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This is VAERS ID 71489

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 71489
VAERS Form:
Age:
Sex:Female
Location:New York
Vaccinated:1994-10-06
Onset:1994-10-14
Submitted:1995-01-27
Entered:1995-02-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1994-1995 / WYETH 4948120 / - A / IM

Administered by: Other      Purchased by: Unknown
Symptoms: DIZZINESS, ANOREXIA, ENCEPHALITIS, ASTHENIA, BLIND

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? Yes, days: 27     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid 0.5 mg daily; Premarin vaginal cream bid;
Current Illness: unknown
Preexisting Conditions: Cervical carcinoma in 1965 w/total hysterectomy, thyroid carcinoma in 1986 tx w/radiation, arthritis affecting both hips, allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; 8 days later fell down & was unable to get up;taken to hosp & dx w/ encephalitis; pt was discharged; however, pt is in wheel chair;


Changed on 12/8/2009

VAERS ID: 71489 Before After
VAERS Form:
Age:
Sex:Female
Location:New York
Vaccinated:1994-10-06
Onset:1994-10-14
Submitted:1995-01-27
Entered:1995-02-21 1995-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1994-1995 INFLUENZA (SEASONAL) (FLUSHIELD 94-95) / WYETH WYETH PHARMACEUTICALS, INC 4948120 / - A / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Anorexia, Asthenia, Blindness, Dizziness, Encephalitis, Hypokinesia, Malaise, Paralysis, DIZZINESS, ANOREXIA, ENCEPHALITIS, ASTHENIA, BLIND

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? Yes, days: 27     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid 0.5 mg daily; Premarin vaginal cream bid;
Current Illness: unknown
Preexisting Conditions: Cervical carcinoma in 1965 w/total hysterectomy, thyroid carcinoma in 1986 tx w/radiation, arthritis affecting both hips, allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 895031002A

Write-up: pt recvd vax; 8 days later fell down & was unable to get up;taken to hosp & dx w/ encephalitis; pt was discharged; however, pt is in wheel chair;


Changed on 8/31/2010

VAERS ID: 71489 Before After
VAERS Form:
Age:
Sex:Female
Location:New York
Vaccinated:1994-10-06
Onset:1994-10-14
Submitted:1995-01-27
Entered:1995-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 94-95) INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4948120 / - A / IM

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Blindness, Dizziness, Encephalitis, Hypokinesia, Malaise, Paralysis

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? Yes, days: 27     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid 0.5 mg daily; Premarin vaginal cream bid;
Current Illness: unknown
Preexisting Conditions: Cervical carcinoma in 1965 w/total hysterectomy, thyroid carcinoma in 1986 tx w/radiation, arthritis affecting both hips, allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895031002A

Write-up: pt recvd vax; 8 days later fell down & was unable to get up;taken to hosp & dx w/ encephalitis; pt was discharged; however, pt is in wheel chair;


Changed on 7/7/2013

VAERS ID: 71489 Before After
VAERS Form:
Age:
Sex:Female
Location:New York
Vaccinated:1994-10-06
Onset:1994-10-14
Submitted:1995-01-27
Entered:1995-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4948120 / - A / IM
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4948120 / - A / IM

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Blindness, Dizziness, Encephalitis, Hypokinesia, Malaise, Paralysis

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? Yes, days: 27     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid 0.5 mg daily; Premarin vaginal cream bid;
Current Illness: unknown
Preexisting Conditions: Cervical carcinoma in 1965 w/total hysterectomy, thyroid carcinoma in 1986 tx w/radiation, arthritis affecting both hips, allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895031002A

Write-up: pt recvd vax; 8 days later fell down & was unable to get up;taken to hosp & dx w/ encephalitis; pt was discharged; however, pt is in wheel chair;


Changed on 5/14/2017

VAERS ID: 71489 Before After
VAERS Form:
Age:
Sex:Female
Location:New York
Vaccinated:1994-10-06
Onset:1994-10-14
Submitted:1995-01-27
Entered:1995-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4948120 / - A - / IM IM A

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Blindness, Dizziness, Encephalitis, Hypokinesia, Malaise, Paralysis

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? Yes, days: 27     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid 0.5 mg daily; Premarin vaginal cream bid;
Current Illness: unknown
Preexisting Conditions: Cervical carcinoma in 1965 w/total hysterectomy, thyroid carcinoma in 1986 tx w/radiation, arthritis affecting both hips, allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895031002A

