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This is VAERS ID 59775

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 59775
VAERS Form:
Age:70.5
Sex:Female
Location:Maine
Vaccinated:1993-08-31
Onset:1993-09-05
Submitted:1994-01-04
Entered:1994-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1993-1994 / WYETH - / - A / IM

Administered by: Private      Purchased by: Unknown
Symptoms: NEUROPATHY, GUILLAIN BARRE SYND, ASTHENIA, CSF ABNORM, ATROPHY MUSCLE

Life Threatening? Yes
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: 90     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Synthroid; Glynase 1.5 mg; Relafen 500 mg;
Current Illness: NONE
Preexisting Conditions: pt is diabetic; allergic to penicillin & sulfa; has hypertension, hypercalcemia, obesity, hypercholesterolemia, hematuria, proteinuria; s/p rt arm tumor resection in 1980 & throidectomy for malignant nodule in 1970''s;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax SEP93 & devel nausea & vomiting; the next day devel severe pain in both shoulder & throughout body; subsequently lost the use of arms; adm to hosp where was given a dx of GBS;


Changed on 12/8/2009

VAERS ID: 59775 Before After
VAERS Form:
Age:70.5
Sex:Female
Location:Maine
Vaccinated:1993-08-31
Onset:1993-09-05
Submitted:1994-01-04
Entered:1994-02-14 1994-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1993-1994 INFLUENZA (SEASONAL) (NO BRAND NAME, 93-94) / WYETH WYETH PHARMACEUTICALS, INC - / - A / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Asthenia, Guillain-Barre syndrome, Muscle atrophy, Neuropathy, Pain, Quadriplegia, Thinking abnormal, CSF test abnormal, NEUROPATHY, GUILLAIN BARRE SYND, ASTHENIA, CSF ABNORM, ATROPHY MUSCLE

Life Threatening? Yes
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: 90     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Synthroid; Glynase 1.5 mg; Relafen 500 mg;
Current Illness: NONE
Preexisting Conditions: pt is diabetic; allergic to penicillin & sulfa; has hypertension, hypercalcemia, obesity, hypercholesterolemia, hematuria, proteinuria; s/p rt arm tumor resection in 1980 & throidectomy for malignant nodule in 1970''s;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 894024001J

Write-up: pt recvd vax SEP93 & devel nausea & vomiting; the next day devel severe pain in both shoulder & throughout body; subsequently lost the use of arms; adm to hosp where was given a dx of GBS;


Changed on 8/31/2010

VAERS ID: 59775 Before After
VAERS Form:
Age:70.5
Sex:Female
Location:Maine
Vaccinated:1993-08-31
Onset:1993-09-05
Submitted:1994-01-04
Entered:1994-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 93-94) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - A / IM

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Guillain-Barre syndrome, Muscle atrophy, Neuropathy, Pain, Quadriplegia, Thinking abnormal, CSF test abnormal

Life Threatening? Yes
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: 90     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Synthroid; Glynase 1.5 mg; Relafen 500 mg;
Current Illness: NONE
Preexisting Conditions: pt is diabetic; allergic to penicillin & sulfa; has hypertension, hypercalcemia, obesity, hypercholesterolemia, hematuria, proteinuria; s/p rt arm tumor resection in 1980 & throidectomy for malignant nodule in 1970''s;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 894024001J

Write-up: pt recvd vax SEP93 & devel nausea & vomiting; the next day devel severe pain in both shoulder & throughout body; subsequently lost the use of arms; adm to hosp where was given a dx of GBS;


Changed on 7/7/2013

VAERS ID: 59775 Before After
VAERS Form:
Age:70.5
Sex:Female
Location:Maine
Vaccinated:1993-08-31
Onset:1993-09-05
Submitted:1994-01-04
Entered:1994-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - A / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - A / IM

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Guillain-Barre syndrome, Muscle atrophy, Neuropathy, Pain, Quadriplegia, Thinking abnormal, CSF test abnormal

Life Threatening? Yes
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: 90     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Synthroid; Glynase 1.5 mg; Relafen 500 mg;
Current Illness: NONE
Preexisting Conditions: pt is diabetic; allergic to penicillin & sulfa; has hypertension, hypercalcemia, obesity, hypercholesterolemia, hematuria, proteinuria; s/p rt arm tumor resection in 1980 & throidectomy for malignant nodule in 1970''s;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 894024001J

Write-up: pt recvd vax SEP93 & devel nausea & vomiting; the next day devel severe pain in both shoulder & throughout body; subsequently lost the use of arms; adm to hosp where was given a dx of GBS;


