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This is VAERS ID 92507

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

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


Changed on 12/8/2009

VAERS ID: 92507 Before After
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 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


Changed on 8/31/2010

VAERS ID: 92507 Before After
VAERS Form:
Age:39.7
Sex:Female
Location:Michigan
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


Changed on 7/7/2013

VAERS ID: 92507 Before After
VAERS Form:
Age:39.7
Sex:Female
Location:Michigan
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


Changed on 2/14/2017

VAERS ID: 92507 Before After
VAERS Form:
Age:39.7 39.0
Sex:Female
Location:Michigan
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


Changed on 5/14/2017

VAERS ID: 92507 Before After
VAERS Form:
Age:39.0
Sex:Female
Location:Michigan
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


Changed on 9/14/2017

VAERS ID: 92507 Before After
VAERS Form:(blank) 1
Age:39.0
Sex:Female
Location:Michigan
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


Changed on 2/14/2018

VAERS ID: 92507 Before After
VAERS Form:1
Age:39.0
Sex:Female
Location:Michigan
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


Changed on 6/14/2018

VAERS ID: 92507 Before After
VAERS Form:1
Age:39.0
Sex:Female
Location:Michigan
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


Changed on 8/14/2018

VAERS ID: 92507 Before After
VAERS Form:1
Age:39.0
Sex:Female
Location:Michigan
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


Changed on 9/14/2018

VAERS ID: 92507 Before After
VAERS Form:1
Age:39.0
Sex:Female
Location:Michigan
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


Changed on 10/14/2018

VAERS ID: 92507 Before After
VAERS Form:1
Age:39.0
Sex:Female
Location:Michigan
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


Changed on 12/24/2020

VAERS ID: 92507 Before After
VAERS Form:1
Age:39.0
Sex:Female
Location:Michigan
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


Changed on 12/30/2020

VAERS ID: 92507 Before After
VAERS Form:1
Age:39.0
Sex:Female
Location:Michigan
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

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