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This is VAERS ID 86280

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 86280
VAERS Form:
Age:
Sex:Male
Location:Unknown
Vaccinated:1994-10-23
Onset:1994-11-01
Submitted:1996-05-22
Entered:1996-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUVIRIN 1994-1995 / MEDEVA PHARMS LI - / - - / -

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

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: plaintiff alleges that w/in 10 days of vax OCT94 pt fell ill & was ultimately dx w/GBS;pt was hosp & has undergone rehabilitation;residual sx are reported to cont;


Changed on 12/8/2009

VAERS ID: 86280 Before After
VAERS Form:
Age:
Sex:Male
Location:Unknown
Vaccinated:1994-10-23
Onset:1994-11-01
Submitted:1996-05-22
Entered:1996-05-28 1996-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUVIRIN 1994-1995 INFLUENZA (SEASONAL) (FLUVIRIN 94-95) / MEDEVA PHARMS LI MEDEVA PHARMA, LTD. - / - - / -

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

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) ALI96248

Write-up: plaintiff alleges that w/in 10 days of vax OCT94 pt fell ill & was ultimately dx w/GBS;pt was hosp & has undergone rehabilitation;residual sx are reported to cont;


Changed on 8/31/2010

VAERS ID: 86280 Before After
VAERS Form:
Age:
Sex:Male
Location:Unknown
Vaccinated:1994-10-23
Onset:1994-11-01
Submitted:1996-05-22
Entered:1996-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUVIRIN 94-95) INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. - / - - / -

Administered by: Private      Purchased by: Other
Symptoms: Guillain-Barre syndrome

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': ALI96248

Write-up: plaintiff alleges that w/in 10 days of vax OCT94 pt fell ill & was ultimately dx w/GBS;pt was hosp & has undergone rehabilitation;residual sx are reported to cont;


Changed on 7/7/2013

VAERS ID: 86280 Before After
VAERS Form:
Age:
Sex:Male
Location:Unknown
Vaccinated:1994-10-23
Onset:1994-11-01
Submitted:1996-05-22
Entered:1996-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. - / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. - / - - / -

Administered by: Private      Purchased by: Other
Symptoms: Guillain-Barre syndrome

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': ALI96248

Write-up: plaintiff alleges that w/in 10 days of vax OCT94 pt fell ill & was ultimately dx w/GBS;pt was hosp & has undergone rehabilitation;residual sx are reported to cont;


Changed on 5/14/2017

VAERS ID: 86280 Before After
VAERS Form:
Age:
Sex:Male
Location:Unknown
Vaccinated:1994-10-23
Onset:1994-11-01
Submitted:1996-05-22
Entered:1996-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. - / - - / -

Administered by: Private      Purchased by: Other
Symptoms: Guillain-Barre syndrome

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': ALI96248

Write-up: plaintiff alleges that w/in 10 days of vax OCT94 pt fell ill & was ultimately dx w/GBS;pt was hosp & has undergone rehabilitation;residual sx are reported to cont;


Changed on 9/14/2017

VAERS ID: 86280 Before After
VAERS Form:(blank) 1
Age:
Sex:Male
Location:Unknown
Vaccinated:1994-10-23
Onset:1994-11-01
Submitted:1996-05-22
Entered:1996-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. - / - UNK - / -

Administered by: Private      Purchased by: Other
Symptoms: Guillain-Barre syndrome

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': ALI96248

Write-up: plaintiff alleges that w/in 10 days of vax OCT94 pt fell ill & was ultimately dx w/GBS;pt was hosp & has undergone rehabilitation;residual sx are reported to cont;


Changed on 2/14/2018

VAERS ID: 86280 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:1994-10-23
Onset:1994-11-01
Submitted:1996-05-22
Entered:1996-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. - / UNK - / -

Administered by: Private      Purchased by: Other
Symptoms: Guillain-Barre syndrome

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': ALI96248

Write-up: plaintiff alleges that w/in 10 days of vax OCT94 pt fell ill & was ultimately dx w/GBS;pt was hosp & has undergone rehabilitation;residual sx are reported to cont;


