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This is VAERS ID 58025

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 58025
VAERS Form:
Age:52.1
Sex:Female
Location:Michigan
Vaccinated:1991-12-05
Onset:1992-01-05
Submitted:0000-00-00
Entered:1993-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1991-1992 / WYETH - / 0 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND, ASTHENIA, COORDINAT ABNORM, HYPERTENS, CRAMPS LEG

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: 13     Extended hospital stay? No
Previous Vaccinations:
Other Medications: THyroid, Premarin, Provera, Synthroid, multivitamins, MVI;
Current Illness:
Preexisting Conditions: Menopause, hypothyroidism; all-PCN, Emycin, codiene;
Allergies:
Diagnostic Lab Data: CBC, Thyroid, heavy metal poison; MRI-brain, EMG-neck;
CDC 'Split Type':

Write-up: cramping, sore calves x 2 wk; falls on steps, flat surfaces, dropping anything trying to carry; unable to get up when fall; affected even hair brushing, unable to open doors, dress self, fix meals; dx GBS-CIDP;


Changed on 12/8/2009

VAERS ID: 58025 Before After
VAERS Form:
Age:52.1
Sex:Female
Location:Michigan
Vaccinated:1991-12-05
Onset:1992-01-05
Submitted:0000-00-00
Entered:1993-12-15 1993-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1991-1992 INFLUENZA (SEASONAL) (NO BRAND NAME, 91-92) / WYETH WYETH PHARMACEUTICALS, INC - / 0 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertension, Muscle spasms, Myalgia, Neuropathy, Respiratory disorder, GUILLAIN BARRE SYND, ASTHENIA, COORDINAT ABNORM, HYPERTENS, CRAMPS LEG

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: 13     Extended hospital stay? No
Previous Vaccinations:
Other Medications: THyroid, Premarin, Provera, Synthroid, multivitamins, MVI;
Current Illness:
Preexisting Conditions: Menopause, hypothyroidism; all-PCN, Emycin, codiene;
Allergies:
Diagnostic Lab Data: CBC, Thyroid, heavy metal poison; MRI-brain, EMG-neck;
CDC 'Split Type':

Write-up: cramping, sore calves x 2 wk; falls on steps, flat surfaces, dropping anything trying to carry; unable to get up when fall; affected even hair brushing, unable to open doors, dress self, fix meals; dx GBS-CIDP;


Changed on 8/31/2010

VAERS ID: 58025 Before After
VAERS Form:
Age:52.1
Sex:Female
Location:Michigan
Vaccinated:1991-12-05
Onset:1992-01-05
Submitted:0000-00-00
Entered:1993-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 91-92) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / 0 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertension, Muscle spasms, Myalgia, Neuropathy, Respiratory disorder

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: 13     Extended hospital stay? No
Previous Vaccinations:
Other Medications: THyroid, Premarin, Provera, Synthroid, multivitamins, MVI;
Current Illness:
Preexisting Conditions: Menopause, hypothyroidism; all-PCN, Emycin, codiene;
Allergies:
Diagnostic Lab Data: CBC, Thyroid, heavy metal poison; MRI-brain, EMG-neck;
CDC 'Split Type':

Write-up: cramping, sore calves x 2 wk; falls on steps, flat surfaces, dropping anything trying to carry; unable to get up when fall; affected even hair brushing, unable to open doors, dress self, fix meals; dx GBS-CIDP;


Changed on 7/7/2013

VAERS ID: 58025 Before After
VAERS Form:
Age:52.1
Sex:Female
Location:Michigan
Vaccinated:1991-12-05
Onset:1992-01-05
Submitted:0000-00-00
Entered:1993-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 - / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertension, Muscle spasms, Myalgia, Neuropathy, Respiratory disorder

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: 13     Extended hospital stay? No
Previous Vaccinations:
Other Medications: THyroid, Premarin, Provera, Synthroid, multivitamins, MVI;
Current Illness:
Preexisting Conditions: Menopause, hypothyroidism; all-PCN, Emycin, codiene;
Allergies:
Diagnostic Lab Data: CBC, Thyroid, heavy metal poison; MRI-brain, EMG-neck;
CDC 'Split Type':

