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This is VAERS ID 59120

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 59120
VAERS Form:
Age:62.3
Sex:Female
Location:Arizona
Vaccinated:1993-11-28
Onset:1993-12-11
Submitted:1993-12-21
Entered:1994-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1993-1994 / WYETH 4938278 / - A / IM

Administered by: Other      Purchased by: Unknown
Symptoms: DYSPNEA, GUILLAIN BARRE SYND, ASTHENIA, DYSPHAGIA, CARDIOVASC DIS

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: unk
Current Illness: unk
Preexisting Conditions: hx of labile hypertension, uterine cancer--rx''d in 1975, hysterectomy, osteoporosis, acute herniated disc--rx''d w/epidural blocks; allergic to sulfa drugs & possibly Demerol;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd flu vax 28NOV93 & approx 14DEC93 began to devel sx of GBS; remains hospitalized as the date of this report in stable condition;


Changed on 12/8/2009

VAERS ID: 59120 Before After
VAERS Form:
Age:62.3
Sex:Female
Location:Arizona
Vaccinated:1993-11-28
Onset:1993-12-11
Submitted:1993-12-21
Entered:1994-01-21 1994-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1993-1994 INFLUENZA (SEASONAL) (NO BRAND NAME, 93-94) / WYETH WYETH PHARMACEUTICALS, INC 4938278 / - A / IM

Administered by: Other      Purchased by: Unknown Private
Symptoms: Asthenia, Cardiovascular disorder, Dysphagia, Dyspnoea, Guillain-Barre syndrome, Neck pain, Neuropathy, Paraesthesia, DYSPNEA, GUILLAIN BARRE SYND, ASTHENIA, DYSPHAGIA, CARDIOVASC DIS

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: unk
Current Illness: unk
Preexisting Conditions: hx of labile hypertension, uterine cancer--rx''d in 1975, hysterectomy, osteoporosis, acute herniated disc--rx''d w/epidural blocks; allergic to sulfa drugs & possibly Demerol;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 893357001J

Write-up: pt recvd flu vax 28NOV93 & approx 14DEC93 began to devel sx of GBS; remains hospitalized as the date of this report in stable condition;


Changed on 8/31/2010

VAERS ID: 59120 Before After
VAERS Form:
Age:62.3
Sex:Female
Location:Arizona
Vaccinated:1993-11-28
Onset:1993-12-11
Submitted:1993-12-21
Entered:1994-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 93-94) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4938278 / - A / IM

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, Cardiovascular disorder, Dysphagia, Dyspnoea, Guillain-Barre syndrome, Neck pain, Neuropathy, Paraesthesia

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: unk
Current Illness: unk
Preexisting Conditions: hx of labile hypertension, uterine cancer--rx''d in 1975, hysterectomy, osteoporosis, acute herniated disc--rx''d w/epidural blocks; allergic to sulfa drugs & possibly Demerol;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893357001J

Write-up: pt recvd flu vax 28NOV93 & approx 14DEC93 began to devel sx of GBS; remains hospitalized as the date of this report in stable condition;


Changed on 7/7/2013

VAERS ID: 59120 Before After
VAERS Form:
Age:62.3
Sex:Female
Location:Arizona
Vaccinated:1993-11-28
Onset:1993-12-11
Submitted:1993-12-21
Entered:1994-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938278 / - A / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938278 / - A / IM

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, Cardiovascular disorder, Dysphagia, Dyspnoea, Guillain-Barre syndrome, Neck pain, Neuropathy, Paraesthesia

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: unk
Current Illness: unk
Preexisting Conditions: hx of labile hypertension, uterine cancer--rx''d in 1975, hysterectomy, osteoporosis, acute herniated disc--rx''d w/epidural blocks; allergic to sulfa drugs & possibly Demerol;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893357001J

Write-up: pt recvd flu vax 28NOV93 & approx 14DEC93 began to devel sx of GBS; remains hospitalized as the date of this report in stable condition;


Changed on 12/14/2016

VAERS ID: 59120 Before After
VAERS Form:
Age:62.3
Sex:Female
Location:Arizona
Vaccinated:1993-11-28
Onset:1993-12-11
Submitted:1993-12-21
Entered:1994-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938278 / - A / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938278 / - A / IM

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, Cardiovascular disorder, Dysphagia, Dyspnoea, Guillain-Barre syndrome, Neck pain, Neuropathy, Paraesthesia