Write-up: pt recvd vax; 8 days later fell down & was unable to get up;taken to hosp & dx w/ encephalitis; pt was discharged; however, pt is in wheel chair;


Changed on 9/14/2017

VAERS ID: 71489 Before After
VAERS Form:(blank) 1
Age:
Sex:Female
Location:New York
Vaccinated:1994-10-06
Onset:1994-10-14
Submitted:1995-01-27
Entered:1995-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4948120 / - UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Blindness, Dizziness, Encephalitis, Hypokinesia, Malaise, Paralysis

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? Yes, days: 27     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid 0.5 mg daily; Premarin vaginal cream bid;
Current Illness: unknown
Preexisting Conditions: Cervical carcinoma in 1965 w/total hysterectomy, thyroid carcinoma in 1986 tx w/radiation, arthritis affecting both hips, allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895031002A

Write-up: pt recvd vax; 8 days later fell down & was unable to get up;taken to hosp & dx w/ encephalitis; pt was discharged; however, pt is in wheel chair;


Changed on 2/14/2018

VAERS ID: 71489 Before After
VAERS Form:1
Age:
Sex:Female
Location:New York
Vaccinated:1994-10-06
Onset:1994-10-14
Submitted:1995-01-27
Entered:1995-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4948120 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Blindness, Dizziness, Encephalitis, Hypokinesia, Malaise, Paralysis

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? Yes, days: 27     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid 0.5 mg daily; Premarin vaginal cream bid;
Current Illness: unknown
Preexisting Conditions: Cervical carcinoma in 1965 w/total hysterectomy, thyroid carcinoma in 1986 tx w/radiation, arthritis affecting both hips, allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895031002A

Write-up: pt recvd vax; 8 days later fell down & was unable to get up;taken to hosp & dx w/ encephalitis; pt was discharged; however, pt is in wheel chair;


Changed on 6/14/2018

VAERS ID: 71489 Before After
VAERS Form:1
Age:
Sex:Female
Location:New York
Vaccinated:1994-10-06
Onset:1994-10-14
Submitted:1995-01-27
Entered:1995-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4948120 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Blindness, Dizziness, Encephalitis, Hypokinesia, Malaise, Paralysis

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? Yes, days: 27     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid 0.5 mg daily; Premarin vaginal cream bid;
Current Illness: unknown
Preexisting Conditions: Cervical carcinoma in 1965 w/total hysterectomy, thyroid carcinoma in 1986 tx w/radiation, arthritis affecting both hips, allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895031002A

Write-up: pt recvd vax; 8 days later fell down & was unable to get up;taken to hosp & dx w/ encephalitis; pt was discharged; however, pt is in wheel chair;


Changed on 8/14/2018

VAERS ID: 71489 Before After
VAERS Form:1
Age:
Sex:Female
Location:New York
Vaccinated:1994-10-06
Onset:1994-10-14
Submitted:1995-01-27
Entered:1995-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4948120 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Blindness, Dizziness, Encephalitis, Hypokinesia, Malaise, Paralysis

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? Yes, days: 27     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid 0.5 mg daily; Premarin vaginal cream bid;
Current Illness: unknown
Preexisting Conditions: Cervical carcinoma in 1965 w/total hysterectomy, thyroid carcinoma in 1986 tx w/radiation, arthritis affecting both hips, allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895031002A

Write-up: pt recvd vax; 8 days later fell down & was unable to get up;taken to hosp & dx w/ encephalitis; pt was discharged; however, pt is in wheel chair;


Changed on 9/14/2018

VAERS ID: 71489 Before After
VAERS Form:1
Age:
Sex:Female
Location:New York
Vaccinated:1994-10-06
Onset:1994-10-14
Submitted:1995-01-27
Entered:1995-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4948120 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Blindness, Dizziness, Encephalitis, Hypokinesia, Malaise, Paralysis

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? Yes, days: 27     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid 0.5 mg daily; Premarin vaginal cream bid;
Current Illness: unknown
Preexisting Conditions: Cervical carcinoma in 1965 w/total hysterectomy, thyroid carcinoma in 1986 tx w/radiation, arthritis affecting both hips, allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895031002A