Write-up: cramping, sore calves x 2 wk; falls on steps, flat surfaces, dropping anything trying to carry; unable to get up when fall; affected even hair brushing, unable to open doors, dress self, fix meals; dx GBS-CIDP;


Changed on 12/14/2016

VAERS ID: 58025 Before After
VAERS Form:
Age:52.1
Sex:Female
Location:Michigan
Vaccinated:1991-12-05
Onset:1992-01-05
Submitted:0000-00-00
Entered:1993-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertension, Muscle spasms, Myalgia, Neuropathy, Respiratory disorder

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: 13     Extended hospital stay? No
Previous Vaccinations:
Other Medications: THyroid, Premarin, Provera, Synthroid, multivitamins, MVI;
Current Illness:
Preexisting Conditions: Menopause, hypothyroidism; all-PCN, Emycin, codiene;
Allergies:
Diagnostic Lab Data: CBC, Thyroid, heavy metal poison; MRI-brain, EMG-neck;
CDC 'Split Type':

Write-up: cramping, sore calves x 2 wk; falls on steps, flat surfaces, dropping anything trying to carry; unable to get up when fall; affected even hair brushing, unable to open doors, dress self, fix meals; dx GBS-CIDP;


Changed on 2/14/2017

VAERS ID: 58025 Before After
VAERS Form:
Age:52.1 52.0
Sex:Female
Location:Michigan
Vaccinated:1991-12-05
Onset:1992-01-05
Submitted:0000-00-00
Entered:1993-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertension, Muscle spasms, Myalgia, Neuropathy, Respiratory disorder

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: 13     Extended hospital stay? No
Previous Vaccinations:
Other Medications: THyroid, Premarin, Provera, Synthroid, multivitamins, MVI;
Current Illness:
Preexisting Conditions: Menopause, hypothyroidism; all-PCN, Emycin, codiene;
Allergies:
Diagnostic Lab Data: CBC, Thyroid, heavy metal poison; MRI-brain, EMG-neck;
CDC 'Split Type':

Write-up: cramping, sore calves x 2 wk; falls on steps, flat surfaces, dropping anything trying to carry; unable to get up when fall; affected even hair brushing, unable to open doors, dress self, fix meals; dx GBS-CIDP;


Changed on 5/14/2017

VAERS ID: 58025 Before After
VAERS Form:
Age:52.0
Sex:Female
Location:Michigan
Vaccinated:1991-12-05
Onset:1992-01-05
Submitted:0000-00-00
Entered:1993-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertension, Muscle spasms, Myalgia, Neuropathy, Respiratory disorder

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: 13     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: THyroid, Premarin, Provera, Synthroid, multivitamins, MVI;
Current Illness:
Preexisting Conditions: Menopause, hypothyroidism; all-PCN, Emycin, codiene;
Allergies:
Diagnostic Lab Data: CBC, Thyroid, heavy metal poison; MRI-brain, EMG-neck;
CDC 'Split Type':

Write-up: cramping, sore calves x 2 wk; falls on steps, flat surfaces, dropping anything trying to carry; unable to get up when fall; affected even hair brushing, unable to open doors, dress self, fix meals; dx GBS-CIDP;


Changed on 9/14/2017

VAERS ID: 58025 Before After
VAERS Form:(blank) 1
Age:52.0
Sex:Female
Location:Michigan
Vaccinated:1991-12-05
Onset:1992-01-05
Submitted:0000-00-00
Entered:1993-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 1 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertension, Muscle spasms, Myalgia, Neuropathy, Respiratory disorder

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: 13     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: THyroid, Premarin, Provera, Synthroid, multivitamins, MVI;
Current Illness:
Preexisting Conditions: Menopause, hypothyroidism; all-PCN, Emycin, codiene;
Allergies:
Diagnostic Lab Data: CBC, Thyroid, heavy metal poison; MRI-brain, EMG-neck;
CDC 'Split Type':

Write-up: cramping, sore calves x 2 wk; falls on steps, flat surfaces, dropping anything trying to carry; unable to get up when fall; affected even hair brushing, unable to open doors, dress self, fix meals; dx GBS-CIDP;


Changed on 2/14/2018

VAERS ID: 58025 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:Michigan
Vaccinated:1991-12-05
Onset:1992-01-05
Submitted:0000-00-00
Entered:1993-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertension, Muscle spasms, Myalgia, Neuropathy, Respiratory disorder

