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This is VAERS ID 27094

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27094
VAERS Form:
Age:0.0
Sex:Female
Location:Oregon
Vaccinated:1990-10-25
Onset:1990-11-29
Submitted:1990-12-17
Entered:1991-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH 4908191 / 0 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: CHILLS, FEVER, GUILLAIN BARRE SYND, ASTHENIA, DIARRHEA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone?
Current Illness:
Preexisting Conditions: allergy to Septra, Hypertension
Allergies:
Diagnostic Lab Data: Nerve conduction studies suggestive of atypical Guillain Barre, CSF protein normal on 30Nov & 2Dec
CDC 'Split Type':

Write-up: Guillain Barre Synd onset of weakness on 29Nov90, had illness /w vomiting diarrhea, chills & fever /w onset of 19Nov90 & lasting about 2-3 days


Changed on 12/8/2009

VAERS ID: 27094 Before After
VAERS Form:
Age:0.0 64.0
Sex:Female
Location:Oregon
Vaccinated:1990-10-25
Onset:1990-11-29
Submitted:1990-12-17
Entered:1991-01-10 1990-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) / WYETH WYETH PHARMACEUTICALS, INC 4908191 / 0 LA / IM

Administered by: Public Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Diarrhoea, Guillain-Barre syndrome, Pyrexia, Vomiting, CHILLS, FEVER, GUILLAIN BARRE SYND, ASTHENIA, DIARRHEA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone?
Current Illness:
Preexisting Conditions: allergy to Septra, Hypertension
Allergies:
Diagnostic Lab Data: Nerve conduction studies suggestive of atypical Guillain Barre, CSF protein normal on 30Nov & 2Dec
CDC 'Split Type':

Write-up: Guillain Barre Synd onset of weakness on 29Nov90, had illness /w vomiting diarrhea, chills & fever /w onset of 19Nov90 & lasting about 2-3 days


Changed on 8/31/2010

VAERS ID: 27094 Before After
VAERS Form:
Age:64.0
Sex:Female
Location:Oregon
Vaccinated:1990-10-25
Onset:1990-11-29
Submitted:1990-12-17
Entered:1990-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4908191 / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Diarrhoea, Guillain-Barre syndrome, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone?
Current Illness:
Preexisting Conditions: allergy to Septra, Hypertension
Allergies:
Diagnostic Lab Data: Nerve conduction studies suggestive of atypical Guillain Barre, CSF protein normal on 30Nov & 2Dec
CDC 'Split Type':

Write-up: Guillain Barre Synd onset of weakness on 29Nov90, had illness /w vomiting diarrhea, chills & fever /w onset of 19Nov90 & lasting about 2-3 days


Changed on 7/7/2013

VAERS ID: 27094 Before After
VAERS Form:
Age:64.0
Sex:Female
Location:Oregon
Vaccinated:1990-10-25
Onset:1990-11-29
Submitted:1990-12-17
Entered:1990-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908191 / 0 LA / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908191 / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Diarrhoea, Guillain-Barre syndrome, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone?
Current Illness:
Preexisting Conditions: allergy to Septra, Hypertension
Allergies:
Diagnostic Lab Data: Nerve conduction studies suggestive of atypical Guillain Barre, CSF protein normal on 30Nov & 2Dec
CDC 'Split Type':

Write-up: Guillain Barre Synd onset of weakness on 29Nov90, had illness /w vomiting diarrhea, chills & fever /w onset of 19Nov90 & lasting about 2-3 days


Changed on 12/14/2016

VAERS ID: 27094 Before After
VAERS Form:
Age:64.0
Sex:Female
Location:Oregon
Vaccinated:1990-10-25
Onset:1990-11-29
Submitted:1990-12-17
Entered:1990-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908191 / 0 LA / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908191 / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Diarrhoea, Guillain-Barre syndrome, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone?
Current Illness:
Preexisting Conditions: allergy to Septra, Hypertension
Allergies:
Diagnostic Lab Data: Nerve conduction studies suggestive of atypical Guillain Barre, CSF protein normal on 30Nov & 2Dec
CDC 'Split Type':

Write-up: Guillain Barre Synd onset of weakness on 29Nov90, had illness /w vomiting diarrhea, chills & fever /w onset of 19Nov90 & lasting about 2-3 days


Changed on 9/14/2017

VAERS ID: 27094 Before After
VAERS Form:(blank) 1
Age:64.0
Sex:Female
Location:Oregon
Vaccinated:1990-10-25
Onset:1990-11-29
Submitted:1990-12-17
Entered:1990-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908191 / 0 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Diarrhoea, Guillain-Barre syndrome, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone?
Current Illness:
Preexisting Conditions: allergy to Septra, Hypertension
Allergies:
Diagnostic Lab Data: Nerve conduction studies suggestive of atypical Guillain Barre, CSF protein normal on 30Nov & 2Dec
CDC 'Split Type':

Write-up: Guillain Barre Synd onset of weakness on 29Nov90, had illness /w vomiting diarrhea, chills & fever /w onset of 19Nov90 & lasting about 2-3 days


Changed on 2/14/2018

VAERS ID: 27094 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Oregon
Vaccinated:1990-10-25
Onset:1990-11-29
Submitted:1990-12-17
Entered:1990-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908191 / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Diarrhoea, Guillain-Barre syndrome, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone?
Current Illness:
Preexisting Conditions: allergy to Septra, Hypertension
Allergies:
Diagnostic Lab Data: Nerve conduction studies suggestive of atypical Guillain Barre, CSF protein normal on 30Nov & 2Dec
CDC 'Split Type':

Write-up: Guillain Barre Synd onset of weakness on 29Nov90, had illness /w vomiting diarrhea, chills & fever /w onset of 19Nov90 & lasting about 2-3 days


