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This is VAERS ID 88855

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 88855
VAERS Form:
Age:57.7
Sex:Male
Location:Michigan
Vaccinated:1995-10-21
Onset:1995-11-02
Submitted:1996-07-31
Entered:1996-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1995-1996 PASTEUR MERIEUX CONNAUGHT / CONNAUGHT LABS 5F61099 / - LA / -

Administered by: Private      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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS


Changed on 12/8/2009

VAERS ID: 88855 Before After
VAERS Form:
Age:57.7
Sex:Male
Location:Michigan
Vaccinated:1995-10-21
Onset:1995-11-02
Submitted:1996-07-31
Entered:1996-08-13 1996-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1995-1996 PASTEUR MERIEUX CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 95-96) / CONNAUGHT LABS CONNAUGHT LABORATORIES 5F61099 / - LA / -

Administered by: Private      Purchased by: Unknown Private
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS


Changed on 8/31/2010

VAERS ID: 88855 Before After
VAERS Form:
Age:57.7
Sex:Male
Location:Michigan
Vaccinated:1995-10-21
Onset:1995-11-02
Submitted:1996-07-31
Entered:1996-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 95-96) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61099 / - LA / -

Administered by: Private      Purchased by: Private
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS


Changed on 7/7/2013

VAERS ID: 88855 Before After
VAERS Form:
Age:57.7
Sex:Male
Location:Michigan
Vaccinated:1995-10-21
Onset:1995-11-02
Submitted:1996-07-31
Entered:1996-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61099 / - LA / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61099 / - LA / -

Administered by: Private      Purchased by: Private
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS


Changed on 2/14/2017

VAERS ID: 88855 Before After
VAERS Form:
Age:57.7 57.0
Sex:Male
Location:Michigan
Vaccinated:1995-10-21
Onset:1995-11-02
Submitted:1996-07-31
Entered:1996-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61099 / - LA / -

Administered by: Private      Purchased by: Private
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS


Changed on 5/14/2017

VAERS ID: 88855 Before After
VAERS Form:
Age:57.0
Sex:Male
Location:Michigan
Vaccinated:1995-10-21
Onset:1995-11-02
Submitted:1996-07-31
Entered:1996-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61099 / - LA / -

Administered by: Private      Purchased by: Private
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS


Changed on 9/14/2017

VAERS ID: 88855 Before After
VAERS Form:(blank) 1
Age:57.0
Sex:Male
Location:Michigan
Vaccinated:1995-10-21
Onset:1995-11-02
Submitted:1996-07-31
Entered:1996-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61099 / - UNK LA / -

Administered by: Private      Purchased by: Private
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS


Changed on 2/14/2018

VAERS ID: 88855 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Michigan
Vaccinated:1995-10-21
Onset:1995-11-02
Submitted:1996-07-31
Entered:1996-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61099 / UNK LA / -

Administered by: Private      Purchased by: Private
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS


Changed on 6/14/2018

VAERS ID: 88855 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Michigan
Vaccinated:1995-10-21
Onset:1995-11-02
Submitted:1996-07-31
Entered:1996-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61099 / UNK LA / -

Administered by: Private      Purchased by: Private
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS


Changed on 8/14/2018

VAERS ID: 88855 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Michigan
Vaccinated:1995-10-21
Onset:1995-11-02
Submitted:1996-07-31
Entered:1996-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61099 / UNK LA / -

Administered by: Private      Purchased by: Private
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS


Changed on 9/14/2018

VAERS ID: 88855 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Michigan
Vaccinated:1995-10-21
Onset:1995-11-02
Submitted:1996-07-31
Entered:1996-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61099 / UNK LA / -

Administered by: Private      Purchased by: Private
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS


Changed on 10/14/2018

VAERS ID: 88855 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Michigan
Vaccinated:1995-10-21
Onset:1995-11-02
Submitted:1996-07-31
Entered:1996-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61099 / UNK LA / -

Administered by: Private      Purchased by: Private
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS


Changed on 12/24/2020

VAERS ID: 88855 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Michigan
Vaccinated:1995-10-21
Onset:1995-11-02
Submitted:1996-07-31
Entered:1996-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61099 / UNK LA / -

Administered by: Private      Purchased by: Private
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS


Changed on 12/30/2020

VAERS ID: 88855 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Michigan
Vaccinated:1995-10-21
Onset:1995-11-02
Submitted:1996-07-31
Entered:1996-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61099 / UNK LA / -

Administered by: Private      Purchased by: Private
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS


Changed on 5/7/2021

VAERS ID: 88855 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Michigan
Vaccinated:1995-10-21
Onset:1995-11-02
Submitted:1996-07-31
Entered:1996-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61099 / UNK LA / -

Administered by: Private      Purchased by: Private
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS


Changed on 5/14/2021

VAERS ID: 88855 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Michigan
Vaccinated:1995-10-21
Onset:1995-11-02
Submitted:1996-07-31
Entered:1996-08-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61099 / UNK LA / -

Administered by: Private      Purchased by: Private
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: GBS

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=88855&WAYBACKHISTORY=ON


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