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This is VAERS ID 57323

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 57323
VAERS Form:
Age:82.1
Sex:Male
Location:Michigan
Vaccinated:1993-09-13
Onset:1993-09-14
Submitted:1993-10-29
Entered:1993-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1993-1994 / WYETH 493814 / - A / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: APNEA, ENCEPHALITIS, CONFUS, ESR INC, DEMENTIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
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:
Current Illness:
Preexisting Conditions: remains hospitalized on ventilator; outcome remains guarded;
Allergies:
Diagnostic Lab Data: WBC 2.3; nl 4-11; sed rate 36; Ptt 5; CSF WNL; Bl no grwoth; titer for EEE, california E, st louis E pending; Enterovirus & Herpes cultures being done on CSF;;
CDC 'Split Type':

Write-up: rapid progressive dementia ventilation for respiratory failure, t105; family states confusion started about 16 hrs p/vax; post flu vax encephalitis;


Changed on 12/8/2009

VAERS ID: 57323 Before After
VAERS Form:
Age:82.1
Sex:Male
Location:Michigan
Vaccinated:1993-09-13
Onset:1993-09-14
Submitted:1993-10-29
Entered:1993-11-19 1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1993-1994 INFLUENZA (SEASONAL) (NO BRAND NAME, 93-94) / WYETH WYETH PHARMACEUTICALS, INC 493814 / - A / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Blood thromboplastin decreased, Confusional state, Dementia, Encephalitis, Leukopenia, Pyrexia, Red blood cell sedimentation rate increased, APNEA, ENCEPHALITIS, CONFUS, ESR INC, DEMENTIA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
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:
Current Illness:
Preexisting Conditions: remains hospitalized on ventilator; outcome remains guarded;
Allergies:
Diagnostic Lab Data: WBC 2.3; nl 4-11; sed rate 36; Ptt 5; CSF WNL; Bl no grwoth; titer for EEE, california E, st louis E pending; Enterovirus & Herpes cultures being done on CSF;;
CDC 'Split Type':

Write-up: rapid progressive dementia ventilation for respiratory failure, t105; family states confusion started about 16 hrs p/vax; post flu vax encephalitis;


Changed on 8/31/2010

VAERS ID: 57323 Before After
VAERS Form:
Age:82.1
Sex:Male
Location:Michigan
Vaccinated:1993-09-13
Onset:1993-09-14
Submitted:1993-10-29
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 93-94) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 493814 / - A / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Blood thromboplastin decreased, Confusional state, Dementia, Encephalitis, Leukopenia, Pyrexia, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
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:
Current Illness:
Preexisting Conditions: remains hospitalized on ventilator; outcome remains guarded;
Allergies:
Diagnostic Lab Data: WBC 2.3; nl 4-11; sed rate 36; Ptt 5; CSF WNL; Bl no grwoth; titer for EEE, california E, st louis E pending; Enterovirus & Herpes cultures being done on CSF;;
CDC 'Split Type':

Write-up: rapid progressive dementia ventilation for respiratory failure, t105; family states confusion started about 16 hrs p/vax; post flu vax encephalitis;


Changed on 7/7/2013

VAERS ID: 57323 Before After
VAERS Form:
Age:82.1
Sex:Male
Location:Michigan
Vaccinated:1993-09-13
Onset:1993-09-14
Submitted:1993-10-29
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 493814 / - A / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 493814 / - A / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Blood thromboplastin decreased, Confusional state, Dementia, Encephalitis, Leukopenia, Pyrexia, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
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:
Current Illness:
Preexisting Conditions: remains hospitalized on ventilator; outcome remains guarded;
Allergies:
Diagnostic Lab Data: WBC 2.3; nl 4-11; sed rate 36; Ptt 5; CSF WNL; Bl no grwoth; titer for EEE, california E, st louis E pending; Enterovirus & Herpes cultures being done on CSF;;
CDC 'Split Type':

Write-up: rapid progressive dementia ventilation for respiratory failure, t105; family states confusion started about 16 hrs p/vax; post flu vax encephalitis;