Changed on 6/14/2018

VAERS ID: 27094 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Oregon
Vaccinated:1990-10-25
Onset:1990-11-29
Submitted:1990-12-17
Entered:1990-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908191 / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Diarrhoea, Guillain-Barre syndrome, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone?
Current Illness:
Preexisting Conditions: allergy to Septra, Hypertension
Allergies:
Diagnostic Lab Data: Nerve conduction studies suggestive of atypical Guillain Barre, CSF protein normal on 30Nov & 2Dec
CDC 'Split Type':

Write-up: Guillain Barre Synd onset of weakness on 29Nov90, had illness /w vomiting diarrhea, chills & fever /w onset of 19Nov90 & lasting about 2-3 days


Changed on 8/14/2018

VAERS ID: 27094 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Oregon
Vaccinated:1990-10-25
Onset:1990-11-29
Submitted:1990-12-17
Entered:1990-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908191 / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Diarrhoea, Guillain-Barre syndrome, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone?
Current Illness:
Preexisting Conditions: allergy to Septra, Hypertension
Allergies:
Diagnostic Lab Data: Nerve conduction studies suggestive of atypical Guillain Barre, CSF protein normal on 30Nov & 2Dec
CDC 'Split Type':

Write-up: Guillain Barre Synd onset of weakness on 29Nov90, had illness /w vomiting diarrhea, chills & fever /w onset of 19Nov90 & lasting about 2-3 days


Changed on 9/14/2018

VAERS ID: 27094 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Oregon
Vaccinated:1990-10-25
Onset:1990-11-29
Submitted:1990-12-17
Entered:1990-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908191 / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Diarrhoea, Guillain-Barre syndrome, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone?
Current Illness:
Preexisting Conditions: allergy to Septra, Hypertension
Allergies:
Diagnostic Lab Data: Nerve conduction studies suggestive of atypical Guillain Barre, CSF protein normal on 30Nov & 2Dec
CDC 'Split Type':

Write-up: Guillain Barre Synd onset of weakness on 29Nov90, had illness /w vomiting diarrhea, chills & fever /w onset of 19Nov90 & lasting about 2-3 days


Changed on 10/14/2018

VAERS ID: 27094 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Oregon
Vaccinated:1990-10-25
Onset:1990-11-29
Submitted:1990-12-17
Entered:1990-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908191 / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Diarrhoea, Guillain-Barre syndrome, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone?
Current Illness:
Preexisting Conditions: allergy to Septra, Hypertension
Allergies:
Diagnostic Lab Data: Nerve conduction studies suggestive of atypical Guillain Barre, CSF protein normal on 30Nov & 2Dec
CDC 'Split Type':

Write-up: Guillain Barre Synd onset of weakness on 29Nov90, had illness /w vomiting diarrhea, chills & fever /w onset of 19Nov90 & lasting about 2-3 days


Changed on 12/24/2020

VAERS ID: 27094 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Oregon
Vaccinated:1990-10-25
Onset:1990-11-29
Submitted:1990-12-17
Entered:1990-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908191 / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Diarrhoea, Guillain-Barre syndrome, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone?
Current Illness:
Preexisting Conditions: allergy to Septra, Hypertension
Allergies:
Diagnostic Lab Data: Nerve conduction studies suggestive of atypical Guillain Barre, CSF protein normal on 30Nov & 2Dec
CDC 'Split Type':

Write-up: Guillain Barre Synd onset of weakness on 29Nov90, had illness /w vomiting diarrhea, chills & fever /w onset of 19Nov90 & lasting about 2-3 days


Changed on 12/30/2020

VAERS ID: 27094 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Oregon
Vaccinated:1990-10-25
Onset:1990-11-29
Submitted:1990-12-17
Entered:1990-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908191 / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Diarrhoea, Guillain-Barre syndrome, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone?
Current Illness:
Preexisting Conditions: allergy to Septra, Hypertension
Allergies:
Diagnostic Lab Data: Nerve conduction studies suggestive of atypical Guillain Barre, CSF protein normal on 30Nov & 2Dec
CDC 'Split Type':

Write-up: Guillain Barre Synd onset of weakness on 29Nov90, had illness /w vomiting diarrhea, chills & fever /w onset of 19Nov90 & lasting about 2-3 days


Changed on 5/7/2021

VAERS ID: 27094 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Oregon
Vaccinated:1990-10-25
Onset:1990-11-29
Submitted:1990-12-17
Entered:1990-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908191 / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Diarrhoea, Guillain-Barre syndrome, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone?
Current Illness:
Preexisting Conditions: allergy to Septra, Hypertension
Allergies:
Diagnostic Lab Data: Nerve conduction studies suggestive of atypical Guillain Barre, CSF protein normal on 30Nov & 2Dec
CDC 'Split Type':

Write-up: Guillain Barre Synd onset of weakness on 29Nov90, had illness /w vomiting diarrhea, chills & fever /w onset of 19Nov90 & lasting about 2-3 days


Changed on 5/14/2021

VAERS ID: 27094 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Oregon
Vaccinated:1990-10-25
Onset:1990-11-29
Submitted:1990-12-17
Entered:1990-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908191 / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Diarrhoea, Guillain-Barre syndrome, Pyrexia, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone?
Current Illness:
Preexisting Conditions: allergy to Septra, Hypertension
Allergies:
Diagnostic Lab Data: Nerve conduction studies suggestive of atypical Guillain Barre, CSF protein normal on 30Nov & 2Dec
CDC 'Split Type':

Write-up: Guillain Barre Synd onset of weakness on 29Nov90, had illness /w vomiting diarrhea, chills & fever /w onset of 19Nov90 & lasting about 2-3 days

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=27094&WAYBACKHISTORY=ON

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