagnostic Lab Data: neg urine & blood cult; carotid doppler & echo cardiogram nl; MRI brain stem nl; Thyroid profile nl; spinal tap nl;
CDC 'Split Type':

Write-up: suspected post influenza vax encephalitis w/myelitis/ensuing motor neuron paresis; upon discharge, pt was able to ambulate/speech improved;


Changed on 12/8/2009

VAERS ID: 51272 Before After
VAERS Form:
Age:67.0
Sex:Male
Location:Unknown
Vaccinated:1992-10-12
Onset:1992-10-22
Submitted:0000-00-00
Entered:1993-04-01 1993-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE INFLUENZA (SEASONAL) (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Myelitis, Paralysis, ENCEPHALITIS, MYELITIS, PARALYSIS

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? Yes
Previous Vaccinations:
Other Medications: Voltaren, Vasotec & Vicodin
Current Illness:
Preexisting Conditions: hypertension, arthritis
Allergies:
Diagnostic Lab Data: neg urine & blood cult; carotid doppler & echo cardiogram nl; MRI brain stem nl; Thyroid profile nl; spinal tap nl;
CDC 'Split Type':

Write-up: suspected post influenza vax encephalitis w/myelitis/ensuing motor neuron paresis; upon discharge, pt was able to ambulate/speech improved;


Changed on 7/7/2013

VAERS ID: 51272 Before After
VAERS Form:
Age:67.0
Sex:Male
Location:Unknown
Vaccinated:1992-10-12
Onset:1992-10-22
Submitted:0000-00-00
Entered:1993-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Myelitis, Paralysis

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? Yes
Previous Vaccinations:
Other Medications: Voltaren, Vasotec & Vicodin
Current Illness:
Preexisting Conditions: hypertension, arthritis
Allergies:
Diagnostic Lab Data: neg urine & blood cult; carotid doppler & echo cardiogram nl; MRI brain stem nl; Thyroid profile nl; spinal tap nl;
CDC 'Split Type':

Write-up: suspected post influenza vax encephalitis w/myelitis/ensuing motor neuron paresis; upon discharge, pt was able to ambulate/speech improved;


Changed on 12/14/2016

VAERS ID: 51272 Before After
VAERS Form:
Age:67.0
Sex:Male
Location:Unknown
Vaccinated:1992-10-12
Onset:1992-10-22
Submitted:0000-00-00
Entered:1993-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Myelitis, Paralysis

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? Yes
Previous Vaccinations:
Other Medications: Voltaren, Vasotec & Vicodin
Current Illness:
Preexisting Conditions: hypertension, arthritis
Allergies:
Diagnostic Lab Data: neg urine & blood cult; carotid doppler & echo cardiogram nl; MRI brain stem nl; Thyroid profile nl; spinal tap nl;
CDC 'Split Type':

Write-up: suspected post influenza vax encephalitis w/myelitis/ensuing motor neuron paresis; upon discharge, pt was able to ambulate/speech improved;


Changed on 5/14/2017

VAERS ID: 51272 Before After
VAERS Form:
Age:67.0
Sex:Male
Location:Unknown
Vaccinated:1992-10-12
Onset:1992-10-22
Submitted:0000-00-00
Entered:1993-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Myelitis, Paralysis

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Voltaren, Vasotec & Vicodin
Current Illness:
Preexisting Conditions: hypertension, arthritis
Allergies:
Diagnostic Lab Data: neg urine & blood cult; carotid doppler & echo cardiogram nl; MRI brain stem nl; Thyroid profile nl; spinal tap nl;
CDC 'Split Type':

Write-up: suspected post influenza vax encephalitis w/myelitis/ensuing motor neuron paresis; upon discharge, pt was able to ambulate/speech improved;


Changed on 9/14/2017

VAERS ID: 51272 Before After
VAERS Form:(blank) 1
Age:67.0
Sex:Male
Location:Unknown
Vaccinated:1992-10-12
Onset:1992-10-22
Submitted:0000-00-00
Entered:1993-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Myelitis, Paralysis

