![]() |
National Vaccine Information Center Your Health. Your Family. Your Choice. |
MedAlerts Home |
History of Changes from the VAERS Wayback Machine |
VAERS ID: | 92507 |
VAERS Form: | |
Age: | 39.7 |
Sex: | Female |
Location: | Michigan |
Vaccinated: | 1996-10-18 |
Onset: | 1996-10-18 |
Submitted: | 1996-11-22 |
Entered: | 1996-12-04 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: FLUOGEN 1996-1997 / PARKE-DAVIS | - / 0 | A / IM |
Administered by: Other Purchased by: Unknown
Symptoms: FEVER, NEUROPATHY, ASTHENIA, MYASTHENIA, AMNESIA
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: pt felt flushed & warm;by evening pt feet were cold like had bad circulation & devel numbness & tingling & felt like was walking on pins;also devel weakness 19OCT96;22OCT96 exp fluttering in abd;exp memory loss, neuro c/o weakness, fatigue
Vaccinated: | 1996-10-18 |
Onset: | 1996-10-18 |
Submitted: | 1996-11-22 |
Entered: | 1996-12-04 1996-12-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: FLUOGEN 1996-1997 INFLUENZA (SEASONAL) (FLUOGEN 96-97) / PARKE-DAVIS | - / 0 | A / IM |
Administered by: Other Purchased by: Unknown Other
Symptoms: Amnesia, Asthenia, Myasthenic syndrome, Neuropathy, Paraesthesia, Peripheral vascular disorder, Pyrexia, Vasodilatation, FEVER, NEUROPATHY, ASTHENIA, MYASTHENIA, AMNESIA
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) 0010150960040
Write-up: pt felt flushed & warm;by evening pt feet were cold like had bad circulation & devel numbness & tingling & felt like was walking on pins;also devel weakness 19OCT96;22OCT96 exp fluttering in abd;exp memory loss, neuro c/o weakness, fatigue
Vaccinated: | 1996-10-18 |
Onset: | 1996-10-18 |
Submitted: | 1996-11-22 |
Entered: | 1996-12-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (SEASONAL) (FLUOGEN 96-97) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | - / 0 | A / IM |
Administered by: Other Purchased by: Other
Symptoms: Amnesia, Asthenia, Myasthenic syndrome, Neuropathy, Paraesthesia, Peripheral vascular disorder, Pyrexia, Vasodilatation
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 0010150960040
Write-up: pt felt flushed & warm;by evening pt feet were cold like had bad circulation & devel numbness & tingling & felt like was walking on pins;also devel weakness 19OCT96;22OCT96 exp fluttering in abd;exp memory loss, neuro c/o weakness, fatigue
Vaccinated: | 1996-10-18 |
Onset: | 1996-10-18 |
Submitted: | 1996-11-22 |
Entered: | 1996-12-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | - / 0 | A / IM |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | - / 0 | A / IM |
Administered by: Other Purchased by: Other
Symptoms: Amnesia, Asthenia, Myasthenic syndrome, Neuropathy, Paraesthesia, Peripheral vascular disorder, Pyrexia, Vasodilatation
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 0010150960040
Write-up: pt felt flushed & warm;by evening pt feet were cold like had bad circulation & devel numbness & tingling & felt like was walking on pins;also devel weakness 19OCT96;22OCT96 exp fluttering in abd;exp memory loss, neuro c/o weakness, fatigue
Vaccinated: | 1996-10-18 |
Onset: | 1996-10-18 |
Submitted: | 1996-11-22 |
Entered: | 1996-12-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | - / 0 | A / IM |
Administered by: Other Purchased by: Other
Symptoms: Amnesia, Asthenia, Myasthenic syndrome, Neuropathy, Paraesthesia, Peripheral vascular disorder, Pyrexia, Vasodilatation
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 0010150960040
Write-up: pt felt flushed & warm;by evening pt feet were cold like had bad circulation & devel numbness & tingling & felt like was walking on pins;also devel weakness 19OCT96;22OCT96 exp fluttering in abd;exp memory loss, neuro c/o weakness, fatigue
Vaccinated: | 1996-10-18 |
Onset: | 1996-10-18 |
Submitted: | 1996-11-22 |
Entered: | 1996-12-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | - / 0 | A - / IM IM A |
Administered by: Other Purchased by: Other
Symptoms: Amnesia, Asthenia, Myasthenic syndrome, Neuropathy, Paraesthesia, Peripheral vascular disorder, Pyrexia, Vasodilatation
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 0010150960040
Write-up: pt felt flushed & warm;by evening pt feet were cold like had bad circulation & devel numbness & tingling & felt like was walking on pins;also devel weakness 19OCT96;22OCT96 exp fluttering in abd;exp memory loss, neuro c/o weakness, fatigue
Vaccinated: | 1996-10-18 |
Onset: | 1996-10-18 |
Submitted: | 1996-11-22 |
Entered: | 1996-12-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | - / 0 1 | - / IM A |
Administered by: Other Purchased by: Other
Symptoms: Amnesia, Asthenia, Myasthenic syndrome, Neuropathy, Paraesthesia, Peripheral vascular disorder, Pyrexia, Vasodilatation
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 0010150960040