Changed on 6/14/2018

VAERS ID: 86280 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:1994-10-23
Onset:1994-11-01
Submitted:1996-05-22
Entered:1996-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. - / UNK - / -

Administered by: Private      Purchased by: Other
Symptoms: Guillain-Barre syndrome

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': ALI96248

Write-up: plaintiff alleges that w/in 10 days of vax OCT94 pt fell ill & was ultimately dx w/GBS;pt was hosp & has undergone rehabilitation;residual sx are reported to cont;


Changed on 8/14/2018

VAERS ID: 86280 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:1994-10-23
Onset:1994-11-01
Submitted:1996-05-22
Entered:1996-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. - / UNK - / -

Administered by: Private      Purchased by: Other
Symptoms: Guillain-Barre syndrome

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': ALI96248

Write-up: plaintiff alleges that w/in 10 days of vax OCT94 pt fell ill & was ultimately dx w/GBS;pt was hosp & has undergone rehabilitation;residual sx are reported to cont;


Changed on 9/14/2018

VAERS ID: 86280 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:1994-10-23
Onset:1994-11-01
Submitted:1996-05-22
Entered:1996-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. - / UNK - / -

Administered by: Private      Purchased by: Other
Symptoms: Guillain-Barre syndrome

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': ALI96248

Write-up: plaintiff alleges that w/in 10 days of vax OCT94 pt fell ill & was ultimately dx w/GBS;pt was hosp & has undergone rehabilitation;residual sx are reported to cont;


Changed on 10/14/2018

VAERS ID: 86280 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:1994-10-23
Onset:1994-11-01
Submitted:1996-05-22
Entered:1996-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. - / UNK - / -

Administered by: Private      Purchased by: Other
Symptoms: Guillain-Barre syndrome

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': ALI96248

Write-up: plaintiff alleges that w/in 10 days of vax OCT94 pt fell ill & was ultimately dx w/GBS;pt was hosp & has undergone rehabilitation;residual sx are reported to cont;


Changed on 12/24/2020

VAERS ID: 86280 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:1994-10-23
Onset:1994-11-01
Submitted:1996-05-22
Entered:1996-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. - / UNK - / -

Administered by: Private      Purchased by: Other
Symptoms: Guillain-Barre syndrome

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': ALI96248

Write-up: plaintiff alleges that w/in 10 days of vax OCT94 pt fell ill & was ultimately dx w/GBS;pt was hosp & has undergone rehabilitation;residual sx are reported to cont;


Changed on 12/30/2020

VAERS ID: 86280 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:1994-10-23
Onset:1994-11-01
Submitted:1996-05-22
Entered:1996-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. - / UNK - / -

Administered by: Private      Purchased by: Other
Symptoms: Guillain-Barre syndrome

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': ALI96248

Write-up: plaintiff alleges that w/in 10 days of vax OCT94 pt fell ill & was ultimately dx w/GBS;pt was hosp & has undergone rehabilitation;residual sx are reported to cont;


Changed on 5/7/2021

VAERS ID: 86280 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:1994-10-23
Onset:1994-11-01
Submitted:1996-05-22
Entered:1996-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. - / UNK - / -

Administered by: Private      Purchased by: Other
Symptoms: Guillain-Barre syndrome

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': ALI96248

Write-up: plaintiff alleges that w/in 10 days of vax OCT94 pt fell ill & was ultimately dx w/GBS;pt was hosp & has undergone rehabilitation;residual sx are reported to cont;


Changed on 5/14/2021

VAERS ID: 86280 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:1994-10-23
Onset:1994-11-01
Submitted:1996-05-22
Entered:1996-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / MEDEVA PHARMA, LTD. - / UNK - / -

Administered by: Private      Purchased by: Other
Symptoms: Guillain-Barre syndrome

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': ALI96248

Write-up: plaintiff alleges that w/in 10 days of vax OCT94 pt fell ill & was ultimately dx w/GBS;pt was hosp & has undergone rehabilitation;residual sx are reported to cont;

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