National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 92612

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 92612
VAERS Form:
Age:67.3
Sex:Female
Location:Louisiana
Vaccinated:1996-10-21
Onset:1996-10-21
Submitted:1996-11-13
Entered:1996-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1996-1997 / WYETH 4968175 / - RA / IM
PPV: PNEUMOVAX 23 / MSD 1626B / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: APNEA, HEART ARREST, MYELITIS, PARALYSIS, HYPERTENS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: the same day of vax, pt devel transverse myelitis & was hosp & became quadriplegic. The pt exp noted to be permanently disabling.


Changed on 12/8/2009

VAERS ID: 92612 Before After
VAERS Form:
Age:67.3
Sex:Female
Location:Louisiana
Vaccinated:1996-10-21
Onset:1996-10-21
Submitted:1996-11-13
Entered:1996-12-10 1996-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1996-1997 INFLUENZA (SEASONAL) (FLUSHIELD 96-97) / WYETH WYETH PHARMACEUTICALS, INC 4968175 / - RA / IM
PPV: PNEUMOVAX 23 PNEUMO (PNEUMOVAX) / MSD MERCK & CO. INC. 1626B / - LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Apnoea, Cardiac arrest, Hypertension, Myelitis, Paralysis, Quadriplegia, APNEA, HEART ARREST, MYELITIS, PARALYSIS, HYPERTENS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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': (blank) WAES96121718

Write-up: the same day of vax, pt devel transverse myelitis & was hosp & became quadriplegic. The pt exp noted to be permanently disabling.


Changed on 8/31/2010

VAERS ID: 92612 Before After
VAERS Form:
Age:67.3
Sex:Female
Location:Louisiana
Vaccinated:1996-10-21
Onset:1996-10-21
Submitted:1996-11-13
Entered:1996-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 96-97) INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4968175 / - RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1626B / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Hypertension, Myelitis, Paralysis, Quadriplegia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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': WAES96121718

Write-up: the same day of vax, pt devel transverse myelitis & was hosp & became quadriplegic. The pt exp noted to be permanently disabling.


Changed on 7/7/2013

VAERS ID: 92612 Before After
VAERS Form:
Age:67.3
Sex:Female
Location:Louisiana
Vaccinated:1996-10-21
Onset:1996-10-21
Submitted:1996-11-13
Entered:1996-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968175 / - RA / IM
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968175 / - RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1626B / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Hypertension, Myelitis, Paralysis, Quadriplegia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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': WAES96121718

Write-up: the same day of vax, pt devel transverse myelitis & was hosp & became quadriplegic. The pt exp noted to be permanently disabling.


Changed on 2/14/2017

VAERS ID: 92612 Before After
VAERS Form:
Age:67.3 67.0
Sex:Female
Location:Louisiana
Vaccinated:1996-10-21
Onset:1996-10-21
Submitted:1996-11-13
Entered:1996-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968175 / - RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1626B / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Hypertension, Myelitis, Paralysis, Quadriplegia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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': WAES96121718

Write-up: the same day of vax, pt devel transverse myelitis & was hosp & became quadriplegic. The pt exp noted to be permanently disabling.


Changed on 5/14/2017

VAERS ID: 92612 Before After
VAERS Form:
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1996-10-21
Onset:1996-10-21
Submitted:1996-11-13
Entered:1996-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968175 / - RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1626B / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Hypertension, Myelitis, Paralysis, Quadriplegia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness: NONE
Preexisting Conditions: hypertension, hyperlipidemia, hypercholesterolemia and smoking 1.5 packs per day for 13 years
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES96121718 896323001L

Write-up: the same day of vax, pt recv vax & devel transverse myelitis myelitis, & was hosp hosp, & became quadriplegic. is a quadriplegic;reporter was notified The pt exp noted to be permanently disabling. of this event as part of litigation proceedings;


Changed on 9/14/2017

VAERS ID: 92612 Before After
VAERS Form:(blank) 1
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1996-10-21
Onset:1996-10-21
Submitted:1996-11-13
Entered:1996-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968175 / - UNK RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1626B / - UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Hypertension, Myelitis, Paralysis, Quadriplegia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness: NONE
Preexisting Conditions: hypertension, hyperlipidemia, hypercholesterolemia and smoking 1.5 packs per day for 13 years
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896323001L

Write-up: pt recv vax & devel transverse myelitis, & was hosp, & is a quadriplegic;reporter was notified of this event as part of litigation proceedings;


Changed on 2/14/2018

VAERS ID: 92612 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1996-10-21
Onset:1996-10-21
Submitted:1996-11-13
Entered:1996-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968175 / UNK RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1626B / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Hypertension, Myelitis, Paralysis, Quadriplegia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness: NONE
Preexisting Conditions: hypertension, hyperlipidemia, hypercholesterolemia and smoking 1.5 packs per day for 13 years
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896323001L

