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This is VAERS ID 97013

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 97013
VAERS Form:
Age:38.2
Sex:Male
Location:New York
Vaccinated:1996-10-23
Onset:1996-10-23
Submitted:1997-02-14
Entered:1997-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1996-1997 / WYETH - / 0 LA / -

Administered by: Private      Purchased by: Unknown
Symptoms: INFECT, ENCEPHALITIS, CSF ABNORM, ATROPHY MUSCLE, MYOSITIS

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:
Allergies:
Diagnostic Lab Data: EMG/Nerve conduction lower extremities: reportedly abn;CPK: reportedly elevated;CSF: reportedly contained protein;
CDC 'Split Type':

Write-up: pt devel back pain p/vax;exp paresthesias, described as band-like feeling around the abd, arms, & legs as well as flip-flop sensation in feet & puffiness in hands;nerve damage;muscle atrophy;encephalomyelitis;myositis;polyneuropathy synd;


Changed on 12/8/2009

VAERS ID: 97013 Before After
VAERS Form:
Age:38.2
Sex:Male
Location:New York
Vaccinated:1996-10-23
Onset:1996-10-23
Submitted:1997-02-14
Entered:1997-04-22 1997-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1996-1997 INFLUENZA (SEASONAL) (FLUSHIELD 96-97) / WYETH WYETH PHARMACEUTICALS, INC - / 0 LA / -

Administered by: Private      Purchased by: Unknown Other
Symptoms: Back pain, Encephalitis, Infection, Muscle atrophy, Myositis, Neuropathy, Paraesthesia, CSF test abnormal, INFECT, ENCEPHALITIS, CSF ABNORM, ATROPHY MUSCLE, MYOSITIS

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:
Allergies:
Diagnostic Lab Data: EMG/Nerve conduction lower extremities: reportedly abn;CPK: reportedly elevated;CSF: reportedly contained protein;
CDC 'Split Type': (blank) 897072001L

Write-up: pt devel back pain p/vax;exp paresthesias, described as band-like feeling around the abd, arms, & legs as well as flip-flop sensation in feet & puffiness in hands;nerve damage;muscle atrophy;encephalomyelitis;myositis;polyneuropathy synd;


Changed on 8/31/2010

VAERS ID: 97013 Before After
VAERS Form:
Age:38.2
Sex:Male
Location:New York
Vaccinated:1996-10-23
Onset:1996-10-23
Submitted:1997-02-14
Entered:1997-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 96-97) INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / 0 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Back pain, Encephalitis, Infection, Muscle atrophy, Myositis, Neuropathy, Paraesthesia, CSF test abnormal

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:
Allergies:
Diagnostic Lab Data: EMG/Nerve conduction lower extremities: reportedly abn;CPK: reportedly elevated;CSF: reportedly contained protein;
CDC 'Split Type': 897072001L

Write-up: pt devel back pain p/vax;exp paresthesias, described as band-like feeling around the abd, arms, & legs as well as flip-flop sensation in feet & puffiness in hands;nerve damage;muscle atrophy;encephalomyelitis;myositis;polyneuropathy synd;


Changed on 7/7/2013

VAERS ID: 97013 Before After
VAERS Form:
Age:38.2
Sex:Male
Location:New York
Vaccinated:1996-10-23
Onset:1996-10-23
Submitted:1997-02-14
Entered:1997-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / 0 LA / -
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / 0 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Back pain, Encephalitis, Infection, Muscle atrophy, Myositis, Neuropathy, Paraesthesia, CSF test abnormal

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:
Allergies:
Diagnostic Lab Data: EMG/Nerve conduction lower extremities: reportedly abn;CPK: reportedly elevated;CSF: reportedly contained protein;
CDC 'Split Type': 897072001L

Write-up: pt devel back pain p/vax;exp paresthesias, described as band-like feeling around the abd, arms, & legs as well as flip-flop sensation in feet & puffiness in hands;nerve damage;muscle atrophy;encephalomyelitis;myositis;polyneuropathy synd;


Changed on 2/14/2017

VAERS ID: 97013 Before After
VAERS Form:
Age:38.2 38.0
Sex:Male
Location:New York
Vaccinated:1996-10-23
Onset:1996-10-23
Submitted:1997-02-14
Entered:1997-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / 0 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Back pain, Encephalitis, Infection, Muscle atrophy, Myositis, Neuropathy, Paraesthesia, CSF test abnormal

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:
Allergies:
Diagnostic Lab Data: EMG/Nerve conduction lower extremities: reportedly abn;CPK: reportedly elevated;CSF: reportedly contained protein;
CDC 'Split Type': 897072001L

Write-up: pt devel back pain p/vax;exp paresthesias, described as band-like feeling around the abd, arms, & legs as well as flip-flop sensation in feet & puffiness in hands;nerve damage;muscle atrophy;encephalomyelitis;myositis;polyneuropathy synd;


Changed on 5/14/2017

VAERS ID: 97013 Before After
VAERS Form:
Age:38.0
Sex:Male
Location:New York
Vaccinated:1996-10-23
Onset:1996-10-23
Submitted:1997-02-14
Entered:1997-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / 0 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Back pain, Encephalitis, Infection, Muscle atrophy, Myositis, Neuropathy, Paraesthesia, CSF test abnormal