Write-up: pt felt flushed & warm;by evening pt feet were cold like had bad circulation & devel numbness & tingling & felt like was walking on pins;also devel weakness 19OCT96;22OCT96 exp fluttering in abd;exp memory loss, neuro c/o weakness, fatigue
Vaccinated: | 1996-10-18 |
Onset: | 1996-10-18 |
Submitted: | 1996-11-22 |
Entered: | 1996-12-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | - / 1 | - / IM A |
Administered by: Other Purchased by: Other
Symptoms: Amnesia, Asthenia, Myasthenic syndrome, Neuropathy, Paraesthesia, Peripheral vascular disorder, Pyrexia, Vasodilatation
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 0010150960040
Write-up: pt felt flushed & warm;by evening pt feet were cold like had bad circulation & devel numbness & tingling & felt like was walking on pins;also devel weakness 19OCT96;22OCT96 exp fluttering in abd;exp memory loss, neuro c/o weakness, fatigue
Vaccinated: | 1996-10-18 |
Onset: | 1996-10-18 |
Submitted: | 1996-11-22 |
Entered: | 1996-12-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | - / 1 | - / IM A |
Administered by: Other Purchased by: Other
Symptoms: Amnesia, Asthenia, Myasthenic syndrome, Neuropathy, Paraesthesia, Peripheral vascular disorder, Pyrexia, Vasodilatation
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 0010150960040
Write-up: pt felt flushed & warm;by evening pt feet were cold like had bad circulation & devel numbness & tingling & felt like was walking on pins;also devel weakness 19OCT96;22OCT96 exp fluttering in abd;exp memory loss, neuro c/o weakness, fatigue
Vaccinated: | 1996-10-18 |
Onset: | 1996-10-18 |
Submitted: | 1996-11-22 |
Entered: | 1996-12-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | - / 1 | - / IM A |
Administered by: Other Purchased by: Other
Symptoms: Amnesia, Asthenia, Myasthenic syndrome, Neuropathy, Paraesthesia, Peripheral vascular disorder, Pyrexia, Vasodilatation
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 0010150960040
Write-up: pt felt flushed & warm;by evening pt feet were cold like had bad circulation & devel numbness & tingling & felt like was walking on pins;also devel weakness 19OCT96;22OCT96 exp fluttering in abd;exp memory loss, neuro c/o weakness, fatigue
Vaccinated: | 1996-10-18 |
Onset: | 1996-10-18 |
Submitted: | 1996-11-22 |
Entered: | 1996-12-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | - / 1 | - / IM A |
Administered by: Other Purchased by: Other
Symptoms: Amnesia, Asthenia, Myasthenic syndrome, Neuropathy, Paraesthesia, Peripheral vascular disorder, Pyrexia, Vasodilatation
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 0010150960040
Write-up: pt felt flushed & warm;by evening pt feet were cold like had bad circulation & devel numbness & tingling & felt like was walking on pins;also devel weakness 19OCT96;22OCT96 exp fluttering in abd;exp memory loss, neuro c/o weakness, fatigue
Vaccinated: | 1996-10-18 |
Onset: | 1996-10-18 |
Submitted: | 1996-11-22 |
Entered: | 1996-12-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | - / 1 | - / IM A |
Administered by: Other Purchased by: Other
Symptoms: Amnesia, Asthenia, Myasthenic syndrome, Neuropathy, Paraesthesia, Peripheral vascular disorder, Pyrexia, Vasodilatation
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 0010150960040
Write-up: pt felt flushed & warm;by evening pt feet were cold like had bad circulation & devel numbness & tingling & felt like was walking on pins;also devel weakness 19OCT96;22OCT96 exp fluttering in abd;exp memory loss, neuro c/o weakness, fatigue
Vaccinated: | 1996-10-18 |
Onset: | 1996-10-18 |
Submitted: | 1996-11-22 |
Entered: | 1996-12-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | - / 1 | - / IM A |
Administered by: Other Purchased by: Other
Symptoms: Amnesia, Asthenia, Myasthenic syndrome, Neuropathy, Paraesthesia, Peripheral vascular disorder, Pyrexia, Vasodilatation
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 0010150960040
Write-up: pt felt flushed & warm;by evening pt feet were cold like had bad circulation & devel numbness & tingling & felt like was walking on pins;also devel weakness 19OCT96;22OCT96 exp fluttering in abd;exp memory loss, neuro c/o weakness, fatigue
Vaccinated: | 1996-10-18 |
Onset: | 1996-10-18 |
Submitted: | 1996-11-22 |
Entered: | 1996-12-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | - / 1 | - / IM A |
Administered by: Other Purchased by: Other
Symptoms: Amnesia, Asthenia, Myasthenic syndrome, Neuropathy, Paraesthesia, Peripheral vascular disorder, Pyrexia, Vasodilatation
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 0010150960040
Write-up: pt felt flushed & warm;by evening pt feet were cold like had bad circulation & devel numbness & tingling & felt like was walking on pins;also devel weakness 19OCT96;22OCT96 exp fluttering in abd;exp memory loss, neuro c/o weakness, fatigue
Link To This Search Result:
https://medalerts.org/vaersdb/findfield.php?IDNUMBER=92507&WAYBACKHISTORY=ON
Copyright ©
2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166