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This is VAERS ID 58371

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 58371
VAERS Form:
Age:61.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:1993-11-04
Submitted:1993-12-15
Entered:1993-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1993-1994 / PARKE-DAVIS - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: NEUROPATHY, BLIND, VASC DIS

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:
Other Medications:
Current Illness:
Preexisting Conditions: no allergies;
Allergies:
Diagnostic Lab Data: 11NOV MRI brain & optic nerves neg; 2 LP; 12NOV bilateral temporal artery biopsy neg; ESR neg, ANA neg, anticardiolipils; leber''s maker neg; lupus anticoagulent neg;
CDC 'Split Type':

Write-up: progressive bilateral visual loss 3-4 wks following vax; exam consistent w/bilateral anterior ischemic optic neuropathy;


Changed on 12/8/2009

VAERS ID: 58371 Before After
VAERS Form:
Age:61.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:1993-11-04
Submitted:1993-12-15
Entered:1993-12-23 1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1993-1994 INFLUENZA (SEASONAL) (FLUOGEN 93-94) / PARKE-DAVIS - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness, Neuropathy, Angiopathy, NEUROPATHY, BLIND, VASC DIS

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:
Other Medications:
Current Illness:
Preexisting Conditions: no allergies;
Allergies:
Diagnostic Lab Data: 11NOV MRI brain & optic nerves neg; 2 LP; 12NOV bilateral temporal artery biopsy neg; ESR neg, ANA neg, anticardiolipils; leber''s maker neg; lupus anticoagulent neg;
CDC 'Split Type':

Write-up: progressive bilateral visual loss 3-4 wks following vax; exam consistent w/bilateral anterior ischemic optic neuropathy;


Changed on 8/31/2010

VAERS ID: 58371 Before After
VAERS Form:
Age:61.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:1993-11-04
Submitted:1993-12-15
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 93-94) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness, Neuropathy, Angiopathy

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:
Other Medications:
Current Illness:
Preexisting Conditions: no allergies;
Allergies:
Diagnostic Lab Data: 11NOV MRI brain & optic nerves neg; 2 LP; 12NOV bilateral temporal artery biopsy neg; ESR neg, ANA neg, anticardiolipils; leber''s maker neg; lupus anticoagulent neg;
CDC 'Split Type':

Write-up: progressive bilateral visual loss 3-4 wks following vax; exam consistent w/bilateral anterior ischemic optic neuropathy;


Changed on 7/7/2013

VAERS ID: 58371 Before After
VAERS Form:
Age:61.5
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:1993-11-04
Submitted:1993-12-15
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness, Neuropathy, Angiopathy

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:
Other Medications:
Current Illness:
Preexisting Conditions: no allergies;
Allergies:
Diagnostic Lab Data: 11NOV MRI brain & optic nerves neg; 2 LP; 12NOV bilateral temporal artery biopsy neg; ESR neg, ANA neg, anticardiolipils; leber''s maker neg; lupus anticoagulent neg;
CDC 'Split Type':

Write-up: progressive bilateral visual loss 3-4 wks following vax; exam consistent w/bilateral anterior ischemic optic neuropathy;


Changed on 2/14/2017

VAERS ID: 58371 Before After
VAERS Form:
Age:61.5 61.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:1993-11-04
Submitted:1993-12-15
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness, Neuropathy, Angiopathy

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:
Other Medications:
Current Illness:
Preexisting Conditions: no allergies;
Allergies:
Diagnostic Lab Data: 11NOV MRI brain & optic nerves neg; 2 LP; 12NOV bilateral temporal artery biopsy neg; ESR neg, ANA neg, anticardiolipils; leber''s maker neg; lupus anticoagulent neg;
CDC 'Split Type':

Write-up: progressive bilateral visual loss 3-4 wks following vax; exam consistent w/bilateral anterior ischemic optic neuropathy;


Changed on 5/14/2017

VAERS ID: 58371 Before After
VAERS Form:
Age:61.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:1993-11-04
Submitted:1993-12-15
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness, Neuropathy, Angiopathy

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no allergies;
Allergies:
Diagnostic Lab Data: 11NOV MRI brain & optic nerves neg; 2 LP; 12NOV bilateral temporal artery biopsy neg; ESR neg, ANA neg, anticardiolipils; leber''s maker neg; lupus anticoagulent neg;
CDC 'Split Type':

