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This is VAERS ID 60715

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 60715
VAERS Form:
Age:73.0
Sex:Male
Location:Unknown
Vaccinated:1993-10-08
Onset:1993-11-04
Submitted:0000-00-00
Entered:1994-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1993-1994 / WYETH 4938167 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND, PAIN, ASTHENIA, CSF ABNORM

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? Yes
Previous Vaccinations:
Other Medications: HCTZ
Current Illness:
Preexisting Conditions: large cell lymphoma of abdo; dx SEP93 treated w/ 3 cycles of meds; ASCVD, MI
Allergies:
Diagnostic Lab Data: CSF protein inc @ 155;
CDC 'Split Type':

Write-up: Pt exp GBS secondary to flu vax given 8OCT93; since the vax pt had exp 2-3 wks of upper body discomfort & weakness;

Changed on 12/8/2009

VAERS ID: 60715 Before After
VAERS Form:
Age:73.0
Sex:Male
Location:Unknown
Vaccinated:1993-10-08
Onset:1993-11-04
Submitted:0000-00-00
Entered:1994-03-21 1994-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1993-1994 INFLUENZA (SEASONAL) (NO BRAND NAME, 93-94) / WYETH WYETH PHARMACEUTICALS, INC 4938167 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Pain, CSF test abnormal, GUILLAIN BARRE SYND, PAIN, ASTHENIA, CSF ABNORM

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? Yes
Previous Vaccinations:
Other Medications: HCTZ
Current Illness:
Preexisting Conditions: large cell lymphoma of abdo; dx SEP93 treated w/ 3 cycles of meds; ASCVD, MI
Allergies:
Diagnostic Lab Data: CSF protein inc @ 155;
CDC 'Split Type':

Write-up: Pt exp GBS secondary to flu vax given 8OCT93; since the vax pt had exp 2-3 wks of upper body discomfort & weakness;

Changed on 8/31/2010

VAERS ID: 60715 Before After
VAERS Form:
Age:73.0
Sex:Male
Location:Unknown
Vaccinated:1993-10-08
Onset:1993-11-04
Submitted:0000-00-00
Entered:1994-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 93-94) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4938167 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Pain, CSF test abnormal

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? Yes
Previous Vaccinations:
Other Medications: HCTZ
Current Illness:
Preexisting Conditions: large cell lymphoma of abdo; dx SEP93 treated w/ 3 cycles of meds; ASCVD, MI
Allergies:
Diagnostic Lab Data: CSF protein inc @ 155;
CDC 'Split Type':

Write-up: Pt exp GBS secondary to flu vax given 8OCT93; since the vax pt had exp 2-3 wks of upper body discomfort & weakness;

Changed on 7/7/2013

VAERS ID: 60715 Before After
VAERS Form:
Age:73.0
Sex:Male
Location:Unknown
Vaccinated:1993-10-08
Onset:1993-11-04
Submitted:0000-00-00
Entered:1994-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938167 / - - / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938167 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Pain, CSF test abnormal

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? Yes
Previous Vaccinations:
Other Medications: HCTZ
Current Illness:
Preexisting Conditions: large cell lymphoma of abdo; dx SEP93 treated w/ 3 cycles of meds; ASCVD, MI
Allergies:
Diagnostic Lab Data: CSF protein inc @ 155;
CDC 'Split Type':

Write-up: Pt exp GBS secondary to flu vax given 8OCT93; since the vax pt had exp 2-3 wks of upper body discomfort & weakness;

Changed on 12/14/2016

VAERS ID: 60715 Before After
VAERS Form:
Age:73.0
Sex:Male
Location:Unknown
Vaccinated:1993-10-08
Onset:1993-11-04
Submitted:0000-00-00
Entered:1994-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938167 / - - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938167 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Pain, CSF test abnormal

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? Yes
Previous Vaccinations:
Other Medications: HCTZ
Current Illness:
Preexisting Conditions: large cell lymphoma of abdo; dx SEP93 treated w/ 3 cycles of meds; ASCVD, MI
Allergies:
Diagnostic Lab Data: CSF protein inc @ 155;
CDC 'Split Type':

Write-up: Pt exp GBS secondary to flu vax given 8OCT93; since the vax pt had exp 2-3 wks of upper body discomfort & weakness;

Changed on 5/14/2017

VAERS ID: 60715 Before After
VAERS Form:
Age:73.0
Sex:Male
Location:Unknown
Vaccinated:1993-10-08
Onset:1993-11-04
Submitted:0000-00-00
Entered:1994-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938167 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Pain, CSF test abnormal

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: HCTZ
Current Illness:
Preexisting Conditions: large cell lymphoma of abdo; dx SEP93 treated w/ 3 cycles of meds; ASCVD, MI
Allergies:
Diagnostic Lab Data: CSF protein inc @ 155;
CDC 'Split Type':

Write-up: Pt exp GBS secondary to flu vax given 8OCT93; since the vax pt had exp 2-3 wks of upper body discomfort & weakness;

Changed on 9/14/2017

VAERS ID: 60715 Before After
VAERS Form:(blank) 1
Age:73.0
Sex:Male
Location:Unknown
Vaccinated:1993-10-08
Onset:1993-11-04
Submitted:0000-00-00
Entered:1994-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938167 / - UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Pain, CSF test abnormal

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: HCTZ
Current Illness:
Preexisting Conditions: large cell lymphoma of abdo; dx SEP93 treated w/ 3 cycles of meds; ASCVD, MI
Allergies:
Diagnostic Lab Data: CSF protein inc @ 155;
CDC 'Split Type':

Write-up: Pt exp GBS secondary to flu vax given 8OCT93; since the vax pt had exp 2-3 wks of upper body discomfort & weakness;