Changed on 12/14/2016

VAERS ID: 59775 Before After
VAERS Form:
Age:70.5
Sex:Female
Location:Maine
Vaccinated:1993-08-31
Onset:1993-09-05
Submitted:1994-01-04
Entered:1994-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - A / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - A / IM

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Guillain-Barre syndrome, Muscle atrophy, Neuropathy, Pain, Quadriplegia, Thinking abnormal, CSF test abnormal

Life Threatening? Yes
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: 90     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Synthroid; Glynase 1.5 mg; Relafen 500 mg;
Current Illness: NONE
Preexisting Conditions: pt is diabetic; allergic to penicillin & sulfa; has hypertension, hypercalcemia, obesity, hypercholesterolemia, hematuria, proteinuria; s/p rt arm tumor resection in 1980 & throidectomy for malignant nodule in 1970''s;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 894024001J

Write-up: pt recvd vax SEP93 & devel nausea & vomiting; the next day devel severe pain in both shoulder & throughout body; subsequently lost the use of arms; adm to hosp where was given a dx of GBS;


Changed on 2/14/2017

VAERS ID: 59775 Before After
VAERS Form:
Age:70.5 70.0
Sex:Female
Location:Maine
Vaccinated:1993-08-31
Onset:1993-09-05
Submitted:1994-01-04
Entered:1994-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - A / IM

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Guillain-Barre syndrome, Muscle atrophy, Neuropathy, Pain, Quadriplegia, Thinking abnormal, CSF test abnormal

Life Threatening? Yes
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: 90     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Synthroid; Glynase 1.5 mg; Relafen 500 mg;
Current Illness: NONE
Preexisting Conditions: pt is diabetic; allergic to penicillin & sulfa; has hypertension, hypercalcemia, obesity, hypercholesterolemia, hematuria, proteinuria; s/p rt arm tumor resection in 1980 & throidectomy for malignant nodule in 1970''s;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 894024001J

Write-up: pt recvd vax SEP93 & devel nausea & vomiting; the next day devel severe pain in both shoulder & throughout body; subsequently lost the use of arms; adm to hosp where was given a dx of GBS;


Changed on 5/14/2017

VAERS ID: 59775 Before After
VAERS Form:
Age:70.0
Sex:Female
Location:Maine
Vaccinated:1993-08-31
Onset:1993-09-05
Submitted:1994-01-04
Entered:1994-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - A - / IM IM A

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Guillain-Barre syndrome, Muscle atrophy, Neuropathy, Pain, Quadriplegia, Thinking abnormal, CSF test abnormal

Life Threatening? Yes
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: 90     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid; Glynase 1.5 mg; Relafen 500 mg;
Current Illness: NONE
Preexisting Conditions: pt is diabetic; allergic to penicillin & sulfa; has hypertension, hypercalcemia, obesity, hypercholesterolemia, hematuria, proteinuria; s/p rt arm tumor resection in 1980 & throidectomy for malignant nodule in 1970''s;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 894024001J

Write-up: pt recvd vax SEP93 & devel nausea & vomiting; the next day devel severe pain in both shoulder & throughout body; subsequently lost the use of arms; adm to hosp where was given a dx of GBS;


Changed on 9/14/2017

VAERS ID: 59775 Before After
VAERS Form:(blank) 1
Age:70.0
Sex:Female
Location:Maine
Vaccinated:1993-08-31
Onset:1993-09-05
Submitted:1994-01-04
Entered:1994-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - UNK - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Guillain-Barre syndrome, Muscle atrophy, Neuropathy, Pain, Quadriplegia, Thinking abnormal, CSF test abnormal

Life Threatening? Yes
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: 90     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid; Glynase 1.5 mg; Relafen 500 mg;
Current Illness: NONE
Preexisting Conditions: pt is diabetic; allergic to penicillin & sulfa; has hypertension, hypercalcemia, obesity, hypercholesterolemia, hematuria, proteinuria; s/p rt arm tumor resection in 1980 & throidectomy for malignant nodule in 1970''s;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 894024001J

Write-up: pt recvd vax SEP93 & devel nausea & vomiting; the next day devel severe pain in both shoulder & throughout body; subsequently lost the use of arms; adm to hosp where was given a dx of GBS;


Changed on 2/14/2018

VAERS ID: 59775 Before After
VAERS Form:1
Age:70.0
Sex:Female
Location:Maine
Vaccinated:1993-08-31
Onset:1993-09-05
Submitted:1994-01-04
Entered:1994-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Guillain-Barre syndrome, Muscle atrophy, Neuropathy, Pain, Quadriplegia, Thinking abnormal, CSF test abnormal

