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This is VAERS ID 44216

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 44216
VAERS Form:
Age:34.1
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-12
Submitted:0000-00-00
Entered:1992-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ADEN: ADENOVIRUS LIVE ORAL TYPE 7 / WYETH 4888220 / - - / -
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 0511019 / - - / -
MEN: MENOMUNE A/C/Y/W / CONNAUGHT LABS 0D21085 / - - / -
MR: MR VAX II / MSD 0302R / - - / -
MU: MUMPSVAX / MSD 02106 / - - / -
OPV: ORIMUNE / LEDERLE 0611C / - - / -
TD: TD ADSORBED, ADULTS / CONNAUGHT LABS 9L11011 / - - / -

Administered by: Military      Purchased by: Unknown
Symptoms: HYPOKINESIA, GUILLAIN BARRE SYND, ASTHENIA, PHARYNGITIS, LAB TEST ABNORM

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: 18     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Given 30NOV92 PPD Connaught Labs lot# 231712;and Bicyllin Wyth Lot# 2891626;
Current Illness:
Preexisting Conditions: hos of pos PPD;
Allergies:
Diagnostic Lab Data: IGM-17DEC90-abn consistent w/GBS;
CDC 'Split Type':

Write-up: 12DEC90 devel elevated weakness which began in feet & moved upwards; unable to walk, drops things; mild URI sx x 1 wk PTA; IGM-17DEC abn consistent w/GBS; plasmaphoresis x 5 exchgs;


Changed on 12/8/2009

VAERS ID: 44216 Before After
VAERS Form:
Age:34.1
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-12
Submitted:0000-00-00
Entered:1992-08-19 1992-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ADEN: ADENOVIRUS LIVE ORAL TYPE 7 / WYETH 4888220 / - - / -
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 0511019 / - - / -
MEN: MENOMUNE A/C/Y/W MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0D21085 / - - / -
MER: MEASLES + RUBELLA (MR-VAX II) / MERCK & CO. INC. 0302R / - - / -
MR: MR VAX II / MSD 0302R / - - / -
MU: MUMPSVAX MUMPS (MUMPSVAX I) / MSD MERCK & CO. INC. 02106 / - - / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0611C / - - / -
TD: TD ADSORBED, ADULTS TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 9L11011 / - - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypokinesia, Laboratory test abnormal, Pharyngitis, HYPOKINESIA, GUILLAIN BARRE SYND, ASTHENIA, PHARYNGITIS, LAB TEST ABNORM

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: 18     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Given 30NOV92 PPD Connaught Labs lot# 231712;and Bicyllin Wyth Lot# 2891626;
Current Illness:
Preexisting Conditions: hos of pos PPD;
Allergies:
Diagnostic Lab Data: IGM-17DEC90-abn consistent w/GBS;
CDC 'Split Type':

Write-up: 12DEC90 devel elevated weakness which began in feet & moved upwards; unable to walk, drops things; mild URI sx x 1 wk PTA; IGM-17DEC abn consistent w/GBS; plasmaphoresis x 5 exchgs;


Changed on 1/5/2010

VAERS ID: 44216 Before After
VAERS Form:
Age:34.1 34.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-12
Submitted:0000-00-00
Entered:1992-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ADEN: ADENOVIRUS (TYPE 7, NO BRAND NAME) / WYETH PHARMACEUTICALS, INC 4888220 / - - / -
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABORATORIES 0511019 / - - / -
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0D21085 / - - / -
MER: MEASLES + RUBELLA (MR-VAX II) / MERCK & CO. INC. 0302R / - - / -
MU: MUMPS (MUMPSVAX I) / MERCK & CO. INC. 02106 / - - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES WYETH PHARMACEUTICALS, INC 0611C / - - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 9L11011 / - - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypokinesia, Laboratory test abnormal, Pharyngitis

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: 18     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~ ~~In patient
Other Medications: Given 30NOV92 PPD Connaught Labs lot# 231712;and Bicyllin Wyth Lot# 2891626;
Current Illness:
Preexisting Conditions: hos of pos PPD;
Allergies:
Diagnostic Lab Data: IGM-17DEC90-abn consistent w/GBS;
CDC 'Split Type':