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:
Allergies:
Diagnostic Lab Data: EMG/Nerve conduction lower extremities: reportedly abn;CPK: reportedly elevated;CSF: reportedly contained protein;
CDC 'Split Type': 897072001L

Write-up: pt devel back pain p/vax;exp paresthesias, described as band-like feeling around the abd, arms, & legs as well as flip-flop sensation in feet & puffiness in hands;nerve damage;muscle atrophy;encephalomyelitis;myositis;polyneuropathy synd;


Changed on 9/14/2017

VAERS ID: 97013 Before After
VAERS Form:(blank) 1
Age:38.0
Sex:Male
Location:New York
Vaccinated:1996-10-23
Onset:1996-10-23
Submitted:1997-02-14
Entered:1997-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / 0 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Back pain, Encephalitis, Infection, Muscle atrophy, Myositis, Neuropathy, Paraesthesia, CSF test abnormal

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:
Allergies:
Diagnostic Lab Data: EMG/Nerve conduction lower extremities: reportedly abn;CPK: reportedly elevated;CSF: reportedly contained protein;
CDC 'Split Type': 897072001L

Write-up: pt devel back pain p/vax;exp paresthesias, described as band-like feeling around the abd, arms, & legs as well as flip-flop sensation in feet & puffiness in hands;nerve damage;muscle atrophy;encephalomyelitis;myositis;polyneuropathy synd;


Changed on 2/14/2018

VAERS ID: 97013 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:New York
Vaccinated:1996-10-23
Onset:1996-10-23
Submitted:1997-02-14
Entered:1997-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Back pain, Encephalitis, Infection, Muscle atrophy, Myositis, Neuropathy, Paraesthesia, CSF test abnormal

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:
Allergies:
Diagnostic Lab Data: EMG/Nerve conduction lower extremities: reportedly abn;CPK: reportedly elevated;CSF: reportedly contained protein;
CDC 'Split Type': 897072001L

Write-up: pt devel back pain p/vax;exp paresthesias, described as band-like feeling around the abd, arms, & legs as well as flip-flop sensation in feet & puffiness in hands;nerve damage;muscle atrophy;encephalomyelitis;myositis;polyneuropathy synd;


Changed on 6/14/2018

VAERS ID: 97013 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:New York
Vaccinated:1996-10-23
Onset:1996-10-23
Submitted:1997-02-14
Entered:1997-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Back pain, Encephalitis, Infection, Muscle atrophy, Myositis, Neuropathy, Paraesthesia, CSF test abnormal

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:
Allergies:
Diagnostic Lab Data: EMG/Nerve conduction lower extremities: reportedly abn;CPK: reportedly elevated;CSF: reportedly contained protein;
CDC 'Split Type': 897072001L

Write-up: pt devel back pain p/vax;exp paresthesias, described as band-like feeling around the abd, arms, & legs as well as flip-flop sensation in feet & puffiness in hands;nerve damage;muscle atrophy;encephalomyelitis;myositis;polyneuropathy synd;


Changed on 8/14/2018

VAERS ID: 97013 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:New York
Vaccinated:1996-10-23
Onset:1996-10-23
Submitted:1997-02-14
Entered:1997-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Back pain, Encephalitis, Infection, Muscle atrophy, Myositis, Neuropathy, Paraesthesia, CSF test abnormal

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:
Allergies:
Diagnostic Lab Data: EMG/Nerve conduction lower extremities: reportedly abn;CPK: reportedly elevated;CSF: reportedly contained protein;
CDC 'Split Type': 897072001L

Write-up: pt devel back pain p/vax;exp paresthesias, described as band-like feeling around the abd, arms, & legs as well as flip-flop sensation in feet & puffiness in hands;nerve damage;muscle atrophy;encephalomyelitis;myositis;polyneuropathy synd;


Changed on 9/14/2018

VAERS ID: 97013 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:New York
Vaccinated:1996-10-23
Onset:1996-10-23
Submitted:1997-02-14
Entered:1997-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Back pain, Encephalitis, Infection, Muscle atrophy, Myositis, Neuropathy, Paraesthesia, CSF test abnormal

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:
Allergies:
Diagnostic Lab Data: EMG/Nerve conduction lower extremities: reportedly abn;CPK: reportedly elevated;CSF: reportedly contained protein;
CDC 'Split Type': 897072001L

Write-up: pt devel back pain p/vax;exp paresthesias, described as band-like feeling around the abd, arms, & legs as well as flip-flop sensation in feet & puffiness in hands;nerve damage;muscle atrophy;encephalomyelitis;myositis;polyneuropathy synd;


Changed on 10/14/2018

VAERS ID: 97013 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:New York
Vaccinated:1996-10-23
Onset:1996-10-23
Submitted:1997-02-14
Entered:1997-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / 1 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Back pain, Encephalitis, Infection, Muscle atrophy, Myositis, Neuropathy, Paraesthesia, CSF test abnormal

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:
Allergies:
Diagnostic Lab Data: EMG/Nerve conduction lower extremities: reportedly abn;CPK: reportedly elevated;CSF: reportedly contained protein;
CDC 'Split Type': 897072001L

Write-up: pt devel back pain p/vax;exp paresthesias, described as band-like feeling around the abd, arms, & legs as well as flip-flop sensation in feet & puffiness in hands;nerve damage;muscle atrophy;encephalomyelitis;myositis;polyneuropathy synd;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=97013&WAYBACKHISTORY=ON


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