National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 93142

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 93142
VAERS Form:
Age:58.6
Sex:Male
Location:Oklahoma
Vaccinated:1996-10-29
Onset:1996-11-13
Submitted:1996-12-09
Entered:1996-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1996-1997 / PARKE-DAVIS - / 1 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: HYPOKINESIA, GUILLAIN BARRE SYND, ASTHENIA, MYASTHENIA, LACRIMATION DIS

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CAT scan, MRI, back & chest x-ray, EKG;
CDC 'Split Type':

Write-up: pt recv flu vax 29OCT96 & exp tingling sensation & back pain NOV 12, 14, & 15; severe back pain & numbness in face & lower leg;16 & 17 & 18NOV complete facial & lt leg paralysis;(no prior illness);dx GBS


Changed on 12/8/2009

VAERS ID: 93142 Before After
VAERS Form:
Age:58.6
Sex:Male
Location:Oklahoma
Vaccinated:1996-10-29
Onset:1996-11-13
Submitted:1996-12-09
Entered:1996-12-23 1996-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1996-1997 INFLUENZA (SEASONAL) (FLUOGEN 96-97) / PARKE-DAVIS - / 1 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Facial palsy, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia, Speech disorder, Lacrimal disorder, HYPOKINESIA, GUILLAIN BARRE SYND, ASTHENIA, MYASTHENIA, LACRIMATION DIS

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CAT scan, MRI, back & chest x-ray, EKG;
CDC 'Split Type':

Write-up: pt recv flu vax 29OCT96 & exp tingling sensation & back pain NOV 12, 14, & 15; severe back pain & numbness in face & lower leg;16 & 17 & 18NOV complete facial & lt leg paralysis;(no prior illness);dx GBS


Changed on 8/31/2010

VAERS ID: 93142 Before After
VAERS Form:
Age:58.6
Sex:Male
Location:Oklahoma
Vaccinated:1996-10-29
Onset:1996-11-13
Submitted:1996-12-09
Entered:1996-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 96-97) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Facial palsy, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia, Speech disorder, Lacrimal disorder

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CAT scan, MRI, back & chest x-ray, EKG;
CDC 'Split Type':

Write-up: pt recv flu vax 29OCT96 & exp tingling sensation & back pain NOV 12, 14, & 15; severe back pain & numbness in face & lower leg;16 & 17 & 18NOV complete facial & lt leg paralysis;(no prior illness);dx GBS


Changed on 7/7/2013

VAERS ID: 93142 Before After
VAERS Form:
Age:58.6
Sex:Male
Location:Oklahoma
Vaccinated:1996-10-29
Onset:1996-11-13
Submitted:1996-12-09
Entered:1996-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / -
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Facial palsy, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia, Speech disorder, Lacrimal disorder

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CAT scan, MRI, back & chest x-ray, EKG;
CDC 'Split Type':

Write-up: pt recv flu vax 29OCT96 & exp tingling sensation & back pain NOV 12, 14, & 15; severe back pain & numbness in face & lower leg;16 & 17 & 18NOV complete facial & lt leg paralysis;(no prior illness);dx GBS


Changed on 2/14/2017

VAERS ID: 93142 Before After
VAERS Form:
Age:58.6 58.0
Sex:Male
Location:Oklahoma
Vaccinated:1996-10-29
Onset:1996-11-13
Submitted:1996-12-09
Entered:1996-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Facial palsy, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia, Speech disorder, Lacrimal disorder

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CAT scan, MRI, back & chest x-ray, EKG;
CDC 'Split Type':

Write-up: pt recv flu vax 29OCT96 & exp tingling sensation & back pain NOV 12, 14, & 15; severe back pain & numbness in face & lower leg;16 & 17 & 18NOV complete facial & lt leg paralysis;(no prior illness);dx GBS


Changed on 5/14/2017

VAERS ID: 93142 Before After
VAERS Form:
Age:58.0
Sex:Male
Location:Oklahoma
Vaccinated:1996-10-29
Onset:1996-11-13
Submitted:1996-12-09
Entered:1996-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Facial palsy, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia, Speech disorder, Lacrimal disorder

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CAT scan, MRI, back & chest x-ray, EKG;
CDC 'Split Type':

Write-up: pt recv flu vax 29OCT96 & exp tingling sensation & back pain NOV 12, 14, & 15; severe back pain & numbness in face & lower leg;16 & 17 & 18NOV complete facial & lt leg paralysis;(no prior illness);dx GBS


Changed on 9/14/2017

VAERS ID: 93142 Before After
VAERS Form:(blank) 1
Age:58.0
Sex:Male
Location:Oklahoma
Vaccinated:1996-10-29
Onset:1996-11-13
Submitted:1996-12-09
Entered:1996-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Facial palsy, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia, Speech disorder, Lacrimal disorder

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CAT scan, MRI, back & chest x-ray, EKG;
CDC 'Split Type':

Write-up: pt recv flu vax 29OCT96 & exp tingling sensation & back pain NOV 12, 14, & 15; severe back pain & numbness in face & lower leg;16 & 17 & 18NOV complete facial & lt leg paralysis;(no prior illness);dx GBS


Changed on 2/14/2018

VAERS ID: 93142 Before After
VAERS Form:1
Age:58.0
Sex:Male
Location:Oklahoma
Vaccinated:1996-10-29
Onset:1996-11-13
Submitted:1996-12-09
Entered:1996-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Facial palsy, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia, Speech disorder, Lacrimal disorder

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CAT scan, MRI, back & chest x-ray, EKG;
CDC 'Split Type':

