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This is VAERS ID 56832

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 56832
VAERS Form:
Age:87.4
Sex:Female
Location:Michigan
Vaccinated:1993-10-01
Onset:1993-10-11
Submitted:1993-10-20
Entered:1993-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1993-1994 / PARKE-DAVIS 00863P / 0 A / -

Administered by: Private      Purchased by: Unknown
Symptoms: APNEA, GUILLAIN BARRE SYND, PARALYSIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-14
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-Micro K; Ventolin-Aero Bid uniphyl;
Current Illness: NONE
Preexisting Conditions: bronchial asthma, hypertensive cardio vascular disease;
Allergies:
Diagnostic Lab Data: LP-nl; EMG-nl; consistant w/GBS:
CDC 'Split Type':

Write-up: ascending paralysis, w/resp failure, consistant w/GBS;


Changed on 12/8/2009

VAERS ID: 56832 Before After
VAERS Form:
Age:87.4
Sex:Female
Location:Michigan
Vaccinated:1993-10-01
Onset:1993-10-11
Submitted:1993-10-20
Entered:1993-11-03 1993-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1993-1994 INFLUENZA (SEASONAL) (FLUOGEN 93-94) / PARKE-DAVIS 00863P / 0 A / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Apnoea, Guillain-Barre syndrome, Paralysis, APNEA, GUILLAIN BARRE SYND, PARALYSIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-14
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-Micro K; Ventolin-Aero Bid uniphyl;
Current Illness: NONE
Preexisting Conditions: bronchial asthma, hypertensive cardio vascular disease;
Allergies:
Diagnostic Lab Data: LP-nl; EMG-nl; consistant w/GBS:
CDC 'Split Type':

Write-up: ascending paralysis, w/resp failure, consistant w/GBS;


Changed on 8/31/2010

VAERS ID: 56832 Before After
VAERS Form:
Age:87.4
Sex:Female
Location:Michigan
Vaccinated:1993-10-01
Onset:1993-10-11
Submitted:1993-10-20
Entered:1993-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 93-94) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00863P / 0 A / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Paralysis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-14
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-Micro K; Ventolin-Aero Bid uniphyl;
Current Illness: NONE
Preexisting Conditions: bronchial asthma, hypertensive cardio vascular disease;
Allergies:
Diagnostic Lab Data: LP-nl; EMG-nl; consistant w/GBS:
CDC 'Split Type':

Write-up: ascending paralysis, w/resp failure, consistant w/GBS;


Changed on 7/7/2013

VAERS ID: 56832 Before After
VAERS Form:
Age:87.4
Sex:Female
Location:Michigan
Vaccinated:1993-10-01
Onset:1993-10-11
Submitted:1993-10-20
Entered:1993-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00863P / 0 A / -
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00863P / 0 A / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Paralysis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-14
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-Micro K; Ventolin-Aero Bid uniphyl;
Current Illness: NONE
Preexisting Conditions: bronchial asthma, hypertensive cardio vascular disease;
Allergies:
Diagnostic Lab Data: LP-nl; EMG-nl; consistant w/GBS:
CDC 'Split Type':

Write-up: ascending paralysis, w/resp failure, consistant w/GBS;


Changed on 2/14/2017

VAERS ID: 56832 Before After
VAERS Form:
Age:87.4 87.0
Sex:Female
Location:Michigan
Vaccinated:1993-10-01
Onset:1993-10-11
Submitted:1993-10-20
Entered:1993-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00863P / 0 A / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Paralysis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-14
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-Micro K; Ventolin-Aero Bid uniphyl;
Current Illness: NONE
Preexisting Conditions: bronchial asthma, hypertensive cardio vascular disease;
Allergies:
Diagnostic Lab Data: LP-nl; EMG-nl; consistant w/GBS:
CDC 'Split Type':

Write-up: ascending paralysis, w/resp failure, consistant w/GBS;


Changed on 5/14/2017

VAERS ID: 56832 Before After
VAERS Form:
Age:87.0
Sex:Female
Location:Michigan
Vaccinated:1993-10-01
Onset:1993-10-11
Submitted:1993-10-20
Entered:1993-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00863P / 0 A - / - A

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Paralysis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-14
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide-Micro K; Ventolin-Aero Bid uniphyl;
Current Illness: NONE
Preexisting Conditions: bronchial asthma, hypertensive cardio vascular disease;
Allergies:
Diagnostic Lab Data: LP-nl; EMG-nl; consistant w/GBS:
CDC 'Split Type':

