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This is VAERS ID 79638

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 79638
VAERS Form:
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: DYSPNEA, NEUROPATHY, GUILLAIN BARRE SYND, ASTHENIA, ATAXIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;


Changed on 12/8/2009

VAERS ID: 79638 Before After
VAERS Form:
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-30 1995-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) / WYETH WYETH PHARMACEUTICALS, INC - / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Asthenia, Coordination abnormal, Dyspnoea, Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia, Paralysis, DYSPNEA, NEUROPATHY, GUILLAIN BARRE SYND, ASTHENIA, ATAXIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 895317002L

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;


Changed on 8/31/2010

VAERS ID: 79638 Before After
VAERS Form:
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Coordination abnormal, Dyspnoea, Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia, Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895317002L

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;


Changed on 7/7/2013

VAERS ID: 79638 Before After
VAERS Form:
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Coordination abnormal, Dyspnoea, Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia, Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895317002L

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;


Changed on 12/14/2016

VAERS ID: 79638 Before After
VAERS Form:
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Coordination abnormal, Dyspnoea, Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia, Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895317002L

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;


Changed on 5/14/2017

VAERS ID: 79638 Before After
VAERS Form:
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Coordination abnormal, Dyspnoea, Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia, Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895317002L

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;


Changed on 9/14/2017

VAERS ID: 79638 Before After
VAERS Form:(blank) 1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Coordination abnormal, Dyspnoea, Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia, Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895317002L

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;


Changed on 2/14/2018

VAERS ID: 79638 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Coordination abnormal, Dyspnoea, Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia, Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895317002L

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;


Changed on 6/14/2018

VAERS ID: 79638 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Coordination abnormal, Dyspnoea, Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia, Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895317002L

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;


Changed on 8/14/2018

VAERS ID: 79638 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Coordination abnormal, Dyspnoea, Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia, Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895317002L

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;


Changed on 9/14/2018

VAERS ID: 79638 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Coordination abnormal, Dyspnoea, Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia, Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895317002L

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;


Changed on 10/14/2018

VAERS ID: 79638 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Coordination abnormal, Dyspnoea, Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia, Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895317002L

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;


Changed on 12/10/2020

VAERS ID: 79638 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown Oregon
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Coordination abnormal, Dyspnoea, Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia, Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895317002L

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;


Changed on 12/24/2020

VAERS ID: 79638 Before After
VAERS Form:1
Age:
Sex:Male
Location:Oregon
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Coordination abnormal, Dyspnoea, Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia, Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895317002L

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;


Changed on 12/30/2020

VAERS ID: 79638 Before After
VAERS Form:1
Age:
Sex:Male
Location:Oregon
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Coordination abnormal, Dyspnoea, Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia, Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895317002L

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;


Changed on 5/7/2021

VAERS ID: 79638 Before After
VAERS Form:1
Age:
Sex:Male
Location:Oregon
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Coordination abnormal, Dyspnoea, Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia, Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895317002L

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;


Changed on 5/14/2021

VAERS ID: 79638 Before After
VAERS Form:1
Age:
Sex:Male
Location:Oregon
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1995-11-09
Entered:1995-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Coordination abnormal, Dyspnoea, Guillain-Barre syndrome, Neuropathy, Pain, Paraesthesia, Paralysis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895317002L

Write-up: pt recvd vax in 1990 & devel GBS which resulted in pain, fatigue, neuropathies, muscle weakness, paralyzation, numbness, tingling in the extremities, balance disturbances, SOB, sense of coldness in extremities, paresthesias;

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