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This is VAERS ID 37209

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 37209
VAERS Form:
Age:20.0
Sex:Male
Location:New Jersey
Vaccinated:1992-02-17
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: UNK. DT ADSORBED, PEDIATRIC / UNCLASSIFIED - / - - / -
FLU: FLU-IMUNE 1991-1992 EVANS MED & LEDERLE / LEDERLE - / - - / -
MEN: UNK. MENINGOCOCCAL POLYSACCHARIDE / UNCLASSIFIED - / - - / -

Administered by: Military      Purchased by: Unknown
Symptoms: PARESTHESIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: UNK
Current Illness: NONE
Preexisting Conditions: pt had surgery on rt hip related to chondromalacia @ age of 9;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt devel numbness on rt side of body 24 hrs p/flu vax/DT/Meningococcal vax; pt was hospitalized due to adverse effect & was noted to be improving w/numbness currently localized to the rt leg;


Changed on 12/8/2009

VAERS ID: 37209 Before After
VAERS Form:
Age:20.0
Sex:Male
Location:New Jersey
Vaccinated:1992-02-17
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-07-20 1992-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: UNK. DT ADSORBED, PEDIATRIC DT ADSORBED (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -
FLU: FLU-IMUNE 1991-1992 EVANS MED & LEDERLE / LEDERLE - / - - / -
MEN: UNK. MENINGOCOCCAL POLYSACCHARIDE MENINGOCOCCAL (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -

Administered by: Military      Purchased by: Unknown Military
Symptoms: Paraesthesia, PARESTHESIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: UNK
Current Illness: NONE
Preexisting Conditions: pt had surgery on rt hip related to chondromalacia @ age of 9;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 892051005L

Write-up: pt devel numbness on rt side of body 24 hrs p/flu vax/DT/Meningococcal vax; pt was hospitalized due to adverse effect & was noted to be improving w/numbness currently localized to the rt leg;


Changed on 5/14/2017

VAERS ID: 37209 Before After
VAERS Form:
Age:20.0
Sex:Male
Location:New Jersey
Vaccinated:1992-02-17
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES - / - - / -
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Military      Purchased by: Military
Symptoms: Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: pt had surgery on rt hip related to chondromalacia @ age of 9;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892051005L

Write-up: pt devel numbness on rt side of body 24 hrs p/flu vax/DT/Meningococcal vax; pt was hospitalized due to adverse effect & was noted to be improving w/numbness currently localized to the rt leg;


Changed on 9/14/2017

VAERS ID: 37209 Before After
VAERS Form:(blank) 1
Age:20.0
Sex:Male
Location:New Jersey
Vaccinated:1992-02-17
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES - / - UNK - / -
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Military      Purchased by: Military
Symptoms: Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: pt had surgery on rt hip related to chondromalacia @ age of 9;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892051005L

Write-up: pt devel numbness on rt side of body 24 hrs p/flu vax/DT/Meningococcal vax; pt was hospitalized due to adverse effect & was noted to be improving w/numbness currently localized to the rt leg;


Changed on 2/14/2018

VAERS ID: 37209 Before After
VAERS Form:1
Age:20.0
Sex:Male
Location:New Jersey
Vaccinated:1992-02-17
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES - / UNK - / -
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Military      Purchased by: Military
Symptoms: Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: pt had surgery on rt hip related to chondromalacia @ age of 9;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892051005L

Write-up: pt devel numbness on rt side of body 24 hrs p/flu vax/DT/Meningococcal vax; pt was hospitalized due to adverse effect & was noted to be improving w/numbness currently localized to the rt leg;


Changed on 6/14/2018

VAERS ID: 37209 Before After
VAERS Form:1
Age:20.0
Sex:Male
Location:New Jersey
Vaccinated:1992-02-17
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES - / UNK - / -
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Military      Purchased by: Military
Symptoms: Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: pt had surgery on rt hip related to chondromalacia @ age of 9;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892051005L

Write-up: pt devel numbness on rt side of body 24 hrs p/flu vax/DT/Meningococcal vax; pt was hospitalized due to adverse effect & was noted to be improving w/numbness currently localized to the rt leg;


Changed on 8/14/2018

VAERS ID: 37209 Before After
VAERS Form:1
Age:20.0
Sex:Male
Location:New Jersey
Vaccinated:1992-02-17
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES - / UNK - / -
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Military      Purchased by: Military
Symptoms: Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: pt had surgery on rt hip related to chondromalacia @ age of 9;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892051005L

Write-up: pt devel numbness on rt side of body 24 hrs p/flu vax/DT/Meningococcal vax; pt was hospitalized due to adverse effect & was noted to be improving w/numbness currently localized to the rt leg;


Changed on 9/14/2018

VAERS ID: 37209 Before After
VAERS Form:1
Age:20.0
Sex:Male
Location:New Jersey
Vaccinated:1992-02-17
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES - / UNK - / -
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Military      Purchased by: Military
Symptoms: Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: pt had surgery on rt hip related to chondromalacia @ age of 9;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892051005L

Write-up: pt devel numbness on rt side of body 24 hrs p/flu vax/DT/Meningococcal vax; pt was hospitalized due to adverse effect & was noted to be improving w/numbness currently localized to the rt leg;


Changed on 10/14/2018

VAERS ID: 37209 Before After
VAERS Form:1
Age:20.0
Sex:Male
Location:New Jersey
Vaccinated:1992-02-17
Onset:1992-02-18
Submitted:1992-02-19
Entered:1992-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES - / UNK - / -
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Military      Purchased by: Military
Symptoms: Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: pt had surgery on rt hip related to chondromalacia @ age of 9;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892051005L

Write-up: pt devel numbness on rt side of body 24 hrs p/flu vax/DT/Meningococcal vax; pt was hospitalized due to adverse effect & was noted to be improving w/numbness currently localized to the rt leg;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=37209&WAYBACKHISTORY=ON


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