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This is VAERS ID 88869

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 88869
VAERS Form:
Age:
Sex:Male
Location:California
Vaccinated:1993-10-29
Onset:1993-11-26
Submitted:1996-07-23
Entered:1996-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1993-1994 / WYETH - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: HYPOKINESIA, HEADACHE, GUILLAIN BARRE SYND, AMBLYOPIA, 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)? No
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 recv vax 29OCT93 & 26NOV93 pt exp h/a, blurred vision, gen pain;pt was allegedly dx w/GBS on 29NOV93;it is alleged that pt exp & cont to exp paralysis, loss of mobility, impaired, & periodic loss of equilibrium;


Changed on 12/8/2009

VAERS ID: 88869 Before After
VAERS Form:
Age:
Sex:Male
Location:California
Vaccinated:1993-10-29
Onset:1993-11-26
Submitted:1996-07-23
Entered:1996-08-14 1996-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1993-1994 INFLUENZA (SEASONAL) (NO BRAND NAME, 93-94) / WYETH WYETH PHARMACEUTICALS, INC - / - - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Amblyopia, Coordination abnormal, Guillain-Barre syndrome, Headache, Hypokinesia, Pain, Paralysis, Visual disturbance, HYPOKINESIA, HEADACHE, GUILLAIN BARRE SYND, AMBLYOPIA, 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)? No
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) 896207001L

Write-up: pt recv vax 29OCT93 & 26NOV93 pt exp h/a, blurred vision, gen pain;pt was allegedly dx w/GBS on 29NOV93;it is alleged that pt exp & cont to exp paralysis, loss of mobility, impaired, & periodic loss of equilibrium;


Changed on 8/31/2010

VAERS ID: 88869 Before After
VAERS Form:
Age:
Sex:Male
Location:California
Vaccinated:1993-10-29
Onset:1993-11-26
Submitted:1996-07-23
Entered:1996-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 93-94) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Amblyopia, Coordination abnormal, Guillain-Barre syndrome, Headache, Hypokinesia, Pain, Paralysis, Visual disturbance

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: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896207001L

Write-up: pt recv vax 29OCT93 & 26NOV93 pt exp h/a, blurred vision, gen pain;pt was allegedly dx w/GBS on 29NOV93;it is alleged that pt exp & cont to exp paralysis, loss of mobility, impaired, & periodic loss of equilibrium;


Changed on 7/7/2013

VAERS ID: 88869 Before After
VAERS Form:
Age:
Sex:Male
Location:California
Vaccinated:1993-10-29
Onset:1993-11-26
Submitted:1996-07-23
Entered:1996-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Amblyopia, Coordination abnormal, Guillain-Barre syndrome, Headache, Hypokinesia, Pain, Paralysis, Visual disturbance

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: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896207001L

Write-up: pt recv vax 29OCT93 & 26NOV93 pt exp h/a, blurred vision, gen pain;pt was allegedly dx w/GBS on 29NOV93;it is alleged that pt exp & cont to exp paralysis, loss of mobility, impaired, & periodic loss of equilibrium;


Changed on 12/14/2016

VAERS ID: 88869 Before After
VAERS Form:
Age:
Sex:Male
Location:California
Vaccinated:1993-10-29
Onset:1993-11-26
Submitted:1996-07-23
Entered:1996-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Amblyopia, Coordination abnormal, Guillain-Barre syndrome, Headache, Hypokinesia, Pain, Paralysis, Visual disturbance

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: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896207001L

Write-up: pt recv vax 29OCT93 & 26NOV93 pt exp h/a, blurred vision, gen pain;pt was allegedly dx w/GBS on 29NOV93;it is alleged that pt exp & cont to exp paralysis, loss of mobility, impaired, & periodic loss of equilibrium;


Changed on 5/14/2017

VAERS ID: 88869 Before After
VAERS Form:
Age:
Sex:Male
Location:California
Vaccinated:1993-10-29
Onset:1993-11-26
Submitted:1996-07-23
Entered:1996-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Amblyopia, Coordination abnormal, Guillain-Barre syndrome, Headache, Hypokinesia, Pain, Paralysis, Visual disturbance

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: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896207001L

Write-up: pt recv vax 29OCT93 & 26NOV93 pt exp h/a, blurred vision, gen pain;pt was allegedly dx w/GBS on 29NOV93;it is alleged that pt exp & cont to exp paralysis, loss of mobility, impaired, & periodic loss of equilibrium;


Changed on 9/14/2017

VAERS ID: 88869 Before After
VAERS Form:(blank) 1
Age:
Sex:Male
Location:California
Vaccinated:1993-10-29
Onset:1993-11-26
Submitted:1996-07-23
Entered:1996-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amblyopia, Coordination abnormal, Guillain-Barre syndrome, Headache, Hypokinesia, Pain, Paralysis, Visual disturbance

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: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896207001L

Write-up: pt recv vax 29OCT93 & 26NOV93 pt exp h/a, blurred vision, gen pain;pt was allegedly dx w/GBS on 29NOV93;it is alleged that pt exp & cont to exp paralysis, loss of mobility, impaired, & periodic loss of equilibrium;


Changed on 2/14/2018

VAERS ID: 88869 Before After
VAERS Form:1
Age:
Sex:Male
Location:California
Vaccinated:1993-10-29
Onset:1993-11-26
Submitted:1996-07-23
Entered:1996-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amblyopia, Coordination abnormal, Guillain-Barre syndrome, Headache, Hypokinesia, Pain, Paralysis, Visual disturbance

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: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896207001L

Write-up: pt recv vax 29OCT93 & 26NOV93 pt exp h/a, blurred vision, gen pain;pt was allegedly dx w/GBS on 29NOV93;it is alleged that pt exp & cont to exp paralysis, loss of mobility, impaired, & periodic loss of equilibrium;