Write-up: ascending paralysis, w/resp failure, consistant w/GBS;


Changed on 9/14/2017

VAERS ID: 56832 Before After
VAERS Form:(blank) 1
Age:87.0
Sex:Female
Location:Michigan
Vaccinated:1993-10-01
Onset:1993-10-11
Submitted:1993-10-20
Entered:1993-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00863P / 0 1 - / A

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Paralysis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-14
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide-Micro K; Ventolin-Aero Bid uniphyl;
Current Illness: NONE
Preexisting Conditions: bronchial asthma, hypertensive cardio vascular disease;
Allergies:
Diagnostic Lab Data: LP-nl; EMG-nl; consistant w/GBS:
CDC 'Split Type':

Write-up: ascending paralysis, w/resp failure, consistant w/GBS;


Changed on 2/14/2018

VAERS ID: 56832 Before After
VAERS Form:1
Age:87.0
Sex:Female
Location:Michigan
Vaccinated:1993-10-01
Onset:1993-10-11
Submitted:1993-10-20
Entered:1993-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00863P / 1 - / A

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Paralysis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-14
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide-Micro K; Ventolin-Aero Bid uniphyl;
Current Illness: NONE
Preexisting Conditions: bronchial asthma, hypertensive cardio vascular disease;
Allergies:
Diagnostic Lab Data: LP-nl; EMG-nl; consistant w/GBS:
CDC 'Split Type':

Write-up: ascending paralysis, w/resp failure, consistant w/GBS;


Changed on 6/14/2018

VAERS ID: 56832 Before After
VAERS Form:1
Age:87.0
Sex:Female
Location:Michigan
Vaccinated:1993-10-01
Onset:1993-10-11
Submitted:1993-10-20
Entered:1993-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00863P / 1 - / A

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Paralysis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-14
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide-Micro K; Ventolin-Aero Bid uniphyl;
Current Illness: NONE
Preexisting Conditions: bronchial asthma, hypertensive cardio vascular disease;
Allergies:
Diagnostic Lab Data: LP-nl; EMG-nl; consistant w/GBS:
CDC 'Split Type':

Write-up: ascending paralysis, w/resp failure, consistant w/GBS;


Changed on 8/14/2018

VAERS ID: 56832 Before After
VAERS Form:1
Age:87.0
Sex:Female
Location:Michigan
Vaccinated:1993-10-01
Onset:1993-10-11
Submitted:1993-10-20
Entered:1993-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00863P / 1 - / A

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Paralysis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-14
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide-Micro K; Ventolin-Aero Bid uniphyl;
Current Illness: NONE
Preexisting Conditions: bronchial asthma, hypertensive cardio vascular disease;
Allergies:
Diagnostic Lab Data: LP-nl; EMG-nl; consistant w/GBS:
CDC 'Split Type':

Write-up: ascending paralysis, w/resp failure, consistant w/GBS;


Changed on 9/14/2018

VAERS ID: 56832 Before After
VAERS Form:1
Age:87.0
Sex:Female
Location:Michigan
Vaccinated:1993-10-01
Onset:1993-10-11
Submitted:1993-10-20
Entered:1993-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00863P / 1 - / A

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Paralysis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-14
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide-Micro K; Ventolin-Aero Bid uniphyl;
Current Illness: NONE
Preexisting Conditions: bronchial asthma, hypertensive cardio vascular disease;
Allergies:
Diagnostic Lab Data: LP-nl; EMG-nl; consistant w/GBS:
CDC 'Split Type':

Write-up: ascending paralysis, w/resp failure, consistant w/GBS;


Changed on 10/14/2018

VAERS ID: 56832 Before After
VAERS Form:1
Age:87.0
Sex:Female
Location:Michigan
Vaccinated:1993-10-01
Onset:1993-10-11
Submitted:1993-10-20
Entered:1993-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00863P / 1 - / A

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Paralysis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-14
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide-Micro K; Ventolin-Aero Bid uniphyl;
Current Illness: NONE
Preexisting Conditions: bronchial asthma, hypertensive cardio vascular disease;
Allergies:
Diagnostic Lab Data: LP-nl; EMG-nl; consistant w/GBS:
CDC 'Split Type':

Write-up: ascending paralysis, w/resp failure, consistant w/GBS;

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