National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 69995

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 69995
VAERS Form:
Age:67.9
Sex:Female
Location:Arizona
Vaccinated:1994-10-17
Onset:1994-10-18
Submitted:1994-12-08
Entered:1995-01-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1994-1995 / WYETH - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma, lupus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; pt''s daughter reported, pt adm to hosp 1 wk later w/ dx of GBS;


Changed on 12/8/2009

VAERS ID: 69995 Before After
VAERS Form:
Age:67.9
Sex:Female
Location:Arizona
Vaccinated:1994-10-17
Onset:1994-10-18
Submitted:1994-12-08
Entered:1995-01-05 1995-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1994-1995 INFLUENZA (SEASONAL) (FLUSHIELD 94-95) / WYETH WYETH PHARMACEUTICALS, INC - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, GUILLAIN BARRE SYND

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma, lupus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; pt''s daughter reported, pt adm to hosp 1 wk later w/ dx of GBS;


Changed on 8/31/2010

VAERS ID: 69995 Before After
VAERS Form:
Age:67.9
Sex:Female
Location:Arizona
Vaccinated:1994-10-17
Onset:1994-10-18
Submitted:1994-12-08
Entered:1995-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 94-95) INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma, lupus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; pt''s daughter reported, pt adm to hosp 1 wk later w/ dx of GBS;


Changed on 7/7/2013

VAERS ID: 69995 Before After
VAERS Form:
Age:67.9
Sex:Female
Location:Arizona
Vaccinated:1994-10-17
Onset:1994-10-18
Submitted:1994-12-08
Entered:1995-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma, lupus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; pt''s daughter reported, pt adm to hosp 1 wk later w/ dx of GBS;


Changed on 2/14/2017

VAERS ID: 69995 Before After
VAERS Form:
Age:67.9 67.0
Sex:Female
Location:Arizona
Vaccinated:1994-10-17
Onset:1994-10-18
Submitted:1994-12-08
Entered:1995-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: asthma, lupus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; pt''s daughter reported, pt adm to hosp 1 wk later w/ dx of GBS;


Changed on 5/14/2017

VAERS ID: 69995 Before After
VAERS Form:
Age:67.0
Sex:Female
Location:Arizona
Vaccinated:1994-10-17
Onset:1994-10-18
Submitted:1994-12-08
Entered:1995-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: asthma, lupus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; pt''s daughter reported, pt adm to hosp 1 wk later w/ dx of GBS;


Changed on 9/14/2017

VAERS ID: 69995 Before After
VAERS Form:(blank) 1
Age:67.0
Sex:Female
Location:Arizona
Vaccinated:1994-10-17
Onset:1994-10-18
Submitted:1994-12-08
Entered:1995-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: asthma, lupus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; pt''s daughter reported, pt adm to hosp 1 wk later w/ dx of GBS;


Changed on 2/14/2018

VAERS ID: 69995 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Arizona
Vaccinated:1994-10-17
Onset:1994-10-18
Submitted:1994-12-08
Entered:1995-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: asthma, lupus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; pt''s daughter reported, pt adm to hosp 1 wk later w/ dx of GBS;


Changed on 6/14/2018

VAERS ID: 69995 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Arizona
Vaccinated:1994-10-17
Onset:1994-10-18
Submitted:1994-12-08
Entered:1995-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: asthma, lupus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; pt''s daughter reported, pt adm to hosp 1 wk later w/ dx of GBS;


Changed on 8/14/2018

VAERS ID: 69995 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Arizona
Vaccinated:1994-10-17
Onset:1994-10-18
Submitted:1994-12-08
Entered:1995-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: asthma, lupus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; pt''s daughter reported, pt adm to hosp 1 wk later w/ dx of GBS;


Changed on 9/14/2018

VAERS ID: 69995 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Arizona
Vaccinated:1994-10-17
Onset:1994-10-18
Submitted:1994-12-08
Entered:1995-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: asthma, lupus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; pt''s daughter reported, pt adm to hosp 1 wk later w/ dx of GBS;


Changed on 10/14/2018

VAERS ID: 69995 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Arizona
Vaccinated:1994-10-17
Onset:1994-10-18
Submitted:1994-12-08
Entered:1995-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: asthma, lupus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; pt''s daughter reported, pt adm to hosp 1 wk later w/ dx of GBS;


Changed on 12/24/2020

VAERS ID: 69995 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Arizona
Vaccinated:1994-10-17
Onset:1994-10-18
Submitted:1994-12-08
Entered:1995-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: asthma, lupus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; pt''s daughter reported, pt adm to hosp 1 wk later w/ dx of GBS;


Changed on 12/30/2020

VAERS ID: 69995 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Arizona
Vaccinated:1994-10-17
Onset:1994-10-18
Submitted:1994-12-08
Entered:1995-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: asthma, lupus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; pt''s daughter reported, pt adm to hosp 1 wk later w/ dx of GBS;


Changed on 5/7/2021

VAERS ID: 69995 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Arizona
Vaccinated:1994-10-17
Onset:1994-10-18
Submitted:1994-12-08
Entered:1995-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: asthma, lupus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; pt''s daughter reported, pt adm to hosp 1 wk later w/ dx of GBS;


Changed on 5/14/2021

VAERS ID: 69995 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Arizona
Vaccinated:1994-10-17
Onset:1994-10-18
Submitted:1994-12-08
Entered:1995-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome

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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: asthma, lupus
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; pt''s daughter reported, pt adm to hosp 1 wk later w/ dx of GBS;

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=69995&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166