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This is VAERS ID 83619

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 83619
VAERS Form:
Age:39.4
Sex:Female
Location:Minnesota
Vaccinated:1995-10-18
Onset:1995-10-18
Submitted:1996-03-04
Entered:1996-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1995-1996 PASTEUR MERIEUX CONNAUGHT / CONNAUGHT LABS 5F61123 / 0 LA / -
PPV: PNEUMOVAX 23 / MSD 1541A / 0 LA / -

Administered by: Private      Purchased by: Unknown
Symptoms: CONVULS, GAIT ABNORM, MYASTHENIA, PAIN EAR, PARESTH CIRCUMORAL

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: NA
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: blood tests, MRI, spinal tap etc
CDC 'Split Type':

Write-up: 7 1/2 hrs p/vax numbness in lips on lt side;progressed to numbness & tingling in entire lt side of body;pain in lt ear,weakness on entire lt side;effected vision on lt side;2 sz,effected speech & walking ability,muscle control


Changed on 12/8/2009

VAERS ID: 83619 Before After
VAERS Form:
Age:39.4
Sex:Female
Location:Minnesota
Vaccinated:1995-10-18
Onset:1995-10-18
Submitted:1996-03-04
Entered:1996-03-13 1996-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1995-1996 PASTEUR MERIEUX CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 95-96) / CONNAUGHT LABS CONNAUGHT LABORATORIES 5F61123 / 0 LA / -
PPV: PNEUMOVAX 23 PNEUMO (PNEUMOVAX) / MSD MERCK & CO. INC. 1541A / 0 LA / -

Administered by: Private      Purchased by: Unknown Other
Symptoms: Convulsion, Ear pain, Gait disturbance, Myasthenic syndrome, Paraesthesia, Speech disorder, Visual disturbance, Paraesthesia oral, CONVULS, GAIT ABNORM, MYASTHENIA, PAIN EAR, PARESTH CIRCUMORAL

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: NA
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: blood tests, MRI, spinal tap etc
CDC 'Split Type':

Write-up: 7 1/2 hrs p/vax numbness in lips on lt side;progressed to numbness & tingling in entire lt side of body;pain in lt ear,weakness on entire lt side;effected vision on lt side;2 sz,effected speech & walking ability,muscle control


Changed on 8/31/2010

VAERS ID: 83619 Before After
VAERS Form:
Age:39.4
Sex:Female
Location:Minnesota
Vaccinated:1995-10-18
Onset:1995-10-18
Submitted:1996-03-04
Entered:1996-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 95-96) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61123 / 0 LA / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1541A / 0 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Convulsion, Ear pain, Gait disturbance, Myasthenic syndrome, Paraesthesia, Speech disorder, Visual disturbance, Paraesthesia oral

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: NA
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: blood tests, MRI, spinal tap etc
CDC 'Split Type':

Write-up: 7 1/2 hrs p/vax numbness in lips on lt side;progressed to numbness & tingling in entire lt side of body;pain in lt ear,weakness on entire lt side;effected vision on lt side;2 sz,effected speech & walking ability,muscle control


Changed on 7/7/2013

VAERS ID: 83619 Before After
VAERS Form:
Age:39.4
Sex:Female
Location:Minnesota
Vaccinated:1995-10-18
Onset:1995-10-18
Submitted:1996-03-04
Entered:1996-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61123 / 0 LA / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61123 / 0 LA / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1541A / 0 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Convulsion, Ear pain, Gait disturbance, Myasthenic syndrome, Paraesthesia, Speech disorder, Visual disturbance, Paraesthesia oral

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: NA
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: blood tests, MRI, spinal tap etc
CDC 'Split Type':

Write-up: 7 1/2 hrs p/vax numbness in lips on lt side;progressed to numbness & tingling in entire lt side of body;pain in lt ear,weakness on entire lt side;effected vision on lt side;2 sz,effected speech & walking ability,muscle control


Changed on 2/14/2017

VAERS ID: 83619 Before After
VAERS Form:
Age:39.4 39.0
Sex:Female
Location:Minnesota
Vaccinated:1995-10-18
Onset:1995-10-18
Submitted:1996-03-04
Entered:1996-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61123 / 0 LA / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1541A / 0 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Convulsion, Ear pain, Gait disturbance, Myasthenic syndrome, Paraesthesia, Speech disorder, Visual disturbance, Paraesthesia oral

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: NA
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: blood tests, MRI, spinal tap etc
CDC 'Split Type':