Write-up: 12DEC90 devel elevated weakness which began in feet & moved upwards; unable to walk, drops things; mild URI sx x 1 wk PTA; IGM-17DEC abn consistent w/GBS; plasmaphoresis x 5 exchgs;


Changed on 8/31/2010

VAERS ID: 44216 Before After
VAERS Form:
Age:34.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-12
Submitted:0000-00-00
Entered:1992-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ADEN: ADENOVIRUS (TYPE 7, NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4888220 / - - / -
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0511019 / - - / -
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0D21085 / - - / -
MER: MEASLES + RUBELLA (MR-VAX II) / MERCK & CO. INC. 0302R / - - / -
MU: MUMPS (MUMPSVAX I) / MERCK & CO. INC. 02106 / - - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 0611C / - - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 9L11011 / - - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypokinesia, Laboratory test abnormal, Pharyngitis

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: 18     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~ ~~In patient
Other Medications: Given 30NOV92 PPD Connaught Labs lot# 231712;and Bicyllin Wyth Lot# 2891626;
Current Illness:
Preexisting Conditions: hos of pos PPD;
Allergies:
Diagnostic Lab Data: IGM-17DEC90-abn consistent w/GBS;
CDC 'Split Type':

Write-up: 12DEC90 devel elevated weakness which began in feet & moved upwards; unable to walk, drops things; mild URI sx x 1 wk PTA; IGM-17DEC abn consistent w/GBS; plasmaphoresis x 5 exchgs;


Changed on 7/7/2013

VAERS ID: 44216 Before After
VAERS Form:
Age:34.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-12
Submitted:0000-00-00
Entered:1992-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ADEN: ADENOVIRUS (TYPE 7, NO BRAND NAME) / PFIZER/WYETH 4888220 / - - / -
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0511019 / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0511019 / - - / -
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0D21085 / - - / -
MER: MEASLES + RUBELLA (MR-VAX II) / MERCK & CO. INC. 0302R / - - / -
MU: MUMPS (MUMPSVAX I) / MERCK & CO. INC. 02106 / - - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0611C / - - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 9L11011 / - - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypokinesia, Laboratory test abnormal, Pharyngitis

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: 18     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~ ~~In patient
Other Medications: Given 30NOV92 PPD Connaught Labs lot# 231712;and Bicyllin Wyth Lot# 2891626;
Current Illness:
Preexisting Conditions: hos of pos PPD;
Allergies:
Diagnostic Lab Data: IGM-17DEC90-abn consistent w/GBS;
CDC 'Split Type':

Write-up: 12DEC90 devel elevated weakness which began in feet & moved upwards; unable to walk, drops things; mild URI sx x 1 wk PTA; IGM-17DEC abn consistent w/GBS; plasmaphoresis x 5 exchgs;


Changed on 6/14/2014

VAERS ID: 44216 Before After
VAERS Form:
Age:34.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-12
Submitted:0000-00-00
Entered:1992-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ADEN: ADENOVIRUS (TYPE 7, NO BRAND NAME) / PFIZER/WYETH 4888220 / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0511019 / - - / -
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0D21085 / - - / -
MER: MEASLES + RUBELLA (MR-VAX II) / MERCK & CO. INC. 0302R / - - / -
MU: MUMPS (MUMPSVAX I) / MERCK & CO. INC. 02106 / - - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0611C / - - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 9L11011 / - - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypokinesia, Laboratory test abnormal, Pharyngitis

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: 18     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~ ~~In patient
Other Medications: Given 30NOV92 PPD Connaught Labs lot# 231712;and Bicyllin Wyth Lot# 2891626;
Current Illness:
Preexisting Conditions: hos of pos PPD;
Allergies:
Diagnostic Lab Data: IGM-17DEC90-abn consistent w/GBS;
CDC 'Split Type':

Write-up: 12DEC90 devel elevated weakness which began in feet & moved upwards; unable to walk, drops things; mild URI sx x 1 wk PTA; IGM-17DEC abn consistent w/GBS; plasmaphoresis x 5 exchgs;