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Voltaren, Vasotec & Vicodin
Current Illness:
Preexisting Conditions: hypertension, arthritis
Allergies:
Diagnostic Lab Data: neg urine & blood cult; carotid doppler & echo cardiogram nl; MRI brain stem nl; Thyroid profile nl; spinal tap nl;
CDC 'Split Type':

Write-up: suspected post influenza vax encephalitis w/myelitis/ensuing motor neuron paresis; upon discharge, pt was able to ambulate/speech improved;


Changed on 2/14/2018

VAERS ID: 51272 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Unknown
Vaccinated:1992-10-12
Onset:1992-10-22
Submitted:0000-00-00
Entered:1993-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Myelitis, Paralysis

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Voltaren, Vasotec & Vicodin
Current Illness:
Preexisting Conditions: hypertension, arthritis
Allergies:
Diagnostic Lab Data: neg urine & blood cult; carotid doppler & echo cardiogram nl; MRI brain stem nl; Thyroid profile nl; spinal tap nl;
CDC 'Split Type':

Write-up: suspected post influenza vax encephalitis w/myelitis/ensuing motor neuron paresis; upon discharge, pt was able to ambulate/speech improved;


Changed on 6/14/2018

VAERS ID: 51272 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Unknown
Vaccinated:1992-10-12
Onset:1992-10-22
Submitted:0000-00-00
Entered:1993-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Myelitis, Paralysis

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Voltaren, Vasotec & Vicodin
Current Illness:
Preexisting Conditions: hypertension, arthritis
Allergies:
Diagnostic Lab Data: neg urine & blood cult; carotid doppler & echo cardiogram nl; MRI brain stem nl; Thyroid profile nl; spinal tap nl;
CDC 'Split Type':

Write-up: suspected post influenza vax encephalitis w/myelitis/ensuing motor neuron paresis; upon discharge, pt was able to ambulate/speech improved;


Changed on 8/14/2018

VAERS ID: 51272 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Unknown
Vaccinated:1992-10-12
Onset:1992-10-22
Submitted:0000-00-00
Entered:1993-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Myelitis, Paralysis

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Voltaren, Vasotec & Vicodin
Current Illness:
Preexisting Conditions: hypertension, arthritis
Allergies:
Diagnostic Lab Data: neg urine & blood cult; carotid doppler & echo cardiogram nl; MRI brain stem nl; Thyroid profile nl; spinal tap nl;
CDC 'Split Type':

Write-up: suspected post influenza vax encephalitis w/myelitis/ensuing motor neuron paresis; upon discharge, pt was able to ambulate/speech improved;


Changed on 9/14/2018

VAERS ID: 51272 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Unknown
Vaccinated:1992-10-12
Onset:1992-10-22
Submitted:0000-00-00
Entered:1993-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Myelitis, Paralysis

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Voltaren, Vasotec & Vicodin
Current Illness:
Preexisting Conditions: hypertension, arthritis
Allergies:
Diagnostic Lab Data: neg urine & blood cult; carotid doppler & echo cardiogram nl; MRI brain stem nl; Thyroid profile nl; spinal tap nl;
CDC 'Split Type':

Write-up: suspected post influenza vax encephalitis w/myelitis/ensuing motor neuron paresis; upon discharge, pt was able to ambulate/speech improved;


Changed on 10/14/2018

VAERS ID: 51272 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Unknown
Vaccinated:1992-10-12
Onset:1992-10-22
Submitted:0000-00-00
Entered:1993-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Encephalitis, Myelitis, Paralysis

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Voltaren, Vasotec & Vicodin
Current Illness:
Preexisting Conditions: hypertension, arthritis
Allergies:
Diagnostic Lab Data: neg urine & blood cult; carotid doppler & echo cardiogram nl; MRI brain stem nl; Thyroid profile nl; spinal tap nl;
CDC 'Split Type':

Write-up: suspected post influenza vax encephalitis w/myelitis/ensuing motor neuron paresis; upon discharge, pt was able to ambulate/speech improved;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=51272&WAYBACKHISTORY=ON


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