Write-up: 7 1/2 hrs p/vax numbness in lips on lt side;progressed to numbness & tingling in entire lt side of body;pain in lt ear,weakness on entire lt side;effected vision on lt side;2 sz,effected speech & walking ability,muscle control


Changed on 5/14/2017

VAERS ID: 83619 Before After
VAERS Form:
Age:39.0
Sex:Female
Location:Minnesota
Vaccinated:1995-10-18
Onset:1995-10-18
Submitted:1996-03-04
Entered:1996-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61123 / 0 LA / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1541A / 0 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Convulsion, Ear pain, Gait disturbance, Myasthenic syndrome, Paraesthesia, Speech disorder, Visual disturbance, Paraesthesia oral

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: NA
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: blood tests, MRI, spinal tap etc
CDC 'Split Type':

Write-up: 7 1/2 hrs p/vax numbness in lips on lt side;progressed to numbness & tingling in entire lt side of body;pain in lt ear,weakness on entire lt side;effected vision on lt side;2 sz,effected speech & walking ability,muscle control


Changed on 9/14/2017

VAERS ID: 83619 Before After
VAERS Form:(blank) 1
Age:39.0
Sex:Female
Location:Minnesota
Vaccinated:1995-10-18
Onset:1995-10-18
Submitted:1996-03-04
Entered:1996-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61123 / 0 1 LA / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1541A / 0 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Convulsion, Ear pain, Gait disturbance, Myasthenic syndrome, Paraesthesia, Speech disorder, Visual disturbance, Paraesthesia oral

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: NA
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: blood tests, MRI, spinal tap etc
CDC 'Split Type':

Write-up: 7 1/2 hrs p/vax numbness in lips on lt side;progressed to numbness & tingling in entire lt side of body;pain in lt ear,weakness on entire lt side;effected vision on lt side;2 sz,effected speech & walking ability,muscle control


Changed on 2/14/2018

VAERS ID: 83619 Before After
VAERS Form:1
Age:39.0
Sex:Female
Location:Minnesota
Vaccinated:1995-10-18
Onset:1995-10-18
Submitted:1996-03-04
Entered:1996-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61123 / 1 LA / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1541A / 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Convulsion, Ear pain, Gait disturbance, Myasthenic syndrome, Paraesthesia, Speech disorder, Visual disturbance, Paraesthesia oral

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: NA
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: blood tests, MRI, spinal tap etc
CDC 'Split Type':

Write-up: 7 1/2 hrs p/vax numbness in lips on lt side;progressed to numbness & tingling in entire lt side of body;pain in lt ear,weakness on entire lt side;effected vision on lt side;2 sz,effected speech & walking ability,muscle control


Changed on 6/14/2018

VAERS ID: 83619 Before After
VAERS Form:1
Age:39.0
Sex:Female
Location:Minnesota
Vaccinated:1995-10-18
Onset:1995-10-18
Submitted:1996-03-04
Entered:1996-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61123 / 1 LA / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1541A / 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Convulsion, Ear pain, Gait disturbance, Myasthenic syndrome, Paraesthesia, Speech disorder, Visual disturbance, Paraesthesia oral

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: NA
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: blood tests, MRI, spinal tap etc
CDC 'Split Type':

Write-up: 7 1/2 hrs p/vax numbness in lips on lt side;progressed to numbness & tingling in entire lt side of body;pain in lt ear,weakness on entire lt side;effected vision on lt side;2 sz,effected speech & walking ability,muscle control


Changed on 8/14/2018

VAERS ID: 83619 Before After
VAERS Form:1
Age:39.0
Sex:Female
Location:Minnesota
Vaccinated:1995-10-18
Onset:1995-10-18
Submitted:1996-03-04
Entered:1996-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61123 / 1 LA / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1541A / 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Convulsion, Ear pain, Gait disturbance, Myasthenic syndrome, Paraesthesia, Speech disorder, Visual disturbance, Paraesthesia oral

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: NA
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: blood tests, MRI, spinal tap etc
CDC 'Split Type':

Write-up: 7 1/2 hrs p/vax numbness in lips on lt side;progressed to numbness & tingling in entire lt side of body;pain in lt ear,weakness on entire lt side;effected vision on lt side;2 sz,effected speech & walking ability,muscle control


Changed on 9/14/2018

VAERS ID: 83619 Before After
VAERS Form:1
Age:39.0
Sex:Female
Location:Minnesota
Vaccinated:1995-10-18
Onset:1995-10-18
Submitted:1996-03-04
Entered:1996-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61123 / 1 LA / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1541A / 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Convulsion, Ear pain, Gait disturbance, Myasthenic syndrome, Paraesthesia, Speech disorder, Visual disturbance, Paraesthesia oral