Changed on 6/14/2018

VAERS ID: 88869 Before After
VAERS Form:1
Age:
Sex:Male
Location:California
Vaccinated:1993-10-29
Onset:1993-11-26
Submitted:1996-07-23
Entered:1996-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amblyopia, Coordination abnormal, Guillain-Barre syndrome, Headache, Hypokinesia, Pain, Paralysis, Visual disturbance

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: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896207001L

Write-up: pt recv vax 29OCT93 & 26NOV93 pt exp h/a, blurred vision, gen pain;pt was allegedly dx w/GBS on 29NOV93;it is alleged that pt exp & cont to exp paralysis, loss of mobility, impaired, & periodic loss of equilibrium;


Changed on 8/14/2018

VAERS ID: 88869 Before After
VAERS Form:1
Age:
Sex:Male
Location:California
Vaccinated:1993-10-29
Onset:1993-11-26
Submitted:1996-07-23
Entered:1996-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amblyopia, Coordination abnormal, Guillain-Barre syndrome, Headache, Hypokinesia, Pain, Paralysis, Visual disturbance

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: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896207001L

Write-up: pt recv vax 29OCT93 & 26NOV93 pt exp h/a, blurred vision, gen pain;pt was allegedly dx w/GBS on 29NOV93;it is alleged that pt exp & cont to exp paralysis, loss of mobility, impaired, & periodic loss of equilibrium;


Changed on 9/14/2018

VAERS ID: 88869 Before After
VAERS Form:1
Age:
Sex:Male
Location:California
Vaccinated:1993-10-29
Onset:1993-11-26
Submitted:1996-07-23
Entered:1996-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amblyopia, Coordination abnormal, Guillain-Barre syndrome, Headache, Hypokinesia, Pain, Paralysis, Visual disturbance

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: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896207001L

Write-up: pt recv vax 29OCT93 & 26NOV93 pt exp h/a, blurred vision, gen pain;pt was allegedly dx w/GBS on 29NOV93;it is alleged that pt exp & cont to exp paralysis, loss of mobility, impaired, & periodic loss of equilibrium;


Changed on 10/14/2018

VAERS ID: 88869 Before After
VAERS Form:1
Age:
Sex:Male
Location:California
Vaccinated:1993-10-29
Onset:1993-11-26
Submitted:1996-07-23
Entered:1996-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amblyopia, Coordination abnormal, Guillain-Barre syndrome, Headache, Hypokinesia, Pain, Paralysis, Visual disturbance

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: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896207001L

Write-up: pt recv vax 29OCT93 & 26NOV93 pt exp h/a, blurred vision, gen pain;pt was allegedly dx w/GBS on 29NOV93;it is alleged that pt exp & cont to exp paralysis, loss of mobility, impaired, & periodic loss of equilibrium;


Changed on 12/24/2020

VAERS ID: 88869 Before After
VAERS Form:1
Age:
Sex:Male
Location:California
Vaccinated:1993-10-29
Onset:1993-11-26
Submitted:1996-07-23
Entered:1996-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amblyopia, Coordination abnormal, Guillain-Barre syndrome, Headache, Hypokinesia, Pain, Paralysis, Visual disturbance

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: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896207001L

Write-up: pt recv vax 29OCT93 & 26NOV93 pt exp h/a, blurred vision, gen pain;pt was allegedly dx w/GBS on 29NOV93;it is alleged that pt exp & cont to exp paralysis, loss of mobility, impaired, & periodic loss of equilibrium;


Changed on 12/30/2020

VAERS ID: 88869 Before After
VAERS Form:1
Age:
Sex:Male
Location:California
Vaccinated:1993-10-29
Onset:1993-11-26
Submitted:1996-07-23
Entered:1996-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amblyopia, Coordination abnormal, Guillain-Barre syndrome, Headache, Hypokinesia, Pain, Paralysis, Visual disturbance

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: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896207001L

Write-up: pt recv vax 29OCT93 & 26NOV93 pt exp h/a, blurred vision, gen pain;pt was allegedly dx w/GBS on 29NOV93;it is alleged that pt exp & cont to exp paralysis, loss of mobility, impaired, & periodic loss of equilibrium;


Changed on 5/7/2021

VAERS ID: 88869 Before After
VAERS Form:1
Age:
Sex:Male
Location:California
Vaccinated:1993-10-29
Onset:1993-11-26
Submitted:1996-07-23
Entered:1996-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amblyopia, Coordination abnormal, Guillain-Barre syndrome, Headache, Hypokinesia, Pain, Paralysis, Visual disturbance

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: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896207001L

Write-up: pt recv vax 29OCT93 & 26NOV93 pt exp h/a, blurred vision, gen pain;pt was allegedly dx w/GBS on 29NOV93;it is alleged that pt exp & cont to exp paralysis, loss of mobility, impaired, & periodic loss of equilibrium;


Changed on 5/14/2021

VAERS ID: 88869 Before After
VAERS Form:1
Age:
Sex:Male
Location:California
Vaccinated:1993-10-29
Onset:1993-11-26
Submitted:1996-07-23
Entered:1996-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Amblyopia, Coordination abnormal, Guillain-Barre syndrome, Headache, Hypokinesia, Pain, Paralysis, Visual disturbance

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: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896207001L

Write-up: pt recv vax 29OCT93 & 26NOV93 pt exp h/a, blurred vision, gen pain;pt was allegedly dx w/GBS on 29NOV93;it is alleged that pt exp & cont to exp paralysis, loss of mobility, impaired, & periodic loss of equilibrium;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=88869&WAYBACKHISTORY=ON


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