Write-up: progressive bilateral visual loss 3-4 wks following vax; exam consistent w/bilateral anterior ischemic optic neuropathy;


Changed on 9/14/2017

VAERS ID: 58371 Before After
VAERS Form:(blank) 1
Age:61.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:1993-11-04
Submitted:1993-12-15
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness, Neuropathy, Angiopathy

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no allergies;
Allergies:
Diagnostic Lab Data: 11NOV MRI brain & optic nerves neg; 2 LP; 12NOV bilateral temporal artery biopsy neg; ESR neg, ANA neg, anticardiolipils; leber''s maker neg; lupus anticoagulent neg;
CDC 'Split Type':

Write-up: progressive bilateral visual loss 3-4 wks following vax; exam consistent w/bilateral anterior ischemic optic neuropathy;


Changed on 2/14/2018

VAERS ID: 58371 Before After
VAERS Form:1
Age:61.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:1993-11-04
Submitted:1993-12-15
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness, Neuropathy, Angiopathy

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no allergies;
Allergies:
Diagnostic Lab Data: 11NOV MRI brain & optic nerves neg; 2 LP; 12NOV bilateral temporal artery biopsy neg; ESR neg, ANA neg, anticardiolipils; leber''s maker neg; lupus anticoagulent neg;
CDC 'Split Type':

Write-up: progressive bilateral visual loss 3-4 wks following vax; exam consistent w/bilateral anterior ischemic optic neuropathy;


Changed on 6/14/2018

VAERS ID: 58371 Before After
VAERS Form:1
Age:61.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:1993-11-04
Submitted:1993-12-15
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness, Neuropathy, Angiopathy

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no allergies;
Allergies:
Diagnostic Lab Data: 11NOV MRI brain & optic nerves neg; 2 LP; 12NOV bilateral temporal artery biopsy neg; ESR neg, ANA neg, anticardiolipils; leber''s maker neg; lupus anticoagulent neg;
CDC 'Split Type':

Write-up: progressive bilateral visual loss 3-4 wks following vax; exam consistent w/bilateral anterior ischemic optic neuropathy;


Changed on 8/14/2018

VAERS ID: 58371 Before After
VAERS Form:1
Age:61.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:1993-11-04
Submitted:1993-12-15
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness, Neuropathy, Angiopathy

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no allergies;
Allergies:
Diagnostic Lab Data: 11NOV MRI brain & optic nerves neg; 2 LP; 12NOV bilateral temporal artery biopsy neg; ESR neg, ANA neg, anticardiolipils; leber''s maker neg; lupus anticoagulent neg;
CDC 'Split Type':

Write-up: progressive bilateral visual loss 3-4 wks following vax; exam consistent w/bilateral anterior ischemic optic neuropathy;


Changed on 9/14/2018

VAERS ID: 58371 Before After
VAERS Form:1
Age:61.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:1993-11-04
Submitted:1993-12-15
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness, Neuropathy, Angiopathy

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no allergies;
Allergies:
Diagnostic Lab Data: 11NOV MRI brain & optic nerves neg; 2 LP; 12NOV bilateral temporal artery biopsy neg; ESR neg, ANA neg, anticardiolipils; leber''s maker neg; lupus anticoagulent neg;
CDC 'Split Type':

Write-up: progressive bilateral visual loss 3-4 wks following vax; exam consistent w/bilateral anterior ischemic optic neuropathy;


Changed on 10/14/2018

VAERS ID: 58371 Before After
VAERS Form:1
Age:61.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:1993-11-04
Submitted:1993-12-15
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blindness, Neuropathy, Angiopathy

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no allergies;
Allergies:
Diagnostic Lab Data: 11NOV MRI brain & optic nerves neg; 2 LP; 12NOV bilateral temporal artery biopsy neg; ESR neg, ANA neg, anticardiolipils; leber''s maker neg; lupus anticoagulent neg;
CDC 'Split Type':

Write-up: progressive bilateral visual loss 3-4 wks following vax; exam consistent w/bilateral anterior ischemic optic neuropathy;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=58371&WAYBACKHISTORY=ON


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