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: unk
Current Illness: unk
Preexisting Conditions: hx of labile hypertension, uterine cancer--rx''d in 1975, hysterectomy, osteoporosis, acute herniated disc--rx''d w/epidural blocks; allergic to sulfa drugs & possibly Demerol;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893357001J

Write-up: pt recvd flu vax 28NOV93 & approx 14DEC93 began to devel sx of GBS; remains hospitalized as the date of this report in stable condition;


Changed on 2/14/2017

VAERS ID: 59120 Before After
VAERS Form:
Age:62.3 62.0
Sex:Female
Location:Arizona
Vaccinated:1993-11-28
Onset:1993-12-11
Submitted:1993-12-21
Entered:1994-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938278 / - A / IM

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, Cardiovascular disorder, Dysphagia, Dyspnoea, Guillain-Barre syndrome, Neck pain, Neuropathy, Paraesthesia

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: unk
Current Illness: unk
Preexisting Conditions: hx of labile hypertension, uterine cancer--rx''d in 1975, hysterectomy, osteoporosis, acute herniated disc--rx''d w/epidural blocks; allergic to sulfa drugs & possibly Demerol;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893357001J

Write-up: pt recvd flu vax 28NOV93 & approx 14DEC93 began to devel sx of GBS; remains hospitalized as the date of this report in stable condition;


Changed on 5/14/2017

VAERS ID: 59120 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:Arizona
Vaccinated:1993-11-28
Onset:1993-12-11
Submitted:1993-12-21
Entered:1994-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938278 / - A - / IM IM A

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, Cardiovascular disorder, Dysphagia, Dyspnoea, Guillain-Barre syndrome, Neck pain, Neuropathy, Paraesthesia

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: unk
Current Illness: unk
Preexisting Conditions: hx of labile hypertension, uterine cancer--rx''d in 1975, hysterectomy, osteoporosis, acute herniated disc--rx''d w/epidural blocks; allergic to sulfa drugs & possibly Demerol;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893357001J

Write-up: pt recvd flu vax 28NOV93 & approx 14DEC93 began to devel sx of GBS; remains hospitalized as the date of this report in stable condition;


Changed on 9/14/2017

VAERS ID: 59120 Before After
VAERS Form:(blank) 1
Age:62.0
Sex:Female
Location:Arizona
Vaccinated:1993-11-28
Onset:1993-12-11
Submitted:1993-12-21
Entered:1994-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938278 / - UNK - / IM A

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, Cardiovascular disorder, Dysphagia, Dyspnoea, Guillain-Barre syndrome, Neck pain, Neuropathy, Paraesthesia

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: unk
Current Illness: unk
Preexisting Conditions: hx of labile hypertension, uterine cancer--rx''d in 1975, hysterectomy, osteoporosis, acute herniated disc--rx''d w/epidural blocks; allergic to sulfa drugs & possibly Demerol;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893357001J

Write-up: pt recvd flu vax 28NOV93 & approx 14DEC93 began to devel sx of GBS; remains hospitalized as the date of this report in stable condition;


Changed on 2/14/2018

VAERS ID: 59120 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Arizona
Vaccinated:1993-11-28
Onset:1993-12-11
Submitted:1993-12-21
Entered:1994-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938278 / UNK - / IM A

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, Cardiovascular disorder, Dysphagia, Dyspnoea, Guillain-Barre syndrome, Neck pain, Neuropathy, Paraesthesia

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: unk
Current Illness: unk
Preexisting Conditions: hx of labile hypertension, uterine cancer--rx''d in 1975, hysterectomy, osteoporosis, acute herniated disc--rx''d w/epidural blocks; allergic to sulfa drugs & possibly Demerol;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893357001J

Write-up: pt recvd flu vax 28NOV93 & approx 14DEC93 began to devel sx of GBS; remains hospitalized as the date of this report in stable condition;


Changed on 6/14/2018

VAERS ID: 59120 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Arizona
Vaccinated:1993-11-28
Onset:1993-12-11
Submitted:1993-12-21
Entered:1994-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938278 / UNK - / IM A

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, Cardiovascular disorder, Dysphagia, Dyspnoea, Guillain-Barre syndrome, Neck pain, Neuropathy, Paraesthesia

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: unk
Current Illness: unk
Preexisting Conditions: hx of labile hypertension, uterine cancer--rx''d in 1975, hysterectomy, osteoporosis, acute herniated disc--rx''d w/epidural blocks; allergic to sulfa drugs & possibly Demerol;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893357001J