Changed on 12/14/2016

VAERS ID: 57323 Before After
VAERS Form:
Age:82.1
Sex:Male
Location:Michigan
Vaccinated:1993-09-13
Onset:1993-09-14
Submitted:1993-10-29
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 493814 / - A / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 493814 / - A / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Blood thromboplastin decreased, Confusional state, Dementia, Encephalitis, Leukopenia, Pyrexia, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
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:
Current Illness:
Preexisting Conditions: remains hospitalized on ventilator; outcome remains guarded;
Allergies:
Diagnostic Lab Data: WBC 2.3; nl 4-11; sed rate 36; Ptt 5; CSF WNL; Bl no grwoth; titer for EEE, california E, st louis E pending; Enterovirus & Herpes cultures being done on CSF;;
CDC 'Split Type':

Write-up: rapid progressive dementia ventilation for respiratory failure, t105; family states confusion started about 16 hrs p/vax; post flu vax encephalitis;


Changed on 2/14/2017

VAERS ID: 57323 Before After
VAERS Form:
Age:82.1 82.0
Sex:Male
Location:Michigan
Vaccinated:1993-09-13
Onset:1993-09-14
Submitted:1993-10-29
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 493814 / - A / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Blood thromboplastin decreased, Confusional state, Dementia, Encephalitis, Leukopenia, Pyrexia, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
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:
Current Illness:
Preexisting Conditions: remains hospitalized on ventilator; outcome remains guarded;
Allergies:
Diagnostic Lab Data: WBC 2.3; nl 4-11; sed rate 36; Ptt 5; CSF WNL; Bl no grwoth; titer for EEE, california E, st louis E pending; Enterovirus & Herpes cultures being done on CSF;;
CDC 'Split Type':

Write-up: rapid progressive dementia ventilation for respiratory failure, t105; family states confusion started about 16 hrs p/vax; post flu vax encephalitis;


Changed on 5/14/2017

VAERS ID: 57323 Before After
VAERS Form:
Age:82.0
Sex:Male
Location:Michigan
Vaccinated:1993-09-13
Onset:1993-09-14
Submitted:1993-10-29
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 493814 / - A - / - A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Blood thromboplastin decreased, Confusional state, Dementia, Encephalitis, Leukopenia, Pyrexia, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
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:
Current Illness:
Preexisting Conditions: remains hospitalized on ventilator; outcome remains guarded;
Allergies:
Diagnostic Lab Data: WBC 2.3; nl 4-11; sed rate 36; Ptt 5; CSF WNL; Bl no grwoth; titer for EEE, california E, st louis E pending; Enterovirus & Herpes cultures being done on CSF;;
CDC 'Split Type':

Write-up: rapid progressive dementia ventilation for respiratory failure, t105; family states confusion started about 16 hrs p/vax; post flu vax encephalitis;


Changed on 9/14/2017

VAERS ID: 57323 Before After
VAERS Form:(blank) 1
Age:82.0
Sex:Male
Location:Michigan
Vaccinated:1993-09-13
Onset:1993-09-14
Submitted:1993-10-29
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 493814 / - UNK - / A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Blood thromboplastin decreased, Confusional state, Dementia, Encephalitis, Leukopenia, Pyrexia, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
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:
Current Illness:
Preexisting Conditions: remains hospitalized on ventilator; outcome remains guarded;
Allergies:
Diagnostic Lab Data: WBC 2.3; nl 4-11; sed rate 36; Ptt 5; CSF WNL; Bl no grwoth; titer for EEE, california E, st louis E pending; Enterovirus & Herpes cultures being done on CSF;;
CDC 'Split Type':

Write-up: rapid progressive dementia ventilation for respiratory failure, t105; family states confusion started about 16 hrs p/vax; post flu vax encephalitis;


Changed on 2/14/2018

VAERS ID: 57323 Before After
VAERS Form:1
Age:82.0
Sex:Male
Location:Michigan
Vaccinated:1993-09-13
Onset:1993-09-14
Submitted:1993-10-29
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 493814 / UNK - / A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Blood thromboplastin decreased, Confusional state, Dementia, Encephalitis, Leukopenia, Pyrexia, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
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:
Current Illness:
Preexisting Conditions: remains hospitalized on ventilator; outcome remains guarded;
Allergies:
Diagnostic Lab Data: WBC 2.3; nl 4-11; sed rate 36; Ptt 5; CSF WNL; Bl no grwoth; titer for EEE, california E, st louis E pending; Enterovirus & Herpes cultures being done on CSF;;
CDC 'Split Type':

