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This is VAERS ID 80191

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 80191
VAERS Form:
Age:60.0
Sex:Female
Location:New York
Vaccinated:1994-12-09
Onset:1995-01-18
Submitted:1995-12-19
Entered:1995-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1994-1995 / CONNAUGHT LABS 4F5115 / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: HYPOKINESIA, GUILLAIN BARRE SYND, GAIT ABNORM, AMNESIA, DEPRESSION

Life Threatening? Yes
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? Yes, days: 150     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: none
Current Illness: slight cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: plasma pheresis; extensive testing, SCANS, EKG''s & MRI
CDC 'Split Type':

Write-up: pt recvd vax; adm to hosp w/ GBS for 5 mo; difficulty standing, walking,gripping etc...


Changed on 12/8/2009

VAERS ID: 80191 Before After
VAERS Form:
Age:60.0
Sex:Female
Location:New York
Vaccinated:1994-12-09
Onset:1995-01-18
Submitted:1995-12-19
Entered:1995-12-28 1995-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1994-1995 INFLUENZA (SEASONAL) (FLUZONE 94-95) / CONNAUGHT LABS CONNAUGHT LABORATORIES 4F5115 / - - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Amnesia, Depression, Gait disturbance, Guillain-Barre syndrome, Hypokinesia, Hypotonia, Myasthenic syndrome, Paraesthesia, HYPOKINESIA, GUILLAIN BARRE SYND, GAIT ABNORM, AMNESIA, DEPRESSION

Life Threatening? Yes
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? Yes, days: 150     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: none
Current Illness: slight cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: plasma pheresis; extensive testing, SCANS, EKG''s & MRI
CDC 'Split Type':

Write-up: pt recvd vax; adm to hosp w/ GBS for 5 mo; difficulty standing, walking,gripping etc...


Changed on 8/31/2010

VAERS ID: 80191 Before After
VAERS Form:
Age:60.0
Sex:Female
Location:New York
Vaccinated:1994-12-09
Onset:1995-01-18
Submitted:1995-12-19
Entered:1995-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 94-95) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F5115 / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Amnesia, Depression, Gait disturbance, Guillain-Barre syndrome, Hypokinesia, Hypotonia, Myasthenic syndrome, Paraesthesia

Life Threatening? Yes
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? Yes, days: 150     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: none
Current Illness: slight cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: plasma pheresis; extensive testing, SCANS, EKG''s & MRI
CDC 'Split Type':

Write-up: pt recvd vax; adm to hosp w/ GBS for 5 mo; difficulty standing, walking,gripping etc...


Changed on 7/7/2013

VAERS ID: 80191 Before After
VAERS Form:
Age:60.0
Sex:Female
Location:New York
Vaccinated:1994-12-09
Onset:1995-01-18
Submitted:1995-12-19
Entered:1995-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F5115 / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F5115 / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Amnesia, Depression, Gait disturbance, Guillain-Barre syndrome, Hypokinesia, Hypotonia, Myasthenic syndrome, Paraesthesia

Life Threatening? Yes
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? Yes, days: 150     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: none
Current Illness: slight cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: plasma pheresis; extensive testing, SCANS, EKG''s & MRI
CDC 'Split Type':

Write-up: pt recvd vax; adm to hosp w/ GBS for 5 mo; difficulty standing, walking,gripping etc...


Changed on 5/14/2017

VAERS ID: 80191 Before After
VAERS Form:
Age:60.0
Sex:Female
Location:New York
Vaccinated:1994-12-09
Onset:1995-01-18
Submitted:1995-12-19
Entered:1995-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F5115 / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Amnesia, Depression, Gait disturbance, Guillain-Barre syndrome, Hypokinesia, Hypotonia, Myasthenic syndrome, Paraesthesia

Life Threatening? Yes
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? Yes, days: 150     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: none
Current Illness: slight cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: plasma pheresis; extensive testing, SCANS, EKG''s & MRI
CDC 'Split Type':

Write-up: pt recvd vax; adm to hosp w/ GBS for 5 mo; difficulty standing, walking,gripping etc...


Changed on 9/14/2017

VAERS ID: 80191 Before After
VAERS Form:(blank) 1
Age:60.0
Sex:Female
Location:New York
Vaccinated:1994-12-09
Onset:1995-01-18
Submitted:1995-12-19
Entered:1995-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F5115 / - UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amnesia, Depression, Gait disturbance, Guillain-Barre syndrome, Hypokinesia, Hypotonia, Myasthenic syndrome, Paraesthesia

Life Threatening? Yes
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? Yes, days: 150     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: none
Current Illness: slight cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: plasma pheresis; extensive testing, SCANS, EKG''s & MRI
CDC 'Split Type':

Write-up: pt recvd vax; adm to hosp w/ GBS for 5 mo; difficulty standing, walking,gripping etc...


Changed on 2/14/2018

VAERS ID: 80191 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New York
Vaccinated:1994-12-09
Onset:1995-01-18
Submitted:1995-12-19
Entered:1995-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F5115 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amnesia, Depression, Gait disturbance, Guillain-Barre syndrome, Hypokinesia, Hypotonia, Myasthenic syndrome, Paraesthesia

Life Threatening? Yes
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? Yes, days: 150     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: none
Current Illness: slight cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: plasma pheresis; extensive testing, SCANS, EKG''s & MRI
CDC 'Split Type':

Write-up: pt recvd vax; adm to hosp w/ GBS for 5 mo; difficulty standing, walking,gripping etc...


