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This is VAERS ID 57353

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 57353
VAERS Form:
Age:78.5
Sex:Male
Location:California
Vaccinated:1993-10-22
Onset:1993-10-25
Submitted:1993-11-08
Entered:1993-11-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1993-1994 / PARKE-DAVIS 00763P / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: PAIN BACK, MYELITIS, CSF ABNORM, INCONTIN URIN, INCONTIN FECAL

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: NS
Other Medications: APAP, Vitamins;
Current Illness: N?S
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data: spinal aspiration showed elevations of proteins;
CDC 'Split Type': arthritis

Write-up: acute transverse myelitis is reported in a pt who recvd flu vax around 22OCT93; OCT93 exp pain in the back & numbness in rt leg; 26OCT93 devel paralysis in both legs; pt did not have any control over bladder or bowel movements;


Changed on 12/8/2009

VAERS ID: 57353 Before After
VAERS Form:
Age:78.5
Sex:Male
Location:California
Vaccinated:1993-10-22
Onset:1993-10-25
Submitted:1993-11-08
Entered:1993-11-22 1993-11-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1993-1994 INFLUENZA (SEASONAL) (FLUOGEN 93-94) / PARKE-DAVIS 00763P / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Back pain, Faecal incontinence, Myelitis, Paraesthesia, Paralysis, Urinary incontinence, CSF test abnormal, PAIN BACK, MYELITIS, CSF ABNORM, INCONTIN URIN, INCONTIN FECAL

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: NS
Other Medications: APAP, Vitamins;
Current Illness: N?S
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data: spinal aspiration showed elevations of proteins;
CDC 'Split Type': arthritis 27481

Write-up: acute transverse myelitis is reported in a pt who recvd flu vax around 22OCT93; OCT93 exp pain in the back & numbness in rt leg; 26OCT93 devel paralysis in both legs; pt did not have any control over bladder or bowel movements;


Changed on 8/31/2010

VAERS ID: 57353 Before After
VAERS Form:
Age:78.5
Sex:Male
Location:California
Vaccinated:1993-10-22
Onset:1993-10-25
Submitted:1993-11-08
Entered:1993-11-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 93-94) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00763P / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Back pain, Faecal incontinence, Myelitis, Paraesthesia, Paralysis, Urinary incontinence, CSF test abnormal

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: NS
Other Medications: APAP, Vitamins;
Current Illness: N?S
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data: spinal aspiration showed elevations of proteins;
CDC 'Split Type': 27481

Write-up: acute transverse myelitis is reported in a pt who recvd flu vax around 22OCT93; OCT93 exp pain in the back & numbness in rt leg; 26OCT93 devel paralysis in both legs; pt did not have any control over bladder or bowel movements;


Changed on 7/7/2013

VAERS ID: 57353 Before After
VAERS Form:
Age:78.5
Sex:Male
Location:California
Vaccinated:1993-10-22
Onset:1993-10-25
Submitted:1993-11-08
Entered:1993-11-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00763P / - - / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00763P / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Back pain, Faecal incontinence, Myelitis, Paraesthesia, Paralysis, Urinary incontinence, CSF test abnormal

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: NS
Other Medications: APAP, Vitamins;
Current Illness: N?S
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data: spinal aspiration showed elevations of proteins;
CDC 'Split Type': 27481

Write-up: acute transverse myelitis is reported in a pt who recvd flu vax around 22OCT93; OCT93 exp pain in the back & numbness in rt leg; 26OCT93 devel paralysis in both legs; pt did not have any control over bladder or bowel movements;


Changed on 2/14/2017

VAERS ID: 57353 Before After
VAERS Form:
Age:78.5 78.0
Sex:Male
Location:California
Vaccinated:1993-10-22
Onset:1993-10-25
Submitted:1993-11-08
Entered:1993-11-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00763P / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Back pain, Faecal incontinence, Myelitis, Paraesthesia, Paralysis, Urinary incontinence, CSF test abnormal

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: NS
Other Medications: APAP, Vitamins;
Current Illness: N?S
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data: spinal aspiration showed elevations of proteins;
CDC 'Split Type': 27481

Write-up: acute transverse myelitis is reported in a pt who recvd flu vax around 22OCT93; OCT93 exp pain in the back & numbness in rt leg; 26OCT93 devel paralysis in both legs; pt did not have any control over bladder or bowel movements;


Changed on 5/14/2017

VAERS ID: 57353 Before After
VAERS Form:
Age:78.0
Sex:Male
Location:California
Vaccinated:1993-10-22
Onset:1993-10-25
Submitted:1993-11-08
Entered:1993-11-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00763P / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Back pain, Faecal incontinence, Myelitis, Paraesthesia, Paralysis, Urinary incontinence, CSF test abnormal

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: NS NS~ ()~~~In patient
Other Medications: APAP, Vitamins;
Current Illness: N?S
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data: spinal aspiration showed elevations of proteins;
CDC 'Split Type': 27481

Write-up: acute transverse myelitis is reported in a pt who recvd flu vax around 22OCT93; OCT93 exp pain in the back & numbness in rt leg; 26OCT93 devel paralysis in both legs; pt did not have any control over bladder or bowel movements;