Changed on 2/14/2017

VAERS ID: 44216 Before After
VAERS Form:
Age:34.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-12
Submitted:0000-00-00
Entered:1992-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ADEN: ADENOVIRUS (TYPE 7, NO BRAND NAME) / PFIZER/WYETH 4888220 / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0511019 / - - / -
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0D21085 / - - / -
MER: MEASLES + RUBELLA (MR-VAX II) / MERCK & CO. INC. 0302R / - - / -
MU: MUMPS (MUMPSVAX I) / MERCK & CO. INC. 02106 / - - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0611C / - - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 9L11011 / - - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypokinesia, Laboratory test abnormal, Pharyngitis

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: 18     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Given 30NOV92 PPD Connaught Labs lot# 231712;and Bicyllin Wyth Lot# 2891626;
Current Illness:
Preexisting Conditions: hos of pos PPD;
Allergies:
Diagnostic Lab Data: IGM-17DEC90-abn consistent w/GBS;
CDC 'Split Type':

Write-up: 12DEC90 devel elevated weakness which began in feet & moved upwards; unable to walk, drops things; mild URI sx x 1 wk PTA; IGM-17DEC abn consistent w/GBS; plasmaphoresis x 5 exchgs;


Changed on 9/14/2017

VAERS ID: 44216 Before After
VAERS Form:(blank) 1
Age:34.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-12
Submitted:0000-00-00
Entered:1992-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ADEN: ADENOVIRUS (TYPE 7, NO BRAND NAME) / PFIZER/WYETH 4888220 / - UNK - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0511019 / - UNK - / -
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0D21085 / - UNK - / -
MER: MEASLES + RUBELLA (MR-VAX II) / MERCK & CO. INC. 0302R / - UNK - / -
MU: MUMPS (MUMPSVAX I) / MERCK & CO. INC. 02106 / - UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0611C / - UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 9L11011 / - UNK - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypokinesia, Laboratory test abnormal, Pharyngitis

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: 18     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Given 30NOV92 PPD Connaught Labs lot# 231712;and Bicyllin Wyth Lot# 2891626;
Current Illness:
Preexisting Conditions: hos of pos PPD;
Allergies:
Diagnostic Lab Data: IGM-17DEC90-abn consistent w/GBS;
CDC 'Split Type':

Write-up: 12DEC90 devel elevated weakness which began in feet & moved upwards; unable to walk, drops things; mild URI sx x 1 wk PTA; IGM-17DEC abn consistent w/GBS; plasmaphoresis x 5 exchgs;


Changed on 2/14/2018

VAERS ID: 44216 Before After
VAERS Form:1
Age:34.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-12
Submitted:0000-00-00
Entered:1992-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ADEN: ADENOVIRUS (TYPE 7, NO BRAND NAME) / PFIZER/WYETH 4888220 / UNK - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0511019 / UNK - / -
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0D21085 / UNK - / -
MER: MEASLES + RUBELLA (MR-VAX II) / MERCK & CO. INC. 0302R / UNK - / -
MU: MUMPS (MUMPSVAX I) / MERCK & CO. INC. 02106 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0611C / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 9L11011 / UNK - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypokinesia, Laboratory test abnormal, Pharyngitis

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: 18     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Given 30NOV92 PPD Connaught Labs lot# 231712;and Bicyllin Wyth Lot# 2891626;
Current Illness:
Preexisting Conditions: hos of pos PPD;
Allergies:
Diagnostic Lab Data: IGM-17DEC90-abn consistent w/GBS;
CDC 'Split Type':

Write-up: 12DEC90 devel elevated weakness which began in feet & moved upwards; unable to walk, drops things; mild URI sx x 1 wk PTA; IGM-17DEC abn consistent w/GBS; plasmaphoresis x 5 exchgs;


Changed on 6/14/2018

VAERS ID: 44216 Before After
VAERS Form:1
Age:34.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-12
Submitted:0000-00-00
Entered:1992-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ADEN: ADENOVIRUS (TYPE 7, NO BRAND NAME) / PFIZER/WYETH 4888220 / UNK - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0511019 / UNK - / -
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0D21085 / UNK - / -
MER: MEASLES + RUBELLA (MR-VAX II) / MERCK & CO. INC. 0302R / UNK - / -
MU: MUMPS (MUMPSVAX I) / MERCK & CO. INC. 02106 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0611C / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 9L11011 / UNK - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypokinesia, Laboratory test abnormal, Pharyngitis