Changed on 2/14/2018

VAERS ID: 60715 Before After
VAERS Form:1
Age:73.0
Sex:Male
Location:Unknown
Vaccinated:1993-10-08
Onset:1993-11-04
Submitted:0000-00-00
Entered:1994-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938167 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Pain, CSF test abnormal

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: HCTZ
Current Illness:
Preexisting Conditions: large cell lymphoma of abdo; dx SEP93 treated w/ 3 cycles of meds; ASCVD, MI
Allergies:
Diagnostic Lab Data: CSF protein inc @ 155;
CDC 'Split Type':

Write-up: Pt exp GBS secondary to flu vax given 8OCT93; since the vax pt had exp 2-3 wks of upper body discomfort & weakness;

Changed on 6/14/2018

VAERS ID: 60715 Before After
VAERS Form:1
Age:73.0
Sex:Male
Location:Unknown
Vaccinated:1993-10-08
Onset:1993-11-04
Submitted:0000-00-00
Entered:1994-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938167 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Pain, CSF test abnormal

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: HCTZ
Current Illness:
Preexisting Conditions: large cell lymphoma of abdo; dx SEP93 treated w/ 3 cycles of meds; ASCVD, MI
Allergies:
Diagnostic Lab Data: CSF protein inc @ 155;
CDC 'Split Type':

Write-up: Pt exp GBS secondary to flu vax given 8OCT93; since the vax pt had exp 2-3 wks of upper body discomfort & weakness;

Changed on 8/14/2018

VAERS ID: 60715 Before After
VAERS Form:1
Age:73.0
Sex:Male
Location:Unknown
Vaccinated:1993-10-08
Onset:1993-11-04
Submitted:0000-00-00
Entered:1994-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938167 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Pain, CSF test abnormal

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: HCTZ
Current Illness:
Preexisting Conditions: large cell lymphoma of abdo; dx SEP93 treated w/ 3 cycles of meds; ASCVD, MI
Allergies:
Diagnostic Lab Data: CSF protein inc @ 155;
CDC 'Split Type':

Write-up: Pt exp GBS secondary to flu vax given 8OCT93; since the vax pt had exp 2-3 wks of upper body discomfort & weakness;

Changed on 9/14/2018

VAERS ID: 60715 Before After
VAERS Form:1
Age:73.0
Sex:Male
Location:Unknown
Vaccinated:1993-10-08
Onset:1993-11-04
Submitted:0000-00-00
Entered:1994-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938167 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Pain, CSF test abnormal

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: HCTZ
Current Illness:
Preexisting Conditions: large cell lymphoma of abdo; dx SEP93 treated w/ 3 cycles of meds; ASCVD, MI
Allergies:
Diagnostic Lab Data: CSF protein inc @ 155;
CDC 'Split Type':

Write-up: Pt exp GBS secondary to flu vax given 8OCT93; since the vax pt had exp 2-3 wks of upper body discomfort & weakness;

Changed on 10/14/2018

VAERS ID: 60715 Before After
VAERS Form:1
Age:73.0
Sex:Male
Location:Unknown
Vaccinated:1993-10-08
Onset:1993-11-04
Submitted:0000-00-00
Entered:1994-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938167 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Pain, CSF test abnormal

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: HCTZ
Current Illness:
Preexisting Conditions: large cell lymphoma of abdo; dx SEP93 treated w/ 3 cycles of meds; ASCVD, MI
Allergies:
Diagnostic Lab Data: CSF protein inc @ 155;
CDC 'Split Type':

Write-up: Pt exp GBS secondary to flu vax given 8OCT93; since the vax pt had exp 2-3 wks of upper body discomfort & weakness;

Changed on 12/10/2020

VAERS ID: 60715 Before After
VAERS Form:1
Age:73.0
Sex:Male
Location:Unknown Virginia
Vaccinated:1993-10-08
Onset:1993-11-04
Submitted:0000-00-00
Entered:1994-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938167 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Pain, CSF test abnormal

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: HCTZ
Current Illness:
Preexisting Conditions: large cell lymphoma of abdo; dx SEP93 treated w/ 3 cycles of meds; ASCVD, MI
Allergies:
Diagnostic Lab Data: CSF protein inc @ 155;
CDC 'Split Type':

Write-up: Pt exp GBS secondary to flu vax given 8OCT93; since the vax pt had exp 2-3 wks of upper body discomfort & weakness;

Changed on 12/24/2020

VAERS ID: 60715 Before After
VAERS Form:1
Age:73.0
Sex:Male
Location:Virginia
Vaccinated:1993-10-08
Onset:1993-11-04
Submitted:0000-00-00
Entered:1994-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938167 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Pain, CSF test abnormal

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: HCTZ
Current Illness:
Preexisting Conditions: large cell lymphoma of abdo; dx SEP93 treated w/ 3 cycles of meds; ASCVD, MI
Allergies:
Diagnostic Lab Data: CSF protein inc @ 155;
CDC 'Split Type':

Write-up: Pt exp GBS secondary to flu vax given 8OCT93; since the vax pt had exp 2-3 wks of upper body discomfort & weakness;

Changed on 12/30/2020

VAERS ID: 60715 Before After
VAERS Form:1
Age:73.0
Sex:Male
Location:Virginia
Vaccinated:1993-10-08
Onset:1993-11-04
Submitted:0000-00-00
Entered:1994-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938167 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Pain, CSF test abnormal

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? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: HCTZ
Current Illness:
Preexisting Conditions: large cell lymphoma of abdo; dx SEP93 treated w/ 3 cycles of meds; ASCVD, MI
Allergies:
Diagnostic Lab Data: CSF protein inc @ 155;
CDC 'Split Type':

Write-up: Pt exp GBS secondary to flu vax given 8OCT93; since the vax pt had exp 2-3 wks of upper body discomfort & weakness;

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