Changed on 9/14/2017

VAERS ID: 57353 Before After
VAERS Form:(blank) 1
Age:78.0
Sex:Male
Location:California
Vaccinated:1993-10-22
Onset:1993-10-25
Submitted:1993-11-08
Entered:1993-11-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00763P / - UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Back pain, Faecal incontinence, Myelitis, Paraesthesia, Paralysis, Urinary incontinence, CSF test abnormal

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: NS~ ()~~~In patient
Other Medications: APAP, Vitamins;
Current Illness: N?S
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data: spinal aspiration showed elevations of proteins;
CDC 'Split Type': 27481

Write-up: acute transverse myelitis is reported in a pt who recvd flu vax around 22OCT93; OCT93 exp pain in the back & numbness in rt leg; 26OCT93 devel paralysis in both legs; pt did not have any control over bladder or bowel movements;


Changed on 2/14/2018

VAERS ID: 57353 Before After
VAERS Form:1
Age:78.0
Sex:Male
Location:California
Vaccinated:1993-10-22
Onset:1993-10-25
Submitted:1993-11-08
Entered:1993-11-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00763P / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Back pain, Faecal incontinence, Myelitis, Paraesthesia, Paralysis, Urinary incontinence, CSF test abnormal

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: NS~ ()~~~In patient
Other Medications: APAP, Vitamins;
Current Illness: N?S
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data: spinal aspiration showed elevations of proteins;
CDC 'Split Type': 27481

Write-up: acute transverse myelitis is reported in a pt who recvd flu vax around 22OCT93; OCT93 exp pain in the back & numbness in rt leg; 26OCT93 devel paralysis in both legs; pt did not have any control over bladder or bowel movements;


Changed on 6/14/2018

VAERS ID: 57353 Before After
VAERS Form:1
Age:78.0
Sex:Male
Location:California
Vaccinated:1993-10-22
Onset:1993-10-25
Submitted:1993-11-08
Entered:1993-11-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00763P / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Back pain, Faecal incontinence, Myelitis, Paraesthesia, Paralysis, Urinary incontinence, CSF test abnormal

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: NS~ ()~~~In patient
Other Medications: APAP, Vitamins;
Current Illness: N?S
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data: spinal aspiration showed elevations of proteins;
CDC 'Split Type': 27481

Write-up: acute transverse myelitis is reported in a pt who recvd flu vax around 22OCT93; OCT93 exp pain in the back & numbness in rt leg; 26OCT93 devel paralysis in both legs; pt did not have any control over bladder or bowel movements;


Changed on 8/14/2018

VAERS ID: 57353 Before After
VAERS Form:1
Age:78.0
Sex:Male
Location:California
Vaccinated:1993-10-22
Onset:1993-10-25
Submitted:1993-11-08
Entered:1993-11-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00763P / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Back pain, Faecal incontinence, Myelitis, Paraesthesia, Paralysis, Urinary incontinence, CSF test abnormal

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: NS~ ()~~~In patient
Other Medications: APAP, Vitamins;
Current Illness: N?S
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data: spinal aspiration showed elevations of proteins;
CDC 'Split Type': 27481

Write-up: acute transverse myelitis is reported in a pt who recvd flu vax around 22OCT93; OCT93 exp pain in the back & numbness in rt leg; 26OCT93 devel paralysis in both legs; pt did not have any control over bladder or bowel movements;


Changed on 9/14/2018

VAERS ID: 57353 Before After
VAERS Form:1
Age:78.0
Sex:Male
Location:California
Vaccinated:1993-10-22
Onset:1993-10-25
Submitted:1993-11-08
Entered:1993-11-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00763P / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Back pain, Faecal incontinence, Myelitis, Paraesthesia, Paralysis, Urinary incontinence, CSF test abnormal

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: NS~ ()~~~In patient
Other Medications: APAP, Vitamins;
Current Illness: N?S
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data: spinal aspiration showed elevations of proteins;
CDC 'Split Type': 27481

Write-up: acute transverse myelitis is reported in a pt who recvd flu vax around 22OCT93; OCT93 exp pain in the back & numbness in rt leg; 26OCT93 devel paralysis in both legs; pt did not have any control over bladder or bowel movements;


Changed on 10/14/2018

VAERS ID: 57353 Before After
VAERS Form:1
Age:78.0
Sex:Male
Location:California
Vaccinated:1993-10-22
Onset:1993-10-25
Submitted:1993-11-08
Entered:1993-11-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00763P / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Back pain, Faecal incontinence, Myelitis, Paraesthesia, Paralysis, Urinary incontinence, CSF test abnormal

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: NS~ ()~~~In patient
Other Medications: APAP, Vitamins;
Current Illness: N?S
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data: spinal aspiration showed elevations of proteins;
CDC 'Split Type': 27481

Write-up: acute transverse myelitis is reported in a pt who recvd flu vax around 22OCT93; OCT93 exp pain in the back & numbness in rt leg; 26OCT93 devel paralysis in both legs; pt did not have any control over bladder or bowel movements;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=57353&WAYBACKHISTORY=ON


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