Write-up: pt recv vax & devel transverse myelitis, & was hosp, & is a quadriplegic;reporter was notified of this event as part of litigation proceedings;


Changed on 6/14/2018

VAERS ID: 92612 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1996-10-21
Onset:1996-10-21
Submitted:1996-11-13
Entered:1996-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968175 / UNK RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1626B / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Hypertension, Myelitis, Paralysis, Quadriplegia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness: NONE
Preexisting Conditions: hypertension, hyperlipidemia, hypercholesterolemia and smoking 1.5 packs per day for 13 years
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896323001L

Write-up: pt recv vax & devel transverse myelitis, & was hosp, & is a quadriplegic;reporter was notified of this event as part of litigation proceedings;


Changed on 8/14/2018

VAERS ID: 92612 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1996-10-21
Onset:1996-10-21
Submitted:1996-11-13
Entered:1996-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968175 / UNK RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1626B / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Hypertension, Myelitis, Paralysis, Quadriplegia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness: NONE
Preexisting Conditions: hypertension, hyperlipidemia, hypercholesterolemia and smoking 1.5 packs per day for 13 years
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896323001L

Write-up: pt recv vax & devel transverse myelitis, & was hosp, & is a quadriplegic;reporter was notified of this event as part of litigation proceedings;


Changed on 9/14/2018

VAERS ID: 92612 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1996-10-21
Onset:1996-10-21
Submitted:1996-11-13
Entered:1996-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968175 / UNK RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1626B / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Hypertension, Myelitis, Paralysis, Quadriplegia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness: NONE
Preexisting Conditions: hypertension, hyperlipidemia, hypercholesterolemia and smoking 1.5 packs per day for 13 years
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896323001L

Write-up: pt recv vax & devel transverse myelitis, & was hosp, & is a quadriplegic;reporter was notified of this event as part of litigation proceedings;


Changed on 10/14/2018

VAERS ID: 92612 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1996-10-21
Onset:1996-10-21
Submitted:1996-11-13
Entered:1996-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968175 / UNK RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1626B / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Hypertension, Myelitis, Paralysis, Quadriplegia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness: NONE
Preexisting Conditions: hypertension, hyperlipidemia, hypercholesterolemia and smoking 1.5 packs per day for 13 years
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896323001L

Write-up: pt recv vax & devel transverse myelitis, & was hosp, & is a quadriplegic;reporter was notified of this event as part of litigation proceedings;


Changed on 12/24/2020

VAERS ID: 92612 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1996-10-21
Onset:1996-10-21
Submitted:1996-11-13
Entered:1996-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968175 / UNK RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1626B / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Hypertension, Myelitis, Paralysis, Quadriplegia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness: NONE
Preexisting Conditions: hypertension, hyperlipidemia, hypercholesterolemia and smoking 1.5 packs per day for 13 years
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896323001L

Write-up: pt recv vax & devel transverse myelitis, & was hosp, & is a quadriplegic;reporter was notified of this event as part of litigation proceedings;


Changed on 12/30/2020

VAERS ID: 92612 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1996-10-21
Onset:1996-10-21
Submitted:1996-11-13
Entered:1996-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968175 / UNK RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1626B / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Hypertension, Myelitis, Paralysis, Quadriplegia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness: NONE
Preexisting Conditions: hypertension, hyperlipidemia, hypercholesterolemia and smoking 1.5 packs per day for 13 years
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896323001L

Write-up: pt recv vax & devel transverse myelitis, & was hosp, & is a quadriplegic;reporter was notified of this event as part of litigation proceedings;


Changed on 5/7/2021

VAERS ID: 92612 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1996-10-21
Onset:1996-10-21
Submitted:1996-11-13
Entered:1996-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968175 / UNK RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1626B / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Hypertension, Myelitis, Paralysis, Quadriplegia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness: NONE
Preexisting Conditions: hypertension, hyperlipidemia, hypercholesterolemia and smoking 1.5 packs per day for 13 years
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896323001L

Write-up: pt recv vax & devel transverse myelitis, & was hosp, & is a quadriplegic;reporter was notified of this event as part of litigation proceedings;


Changed on 5/14/2021

VAERS ID: 92612 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1996-10-21
Onset:1996-10-21
Submitted:1996-11-13
Entered:1996-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968175 / UNK RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 1626B / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Hypertension, Myelitis, Paralysis, Quadriplegia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: unk
Current Illness: NONE
Preexisting Conditions: hypertension, hyperlipidemia, hypercholesterolemia and smoking 1.5 packs per day for 13 years
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 896323001L

Write-up: pt recv vax & devel transverse myelitis, & was hosp, & is a quadriplegic;reporter was notified of this event as part of litigation proceedings;

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=92612&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166