Write-up: rapid progressive dementia ventilation for respiratory failure, t105; family states confusion started about 16 hrs p/vax; post flu vax encephalitis;


Changed on 6/14/2018

VAERS ID: 57323 Before After
VAERS Form:1
Age:82.0
Sex:Male
Location:Michigan
Vaccinated:1993-09-13
Onset:1993-09-14
Submitted:1993-10-29
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 493814 / UNK - / A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Blood thromboplastin decreased, Confusional state, Dementia, Encephalitis, Leukopenia, Pyrexia, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
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:
Current Illness:
Preexisting Conditions: remains hospitalized on ventilator; outcome remains guarded;
Allergies:
Diagnostic Lab Data: WBC 2.3; nl 4-11; sed rate 36; Ptt 5; CSF WNL; Bl no grwoth; titer for EEE, california E, st louis E pending; Enterovirus & Herpes cultures being done on CSF;;
CDC 'Split Type':

Write-up: rapid progressive dementia ventilation for respiratory failure, t105; family states confusion started about 16 hrs p/vax; post flu vax encephalitis;


Changed on 8/14/2018

VAERS ID: 57323 Before After
VAERS Form:1
Age:82.0
Sex:Male
Location:Michigan
Vaccinated:1993-09-13
Onset:1993-09-14
Submitted:1993-10-29
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 493814 / UNK - / A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Blood thromboplastin decreased, Confusional state, Dementia, Encephalitis, Leukopenia, Pyrexia, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
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:
Current Illness:
Preexisting Conditions: remains hospitalized on ventilator; outcome remains guarded;
Allergies:
Diagnostic Lab Data: WBC 2.3; nl 4-11; sed rate 36; Ptt 5; CSF WNL; Bl no grwoth; titer for EEE, california E, st louis E pending; Enterovirus & Herpes cultures being done on CSF;;
CDC 'Split Type':

Write-up: rapid progressive dementia ventilation for respiratory failure, t105; family states confusion started about 16 hrs p/vax; post flu vax encephalitis;


Changed on 9/14/2018

VAERS ID: 57323 Before After
VAERS Form:1
Age:82.0
Sex:Male
Location:Michigan
Vaccinated:1993-09-13
Onset:1993-09-14
Submitted:1993-10-29
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 493814 / UNK - / A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Blood thromboplastin decreased, Confusional state, Dementia, Encephalitis, Leukopenia, Pyrexia, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
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:
Current Illness:
Preexisting Conditions: remains hospitalized on ventilator; outcome remains guarded;
Allergies:
Diagnostic Lab Data: WBC 2.3; nl 4-11; sed rate 36; Ptt 5; CSF WNL; Bl no grwoth; titer for EEE, california E, st louis E pending; Enterovirus & Herpes cultures being done on CSF;;
CDC 'Split Type':

Write-up: rapid progressive dementia ventilation for respiratory failure, t105; family states confusion started about 16 hrs p/vax; post flu vax encephalitis;


Changed on 10/14/2018

VAERS ID: 57323 Before After
VAERS Form:1
Age:82.0
Sex:Male
Location:Michigan
Vaccinated:1993-09-13
Onset:1993-09-14
Submitted:1993-10-29
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 493814 / UNK - / A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Apnoea, Blood thromboplastin decreased, Confusional state, Dementia, Encephalitis, Leukopenia, Pyrexia, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
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:
Current Illness:
Preexisting Conditions: remains hospitalized on ventilator; outcome remains guarded;
Allergies:
Diagnostic Lab Data: WBC 2.3; nl 4-11; sed rate 36; Ptt 5; CSF WNL; Bl no grwoth; titer for EEE, california E, st louis E pending; Enterovirus & Herpes cultures being done on CSF;;
CDC 'Split Type':

Write-up: rapid progressive dementia ventilation for respiratory failure, t105; family states confusion started about 16 hrs p/vax; post flu vax encephalitis;

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