Changed on 6/14/2018

VAERS ID: 80191 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New York
Vaccinated:1994-12-09
Onset:1995-01-18
Submitted:1995-12-19
Entered:1995-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F5115 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amnesia, Depression, Gait disturbance, Guillain-Barre syndrome, Hypokinesia, Hypotonia, Myasthenic syndrome, Paraesthesia

Life Threatening? Yes
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? Yes, days: 150     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: none
Current Illness: slight cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: plasma pheresis; extensive testing, SCANS, EKG''s & MRI
CDC 'Split Type':

Write-up: pt recvd vax; adm to hosp w/ GBS for 5 mo; difficulty standing, walking,gripping etc...


Changed on 8/14/2018

VAERS ID: 80191 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New York
Vaccinated:1994-12-09
Onset:1995-01-18
Submitted:1995-12-19
Entered:1995-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F5115 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amnesia, Depression, Gait disturbance, Guillain-Barre syndrome, Hypokinesia, Hypotonia, Myasthenic syndrome, Paraesthesia

Life Threatening? Yes
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? Yes, days: 150     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: none
Current Illness: slight cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: plasma pheresis; extensive testing, SCANS, EKG''s & MRI
CDC 'Split Type':

Write-up: pt recvd vax; adm to hosp w/ GBS for 5 mo; difficulty standing, walking,gripping etc...


Changed on 9/14/2018

VAERS ID: 80191 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New York
Vaccinated:1994-12-09
Onset:1995-01-18
Submitted:1995-12-19
Entered:1995-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F5115 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amnesia, Depression, Gait disturbance, Guillain-Barre syndrome, Hypokinesia, Hypotonia, Myasthenic syndrome, Paraesthesia

Life Threatening? Yes
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? Yes, days: 150     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: none
Current Illness: slight cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: plasma pheresis; extensive testing, SCANS, EKG''s & MRI
CDC 'Split Type':

Write-up: pt recvd vax; adm to hosp w/ GBS for 5 mo; difficulty standing, walking,gripping etc...


Changed on 10/14/2018

VAERS ID: 80191 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New York
Vaccinated:1994-12-09
Onset:1995-01-18
Submitted:1995-12-19
Entered:1995-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F5115 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amnesia, Depression, Gait disturbance, Guillain-Barre syndrome, Hypokinesia, Hypotonia, Myasthenic syndrome, Paraesthesia

Life Threatening? Yes
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? Yes, days: 150     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: none
Current Illness: slight cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: plasma pheresis; extensive testing, SCANS, EKG''s & MRI
CDC 'Split Type':

Write-up: pt recvd vax; adm to hosp w/ GBS for 5 mo; difficulty standing, walking,gripping etc...


Changed on 12/24/2020

VAERS ID: 80191 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New York
Vaccinated:1994-12-09
Onset:1995-01-18
Submitted:1995-12-19
Entered:1995-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F5115 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amnesia, Depression, Gait disturbance, Guillain-Barre syndrome, Hypokinesia, Hypotonia, Myasthenic syndrome, Paraesthesia

Life Threatening? Yes
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? Yes, days: 150     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: none
Current Illness: slight cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: plasma pheresis; extensive testing, SCANS, EKG''s & MRI
CDC 'Split Type':

Write-up: pt recvd vax; adm to hosp w/ GBS for 5 mo; difficulty standing, walking,gripping etc...


Changed on 12/30/2020

VAERS ID: 80191 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New York
Vaccinated:1994-12-09
Onset:1995-01-18
Submitted:1995-12-19
Entered:1995-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F5115 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amnesia, Depression, Gait disturbance, Guillain-Barre syndrome, Hypokinesia, Hypotonia, Myasthenic syndrome, Paraesthesia

Life Threatening? Yes
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? Yes, days: 150     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: none
Current Illness: slight cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: plasma pheresis; extensive testing, SCANS, EKG''s & MRI
CDC 'Split Type':

Write-up: pt recvd vax; adm to hosp w/ GBS for 5 mo; difficulty standing, walking,gripping etc...


Changed on 5/7/2021

VAERS ID: 80191 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New York
Vaccinated:1994-12-09
Onset:1995-01-18
Submitted:1995-12-19
Entered:1995-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F5115 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amnesia, Depression, Gait disturbance, Guillain-Barre syndrome, Hypokinesia, Hypotonia, Myasthenic syndrome, Paraesthesia

Life Threatening? Yes
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? Yes, days: 150     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: none
Current Illness: slight cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: plasma pheresis; extensive testing, SCANS, EKG''s & MRI
CDC 'Split Type':

Write-up: pt recvd vax; adm to hosp w/ GBS for 5 mo; difficulty standing, walking,gripping etc...


Changed on 5/14/2021

VAERS ID: 80191 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New York
Vaccinated:1994-12-09
Onset:1995-01-18
Submitted:1995-12-19
Entered:1995-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4F5115 / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amnesia, Depression, Gait disturbance, Guillain-Barre syndrome, Hypokinesia, Hypotonia, Myasthenic syndrome, Paraesthesia

Life Threatening? Yes
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? Yes, days: 150     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: none
Current Illness: slight cold
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: plasma pheresis; extensive testing, SCANS, EKG''s & MRI
CDC 'Split Type':

Write-up: pt recvd vax; adm to hosp w/ GBS for 5 mo; difficulty standing, walking,gripping etc...

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=80191&WAYBACKHISTORY=ON

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