Write-up: pt recv flu vax 29OCT96 & exp tingling sensation & back pain NOV 12, 14, & 15; severe back pain & numbness in face & lower leg;16 & 17 & 18NOV complete facial & lt leg paralysis;(no prior illness);dx GBS


Changed on 6/14/2018

VAERS ID: 93142 Before After
VAERS Form:1
Age:58.0
Sex:Male
Location:Oklahoma
Vaccinated:1996-10-29
Onset:1996-11-13
Submitted:1996-12-09
Entered:1996-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Facial palsy, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia, Speech disorder, Lacrimal disorder

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CAT scan, MRI, back & chest x-ray, EKG;
CDC 'Split Type':

Write-up: pt recv flu vax 29OCT96 & exp tingling sensation & back pain NOV 12, 14, & 15; severe back pain & numbness in face & lower leg;16 & 17 & 18NOV complete facial & lt leg paralysis;(no prior illness);dx GBS


Changed on 8/14/2018

VAERS ID: 93142 Before After
VAERS Form:1
Age:58.0
Sex:Male
Location:Oklahoma
Vaccinated:1996-10-29
Onset:1996-11-13
Submitted:1996-12-09
Entered:1996-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Facial palsy, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia, Speech disorder, Lacrimal disorder

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CAT scan, MRI, back & chest x-ray, EKG;
CDC 'Split Type':

Write-up: pt recv flu vax 29OCT96 & exp tingling sensation & back pain NOV 12, 14, & 15; severe back pain & numbness in face & lower leg;16 & 17 & 18NOV complete facial & lt leg paralysis;(no prior illness);dx GBS


Changed on 9/14/2018

VAERS ID: 93142 Before After
VAERS Form:1
Age:58.0
Sex:Male
Location:Oklahoma
Vaccinated:1996-10-29
Onset:1996-11-13
Submitted:1996-12-09
Entered:1996-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Facial palsy, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia, Speech disorder, Lacrimal disorder

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CAT scan, MRI, back & chest x-ray, EKG;
CDC 'Split Type':

Write-up: pt recv flu vax 29OCT96 & exp tingling sensation & back pain NOV 12, 14, & 15; severe back pain & numbness in face & lower leg;16 & 17 & 18NOV complete facial & lt leg paralysis;(no prior illness);dx GBS


Changed on 10/14/2018

VAERS ID: 93142 Before After
VAERS Form:1
Age:58.0
Sex:Male
Location:Oklahoma
Vaccinated:1996-10-29
Onset:1996-11-13
Submitted:1996-12-09
Entered:1996-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Facial palsy, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia, Speech disorder, Lacrimal disorder

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CAT scan, MRI, back & chest x-ray, EKG;
CDC 'Split Type':

Write-up: pt recv flu vax 29OCT96 & exp tingling sensation & back pain NOV 12, 14, & 15; severe back pain & numbness in face & lower leg;16 & 17 & 18NOV complete facial & lt leg paralysis;(no prior illness);dx GBS


Changed on 12/24/2020

VAERS ID: 93142 Before After
VAERS Form:1
Age:58.0
Sex:Male
Location:Oklahoma
Vaccinated:1996-10-29
Onset:1996-11-13
Submitted:1996-12-09
Entered:1996-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Facial palsy, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia, Speech disorder, Lacrimal disorder

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CAT scan, MRI, back & chest x-ray, EKG;
CDC 'Split Type':

Write-up: pt recv flu vax 29OCT96 & exp tingling sensation & back pain NOV 12, 14, & 15; severe back pain & numbness in face & lower leg;16 & 17 & 18NOV complete facial & lt leg paralysis;(no prior illness);dx GBS


Changed on 12/30/2020

VAERS ID: 93142 Before After
VAERS Form:1
Age:58.0
Sex:Male
Location:Oklahoma
Vaccinated:1996-10-29
Onset:1996-11-13
Submitted:1996-12-09
Entered:1996-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Facial palsy, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia, Speech disorder, Lacrimal disorder

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CAT scan, MRI, back & chest x-ray, EKG;
CDC 'Split Type':

Write-up: pt recv flu vax 29OCT96 & exp tingling sensation & back pain NOV 12, 14, & 15; severe back pain & numbness in face & lower leg;16 & 17 & 18NOV complete facial & lt leg paralysis;(no prior illness);dx GBS


Changed on 5/7/2021

VAERS ID: 93142 Before After
VAERS Form:1
Age:58.0
Sex:Male
Location:Oklahoma
Vaccinated:1996-10-29
Onset:1996-11-13
Submitted:1996-12-09
Entered:1996-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Facial palsy, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia, Speech disorder, Lacrimal disorder

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CAT scan, MRI, back & chest x-ray, EKG;
CDC 'Split Type':

Write-up: pt recv flu vax 29OCT96 & exp tingling sensation & back pain NOV 12, 14, & 15; severe back pain & numbness in face & lower leg;16 & 17 & 18NOV complete facial & lt leg paralysis;(no prior illness);dx GBS


Changed on 5/14/2021

VAERS ID: 93142 Before After
VAERS Form:1
Age:58.0
Sex:Male
Location:Oklahoma
Vaccinated:1996-10-29
Onset:1996-11-13
Submitted:1996-12-09
Entered:1996-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Facial palsy, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia, Speech disorder, Lacrimal disorder

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CAT scan, MRI, back & chest x-ray, EKG;
CDC 'Split Type':

Write-up: pt recv flu vax 29OCT96 & exp tingling sensation & back pain NOV 12, 14, & 15; severe back pain & numbness in face & lower leg;16 & 17 & 18NOV complete facial & lt leg paralysis;(no prior illness);dx GBS

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=93142&WAYBACKHISTORY=ON


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