Write-up: pt recvd vax; 8 days later fell down & was unable to get up;taken to hosp & dx w/ encephalitis; pt was discharged; however, pt is in wheel chair;


Changed on 10/14/2018

VAERS ID: 71489 Before After
VAERS Form:1
Age:
Sex:Female
Location:New York
Vaccinated:1994-10-06
Onset:1994-10-14
Submitted:1995-01-27
Entered:1995-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4948120 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Blindness, Dizziness, Encephalitis, Hypokinesia, Malaise, Paralysis

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? Yes, days: 27     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid 0.5 mg daily; Premarin vaginal cream bid;
Current Illness: unknown
Preexisting Conditions: Cervical carcinoma in 1965 w/total hysterectomy, thyroid carcinoma in 1986 tx w/radiation, arthritis affecting both hips, allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895031002A

Write-up: pt recvd vax; 8 days later fell down & was unable to get up;taken to hosp & dx w/ encephalitis; pt was discharged; however, pt is in wheel chair;


Changed on 12/24/2020

VAERS ID: 71489 Before After
VAERS Form:1
Age:
Sex:Female
Location:New York
Vaccinated:1994-10-06
Onset:1994-10-14
Submitted:1995-01-27
Entered:1995-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4948120 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Blindness, Dizziness, Encephalitis, Hypokinesia, Malaise, Paralysis

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? Yes, days: 27     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid 0.5 mg daily; Premarin vaginal cream bid;
Current Illness: unknown
Preexisting Conditions: Cervical carcinoma in 1965 w/total hysterectomy, thyroid carcinoma in 1986 tx w/radiation, arthritis affecting both hips, allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895031002A

Write-up: pt recvd vax; 8 days later fell down & was unable to get up;taken to hosp & dx w/ encephalitis; pt was discharged; however, pt is in wheel chair;


Changed on 12/30/2020

VAERS ID: 71489 Before After
VAERS Form:1
Age:
Sex:Female
Location:New York
Vaccinated:1994-10-06
Onset:1994-10-14
Submitted:1995-01-27
Entered:1995-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4948120 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Blindness, Dizziness, Encephalitis, Hypokinesia, Malaise, Paralysis

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? Yes, days: 27     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid 0.5 mg daily; Premarin vaginal cream bid;
Current Illness: unknown
Preexisting Conditions: Cervical carcinoma in 1965 w/total hysterectomy, thyroid carcinoma in 1986 tx w/radiation, arthritis affecting both hips, allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895031002A

Write-up: pt recvd vax; 8 days later fell down & was unable to get up;taken to hosp & dx w/ encephalitis; pt was discharged; however, pt is in wheel chair;


Changed on 5/7/2021

VAERS ID: 71489 Before After
VAERS Form:1
Age:
Sex:Female
Location:New York
Vaccinated:1994-10-06
Onset:1994-10-14
Submitted:1995-01-27
Entered:1995-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4948120 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Blindness, Dizziness, Encephalitis, Hypokinesia, Malaise, Paralysis

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? Yes, days: 27     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid 0.5 mg daily; Premarin vaginal cream bid;
Current Illness: unknown
Preexisting Conditions: Cervical carcinoma in 1965 w/total hysterectomy, thyroid carcinoma in 1986 tx w/radiation, arthritis affecting both hips, allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895031002A

Write-up: pt recvd vax; 8 days later fell down & was unable to get up;taken to hosp & dx w/ encephalitis; pt was discharged; however, pt is in wheel chair;


Changed on 5/14/2021

VAERS ID: 71489 Before After
VAERS Form:1
Age:
Sex:Female
Location:New York
Vaccinated:1994-10-06
Onset:1994-10-14
Submitted:1995-01-27
Entered:1995-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4948120 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Blindness, Dizziness, Encephalitis, Hypokinesia, Malaise, Paralysis

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? Yes, days: 27     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid 0.5 mg daily; Premarin vaginal cream bid;
Current Illness: unknown
Preexisting Conditions: Cervical carcinoma in 1965 w/total hysterectomy, thyroid carcinoma in 1986 tx w/radiation, arthritis affecting both hips, allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 895031002A

Write-up: pt recvd vax; 8 days later fell down & was unable to get up;taken to hosp & dx w/ encephalitis; pt was discharged; however, pt is in wheel chair;

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