National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 104866

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 104866
VAERS Form:
Age:64.2
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1996-1997 / PARKE-DAVIS - / 0 A / SC

Administered by: Public      Purchased by: Unknown
Symptoms: HYPOKINESIA, GUILLAIN BARRE SYND, MYALGIA, TENOSYNOVITIS, PARESTHESIA

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type':

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 12/8/2009

VAERS ID: 104866 Before After
VAERS Form:
Age:64.2
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-21 1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1996-1997 INFLUENZA (SEASONAL) (FLUOGEN 96-97) / PARKE-DAVIS - / 0 A / SC

Administered by: Public      Purchased by: Unknown Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting, HYPOKINESIA, GUILLAIN BARRE SYND, MYALGIA, TENOSYNOVITIS, PARESTHESIA

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': (blank) 10150970130000

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 8/31/2010

VAERS ID: 104866 Before After
VAERS Form:
Age:64.2
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 96-97) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 A / SC

Administered by: Public      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': 10150970130000

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 9/12/2012

VAERS ID: 104866 Before After
VAERS Form:
Age:64.2
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 A / SC

Administered by: Public      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': 10150970130000 1.0151E+13

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 10/14/2012

VAERS ID: 104866 Before After
VAERS Form:
Age:64.2
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 A / SC

Administered by: Public      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': 1.0151E+13 10150970130000

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 7/7/2013

VAERS ID: 104866 Before After
VAERS Form:
Age:64.2
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 A / SC
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 A / SC

Administered by: Public      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': 10150970130000

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 2/14/2017

VAERS ID: 104866 Before After
VAERS Form:
Age:64.2 64.0
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 A / SC

Administered by: Public      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': 10150970130000

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 5/14/2017

VAERS ID: 104866 Before After
VAERS Form:
Age:64.0
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 A - / SC SC A

Administered by: Public      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': 10150970130000

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 9/14/2017

VAERS ID: 104866 Before After
VAERS Form:(blank) 1
Age:64.0
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 1 - / SC A

Administered by: Public      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': 10150970130000

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 2/14/2018

VAERS ID: 104866 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / SC A

Administered by: Public      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': 10150970130000

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 6/14/2018

VAERS ID: 104866 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / SC A

Administered by: Public      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': 10150970130000

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 8/14/2018

VAERS ID: 104866 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / SC A

Administered by: Public      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': 10150970130000

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 9/14/2018

VAERS ID: 104866 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / SC A

Administered by: Public      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': 10150970130000

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 10/14/2018

VAERS ID: 104866 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / SC A

Administered by: Public      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': 10150970130000

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 12/24/2020

VAERS ID: 104866 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / SC A

Administered by: Public      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': 10150970130000

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 12/30/2020

VAERS ID: 104866 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / SC A

Administered by: Public      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': 10150970130000

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 5/7/2021

VAERS ID: 104866 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / SC A

Administered by: Public      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': 10150970130000

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;


Changed on 5/14/2021

VAERS ID: 104866 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:South Carolina
Vaccinated:1996-11-07
Onset:1996-11-08
Submitted:1997-10-31
Entered:1997-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / SC A

Administered by: Public      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myalgia, Paraesthesia, Tenosynovitis, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide, premarin, hysterectomy 1980;poss allergy to APAP #3;
Current Illness: NONE
Preexisting Conditions: borderline HTN;
Allergies:
Diagnostic Lab Data: nerve conduction test indicated severe carpal tunnel synd testing for rheumatoid arthritis was negative;
CDC 'Split Type': 10150970130000

Write-up: pt recv vax 7NOV96 & 8NOV96 pt exp v;13NOV96 pt exp muscle pain in legs, back, shoulder, hands & fingers;exp numbness & tingling in fingertips only;pt dx w/severe CTS;diff performing daily activities;tested for GBS;

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=104866&WAYBACKHISTORY=ON


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