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: NA
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: blood tests, MRI, spinal tap etc
CDC 'Split Type':

Write-up: 7 1/2 hrs p/vax numbness in lips on lt side;progressed to numbness & tingling in entire lt side of body;pain in lt ear,weakness on entire lt side;effected vision on lt side;2 sz,effected speech & walking ability,muscle control


Changed on 10/14/2018

VAERS ID: 83619 Before After
VAERS Form:1
Age:39.0
Sex:Female
Location:Minnesota
Vaccinated:1995-10-18
Onset:1995-10-18
Submitted:1996-03-04
Entered:1996-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61123 / 1 LA / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1541A / 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Convulsion, Ear pain, Gait disturbance, Myasthenic syndrome, Paraesthesia, Speech disorder, Visual disturbance, Paraesthesia oral

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: NA
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: blood tests, MRI, spinal tap etc
CDC 'Split Type':

Write-up: 7 1/2 hrs p/vax numbness in lips on lt side;progressed to numbness & tingling in entire lt side of body;pain in lt ear,weakness on entire lt side;effected vision on lt side;2 sz,effected speech & walking ability,muscle control


Changed on 12/24/2020

VAERS ID: 83619 Before After
VAERS Form:1
Age:39.0
Sex:Female
Location:Minnesota
Vaccinated:1995-10-18
Onset:1995-10-18
Submitted:1996-03-04
Entered:1996-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61123 / 1 LA / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1541A / 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Convulsion, Ear pain, Gait disturbance, Myasthenic syndrome, Paraesthesia, Speech disorder, Visual disturbance, Paraesthesia oral

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: NA
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: blood tests, MRI, spinal tap etc
CDC 'Split Type':

Write-up: 7 1/2 hrs p/vax numbness in lips on lt side;progressed to numbness & tingling in entire lt side of body;pain in lt ear,weakness on entire lt side;effected vision on lt side;2 sz,effected speech & walking ability,muscle control


Changed on 12/30/2020

VAERS ID: 83619 Before After
VAERS Form:1
Age:39.0
Sex:Female
Location:Minnesota
Vaccinated:1995-10-18
Onset:1995-10-18
Submitted:1996-03-04
Entered:1996-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61123 / 1 LA / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1541A / 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Convulsion, Ear pain, Gait disturbance, Myasthenic syndrome, Paraesthesia, Speech disorder, Visual disturbance, Paraesthesia oral

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: NA
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: blood tests, MRI, spinal tap etc
CDC 'Split Type':

Write-up: 7 1/2 hrs p/vax numbness in lips on lt side;progressed to numbness & tingling in entire lt side of body;pain in lt ear,weakness on entire lt side;effected vision on lt side;2 sz,effected speech & walking ability,muscle control


Changed on 5/7/2021

VAERS ID: 83619 Before After
VAERS Form:1
Age:39.0
Sex:Female
Location:Minnesota
Vaccinated:1995-10-18
Onset:1995-10-18
Submitted:1996-03-04
Entered:1996-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61123 / 1 LA / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1541A / 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Convulsion, Ear pain, Gait disturbance, Myasthenic syndrome, Paraesthesia, Speech disorder, Visual disturbance, Paraesthesia oral

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: NA
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: blood tests, MRI, spinal tap etc
CDC 'Split Type':

Write-up: 7 1/2 hrs p/vax numbness in lips on lt side;progressed to numbness & tingling in entire lt side of body;pain in lt ear,weakness on entire lt side;effected vision on lt side;2 sz,effected speech & walking ability,muscle control


Changed on 5/14/2021

VAERS ID: 83619 Before After
VAERS Form:1
Age:39.0
Sex:Female
Location:Minnesota
Vaccinated:1995-10-18
Onset:1995-10-18
Submitted:1996-03-04
Entered:1996-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61123 / 1 LA / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1541A / 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Convulsion, Ear pain, Gait disturbance, Myasthenic syndrome, Paraesthesia, Speech disorder, Visual disturbance, Paraesthesia oral

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: NA
Current Illness: NONE
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: blood tests, MRI, spinal tap etc
CDC 'Split Type':

Write-up: 7 1/2 hrs p/vax numbness in lips on lt side;progressed to numbness & tingling in entire lt side of body;pain in lt ear,weakness on entire lt side;effected vision on lt side;2 sz,effected speech & walking ability,muscle control

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