Life Threatening? Yes
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: 90     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid; Glynase 1.5 mg; Relafen 500 mg;
Current Illness: NONE
Preexisting Conditions: pt is diabetic; allergic to penicillin & sulfa; has hypertension, hypercalcemia, obesity, hypercholesterolemia, hematuria, proteinuria; s/p rt arm tumor resection in 1980 & throidectomy for malignant nodule in 1970''s;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 894024001J

Write-up: pt recvd vax SEP93 & devel nausea & vomiting; the next day devel severe pain in both shoulder & throughout body; subsequently lost the use of arms; adm to hosp where was given a dx of GBS;


Changed on 6/14/2018

VAERS ID: 59775 Before After
VAERS Form:1
Age:70.0
Sex:Female
Location:Maine
Vaccinated:1993-08-31
Onset:1993-09-05
Submitted:1994-01-04
Entered:1994-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Guillain-Barre syndrome, Muscle atrophy, Neuropathy, Pain, Quadriplegia, Thinking abnormal, CSF test abnormal

Life Threatening? Yes
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: 90     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid; Glynase 1.5 mg; Relafen 500 mg;
Current Illness: NONE
Preexisting Conditions: pt is diabetic; allergic to penicillin & sulfa; has hypertension, hypercalcemia, obesity, hypercholesterolemia, hematuria, proteinuria; s/p rt arm tumor resection in 1980 & throidectomy for malignant nodule in 1970''s;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 894024001J

Write-up: pt recvd vax SEP93 & devel nausea & vomiting; the next day devel severe pain in both shoulder & throughout body; subsequently lost the use of arms; adm to hosp where was given a dx of GBS;


Changed on 8/14/2018

VAERS ID: 59775 Before After
VAERS Form:1
Age:70.0
Sex:Female
Location:Maine
Vaccinated:1993-08-31
Onset:1993-09-05
Submitted:1994-01-04
Entered:1994-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Guillain-Barre syndrome, Muscle atrophy, Neuropathy, Pain, Quadriplegia, Thinking abnormal, CSF test abnormal

Life Threatening? Yes
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: 90     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid; Glynase 1.5 mg; Relafen 500 mg;
Current Illness: NONE
Preexisting Conditions: pt is diabetic; allergic to penicillin & sulfa; has hypertension, hypercalcemia, obesity, hypercholesterolemia, hematuria, proteinuria; s/p rt arm tumor resection in 1980 & throidectomy for malignant nodule in 1970''s;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 894024001J

Write-up: pt recvd vax SEP93 & devel nausea & vomiting; the next day devel severe pain in both shoulder & throughout body; subsequently lost the use of arms; adm to hosp where was given a dx of GBS;


Changed on 9/14/2018

VAERS ID: 59775 Before After
VAERS Form:1
Age:70.0
Sex:Female
Location:Maine
Vaccinated:1993-08-31
Onset:1993-09-05
Submitted:1994-01-04
Entered:1994-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Guillain-Barre syndrome, Muscle atrophy, Neuropathy, Pain, Quadriplegia, Thinking abnormal, CSF test abnormal

Life Threatening? Yes
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: 90     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid; Glynase 1.5 mg; Relafen 500 mg;
Current Illness: NONE
Preexisting Conditions: pt is diabetic; allergic to penicillin & sulfa; has hypertension, hypercalcemia, obesity, hypercholesterolemia, hematuria, proteinuria; s/p rt arm tumor resection in 1980 & throidectomy for malignant nodule in 1970''s;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 894024001J

Write-up: pt recvd vax SEP93 & devel nausea & vomiting; the next day devel severe pain in both shoulder & throughout body; subsequently lost the use of arms; adm to hosp where was given a dx of GBS;


Changed on 10/14/2018

VAERS ID: 59775 Before After
VAERS Form:1
Age:70.0
Sex:Female
Location:Maine
Vaccinated:1993-08-31
Onset:1993-09-05
Submitted:1994-01-04
Entered:1994-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM A

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Guillain-Barre syndrome, Muscle atrophy, Neuropathy, Pain, Quadriplegia, Thinking abnormal, CSF test abnormal

Life Threatening? Yes
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: 90     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid; Glynase 1.5 mg; Relafen 500 mg;
Current Illness: NONE
Preexisting Conditions: pt is diabetic; allergic to penicillin & sulfa; has hypertension, hypercalcemia, obesity, hypercholesterolemia, hematuria, proteinuria; s/p rt arm tumor resection in 1980 & throidectomy for malignant nodule in 1970''s;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 894024001J

Write-up: pt recvd vax SEP93 & devel nausea & vomiting; the next day devel severe pain in both shoulder & throughout body; subsequently lost the use of arms; adm to hosp where was given a dx of GBS;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=59775&WAYBACKHISTORY=ON


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