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: 13     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: THyroid, Premarin, Provera, Synthroid, multivitamins, MVI;
Current Illness:
Preexisting Conditions: Menopause, hypothyroidism; all-PCN, Emycin, codiene;
Allergies:
Diagnostic Lab Data: CBC, Thyroid, heavy metal poison; MRI-brain, EMG-neck;
CDC 'Split Type':

Write-up: cramping, sore calves x 2 wk; falls on steps, flat surfaces, dropping anything trying to carry; unable to get up when fall; affected even hair brushing, unable to open doors, dress self, fix meals; dx GBS-CIDP;


Changed on 6/14/2018

VAERS ID: 58025 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:Michigan
Vaccinated:1991-12-05
Onset:1992-01-05
Submitted:0000-00-00
Entered:1993-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertension, Muscle spasms, Myalgia, Neuropathy, Respiratory disorder

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: 13     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: THyroid, Premarin, Provera, Synthroid, multivitamins, MVI;
Current Illness:
Preexisting Conditions: Menopause, hypothyroidism; all-PCN, Emycin, codiene;
Allergies:
Diagnostic Lab Data: CBC, Thyroid, heavy metal poison; MRI-brain, EMG-neck;
CDC 'Split Type':

Write-up: cramping, sore calves x 2 wk; falls on steps, flat surfaces, dropping anything trying to carry; unable to get up when fall; affected even hair brushing, unable to open doors, dress self, fix meals; dx GBS-CIDP;


Changed on 8/14/2018

VAERS ID: 58025 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:Michigan
Vaccinated:1991-12-05
Onset:1992-01-05
Submitted:0000-00-00
Entered:1993-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertension, Muscle spasms, Myalgia, Neuropathy, Respiratory disorder

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: 13     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: THyroid, Premarin, Provera, Synthroid, multivitamins, MVI;
Current Illness:
Preexisting Conditions: Menopause, hypothyroidism; all-PCN, Emycin, codiene;
Allergies:
Diagnostic Lab Data: CBC, Thyroid, heavy metal poison; MRI-brain, EMG-neck;
CDC 'Split Type':

Write-up: cramping, sore calves x 2 wk; falls on steps, flat surfaces, dropping anything trying to carry; unable to get up when fall; affected even hair brushing, unable to open doors, dress self, fix meals; dx GBS-CIDP;


Changed on 9/14/2018

VAERS ID: 58025 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:Michigan
Vaccinated:1991-12-05
Onset:1992-01-05
Submitted:0000-00-00
Entered:1993-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertension, Muscle spasms, Myalgia, Neuropathy, Respiratory disorder

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: 13     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: THyroid, Premarin, Provera, Synthroid, multivitamins, MVI;
Current Illness:
Preexisting Conditions: Menopause, hypothyroidism; all-PCN, Emycin, codiene;
Allergies:
Diagnostic Lab Data: CBC, Thyroid, heavy metal poison; MRI-brain, EMG-neck;
CDC 'Split Type':

Write-up: cramping, sore calves x 2 wk; falls on steps, flat surfaces, dropping anything trying to carry; unable to get up when fall; affected even hair brushing, unable to open doors, dress self, fix meals; dx GBS-CIDP;


Changed on 10/14/2018

VAERS ID: 58025 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:Michigan
Vaccinated:1991-12-05
Onset:1992-01-05
Submitted:0000-00-00
Entered:1993-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Coordination abnormal, Guillain-Barre syndrome, Hypertension, Muscle spasms, Myalgia, Neuropathy, Respiratory disorder

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: 13     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: THyroid, Premarin, Provera, Synthroid, multivitamins, MVI;
Current Illness:
Preexisting Conditions: Menopause, hypothyroidism; all-PCN, Emycin, codiene;
Allergies:
Diagnostic Lab Data: CBC, Thyroid, heavy metal poison; MRI-brain, EMG-neck;
CDC 'Split Type':

Write-up: cramping, sore calves x 2 wk; falls on steps, flat surfaces, dropping anything trying to carry; unable to get up when fall; affected even hair brushing, unable to open doors, dress self, fix meals; dx GBS-CIDP;

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