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: 18     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Given 30NOV92 PPD Connaught Labs lot# 231712;and Bicyllin Wyth Lot# 2891626;
Current Illness:
Preexisting Conditions: hos of pos PPD;
Allergies:
Diagnostic Lab Data: IGM-17DEC90-abn consistent w/GBS;
CDC 'Split Type':

Write-up: 12DEC90 devel elevated weakness which began in feet & moved upwards; unable to walk, drops things; mild URI sx x 1 wk PTA; IGM-17DEC abn consistent w/GBS; plasmaphoresis x 5 exchgs;


Changed on 8/14/2018

VAERS ID: 44216 Before After
VAERS Form:1
Age:34.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-12
Submitted:0000-00-00
Entered:1992-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ADEN: ADENOVIRUS (TYPE 7, NO BRAND NAME) / PFIZER/WYETH 4888220 / UNK - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0511019 / UNK - / -
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0D21085 / UNK - / -
MER: MEASLES + RUBELLA (MR-VAX II) / MERCK & CO. INC. 0302R / UNK - / -
MU: MUMPS (MUMPSVAX I) / MERCK & CO. INC. 02106 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0611C / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 9L11011 / UNK - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypokinesia, Laboratory test abnormal, Pharyngitis

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: 18     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Given 30NOV92 PPD Connaught Labs lot# 231712;and Bicyllin Wyth Lot# 2891626;
Current Illness:
Preexisting Conditions: hos of pos PPD;
Allergies:
Diagnostic Lab Data: IGM-17DEC90-abn consistent w/GBS;
CDC 'Split Type':

Write-up: 12DEC90 devel elevated weakness which began in feet & moved upwards; unable to walk, drops things; mild URI sx x 1 wk PTA; IGM-17DEC abn consistent w/GBS; plasmaphoresis x 5 exchgs;


Changed on 9/14/2018

VAERS ID: 44216 Before After
VAERS Form:1
Age:34.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-12
Submitted:0000-00-00
Entered:1992-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ADEN: ADENOVIRUS (TYPE 7, NO BRAND NAME) / PFIZER/WYETH 4888220 / UNK - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0511019 / UNK - / -
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0D21085 / UNK - / -
MER: MEASLES + RUBELLA (MR-VAX II) / MERCK & CO. INC. 0302R / UNK - / -
MU: MUMPS (MUMPSVAX I) / MERCK & CO. INC. 02106 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0611C / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 9L11011 / UNK - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypokinesia, Laboratory test abnormal, Pharyngitis

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: 18     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Given 30NOV92 PPD Connaught Labs lot# 231712;and Bicyllin Wyth Lot# 2891626;
Current Illness:
Preexisting Conditions: hos of pos PPD;
Allergies:
Diagnostic Lab Data: IGM-17DEC90-abn consistent w/GBS;
CDC 'Split Type':

Write-up: 12DEC90 devel elevated weakness which began in feet & moved upwards; unable to walk, drops things; mild URI sx x 1 wk PTA; IGM-17DEC abn consistent w/GBS; plasmaphoresis x 5 exchgs;


Changed on 10/14/2018

VAERS ID: 44216 Before After
VAERS Form:1
Age:34.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-12
Submitted:0000-00-00
Entered:1992-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ADEN: ADENOVIRUS (TYPE 7, NO BRAND NAME) / PFIZER/WYETH 4888220 / UNK - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0511019 / UNK - / -
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0D21085 / UNK - / -
MER: MEASLES + RUBELLA (MR-VAX II) / MERCK & CO. INC. 0302R / UNK - / -
MU: MUMPS (MUMPSVAX I) / MERCK & CO. INC. 02106 / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0611C / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES 9L11011 / UNK - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypokinesia, Laboratory test abnormal, Pharyngitis

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: 18     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Given 30NOV92 PPD Connaught Labs lot# 231712;and Bicyllin Wyth Lot# 2891626;
Current Illness:
Preexisting Conditions: hos of pos PPD;
Allergies:
Diagnostic Lab Data: IGM-17DEC90-abn consistent w/GBS;
CDC 'Split Type':

Write-up: 12DEC90 devel elevated weakness which began in feet & moved upwards; unable to walk, drops things; mild URI sx x 1 wk PTA; IGM-17DEC abn consistent w/GBS; plasmaphoresis x 5 exchgs;

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