Write-up: pt recvd flu vax 28NOV93 & approx 14DEC93 began to devel sx of GBS; remains hospitalized as the date of this report in stable condition;


Changed on 8/14/2018

VAERS ID: 59120 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Arizona
Vaccinated:1993-11-28
Onset:1993-12-11
Submitted:1993-12-21
Entered:1994-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938278 / UNK - / IM A

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, Cardiovascular disorder, Dysphagia, Dyspnoea, Guillain-Barre syndrome, Neck pain, Neuropathy, Paraesthesia

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: unk
Current Illness: unk
Preexisting Conditions: hx of labile hypertension, uterine cancer--rx''d in 1975, hysterectomy, osteoporosis, acute herniated disc--rx''d w/epidural blocks; allergic to sulfa drugs & possibly Demerol;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893357001J

Write-up: pt recvd flu vax 28NOV93 & approx 14DEC93 began to devel sx of GBS; remains hospitalized as the date of this report in stable condition;


Changed on 9/14/2018

VAERS ID: 59120 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Arizona
Vaccinated:1993-11-28
Onset:1993-12-11
Submitted:1993-12-21
Entered:1994-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938278 / UNK - / IM A

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, Cardiovascular disorder, Dysphagia, Dyspnoea, Guillain-Barre syndrome, Neck pain, Neuropathy, Paraesthesia

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: unk
Current Illness: unk
Preexisting Conditions: hx of labile hypertension, uterine cancer--rx''d in 1975, hysterectomy, osteoporosis, acute herniated disc--rx''d w/epidural blocks; allergic to sulfa drugs & possibly Demerol;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893357001J

Write-up: pt recvd flu vax 28NOV93 & approx 14DEC93 began to devel sx of GBS; remains hospitalized as the date of this report in stable condition;


Changed on 10/14/2018

VAERS ID: 59120 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Arizona
Vaccinated:1993-11-28
Onset:1993-12-11
Submitted:1993-12-21
Entered:1994-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938278 / UNK - / IM A

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, Cardiovascular disorder, Dysphagia, Dyspnoea, Guillain-Barre syndrome, Neck pain, Neuropathy, Paraesthesia

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: unk
Current Illness: unk
Preexisting Conditions: hx of labile hypertension, uterine cancer--rx''d in 1975, hysterectomy, osteoporosis, acute herniated disc--rx''d w/epidural blocks; allergic to sulfa drugs & possibly Demerol;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893357001J

Write-up: pt recvd flu vax 28NOV93 & approx 14DEC93 began to devel sx of GBS; remains hospitalized as the date of this report in stable condition;


Changed on 12/24/2020

VAERS ID: 59120 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Arizona
Vaccinated:1993-11-28
Onset:1993-12-11
Submitted:1993-12-21
Entered:1994-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938278 / UNK - / IM A

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, Cardiovascular disorder, Dysphagia, Dyspnoea, Guillain-Barre syndrome, Neck pain, Neuropathy, Paraesthesia

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: unk
Current Illness: unk
Preexisting Conditions: hx of labile hypertension, uterine cancer--rx''d in 1975, hysterectomy, osteoporosis, acute herniated disc--rx''d w/epidural blocks; allergic to sulfa drugs & possibly Demerol;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893357001J

Write-up: pt recvd flu vax 28NOV93 & approx 14DEC93 began to devel sx of GBS; remains hospitalized as the date of this report in stable condition;


Changed on 12/30/2020

VAERS ID: 59120 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Arizona
Vaccinated:1993-11-28
Onset:1993-12-11
Submitted:1993-12-21
Entered:1994-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938278 / UNK - / IM A

Administered by: Other      Purchased by: Private
Symptoms: Asthenia, Cardiovascular disorder, Dysphagia, Dyspnoea, Guillain-Barre syndrome, Neck pain, Neuropathy, Paraesthesia

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: unk
Current Illness: unk
Preexisting Conditions: hx of labile hypertension, uterine cancer--rx''d in 1975, hysterectomy, osteoporosis, acute herniated disc--rx''d w/epidural blocks; allergic to sulfa drugs & possibly Demerol;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893357001J

Write-up: pt recvd flu vax 28NOV93 & approx 14DEC93 began to devel sx of GBS; remains hospitalized as the date of this report in stable condition;

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