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This is VAERS ID 80136

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 80136
VAERS Form:
Age:52.1
Sex:Female
Location:South Carolina
Vaccinated:1995-10-27
Onset:1995-11-04
Submitted:1995-12-06
Entered:1995-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1995-1996 / WYETH 4958079 / 0 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND, CSF ABNORM

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prinivil, Lopid, Glucotrol xl, Synthyroid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: protein inc in CSF
CDC 'Split Type':

Write-up: acute Guillain-Barre Synd; hospitalized 5 days-recvd 5 rounds of immune globulin


Changed on 12/8/2009

VAERS ID: 80136 Before After
VAERS Form:
Age:52.1
Sex:Female
Location:South Carolina
Vaccinated:1995-10-27
Onset:1995-11-04
Submitted:1995-12-06
Entered:1995-12-21 1995-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1995-1996 INFLUENZA (SEASONAL) (FLUSHIELD 95-96) / WYETH WYETH PHARMACEUTICALS, INC 4958079 / 0 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, CSF test abnormal, GUILLAIN BARRE SYND, CSF ABNORM

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prinivil, Lopid, Glucotrol xl, Synthyroid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: protein inc in CSF
CDC 'Split Type':

Write-up: acute Guillain-Barre Synd; hospitalized 5 days-recvd 5 rounds of immune globulin


Changed on 8/31/2010

VAERS ID: 80136 Before After
VAERS Form:
Age:52.1
Sex:Female
Location:South Carolina
Vaccinated:1995-10-27
Onset:1995-11-04
Submitted:1995-12-06
Entered:1995-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 95-96) INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4958079 / 0 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, CSF test abnormal

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prinivil, Lopid, Glucotrol xl, Synthyroid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: protein inc in CSF
CDC 'Split Type':

Write-up: acute Guillain-Barre Synd; hospitalized 5 days-recvd 5 rounds of immune globulin


Changed on 7/7/2013

VAERS ID: 80136 Before After
VAERS Form:
Age:52.1
Sex:Female
Location:South Carolina
Vaccinated:1995-10-27
Onset:1995-11-04
Submitted:1995-12-06
Entered:1995-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958079 / 0 LA / -
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958079 / 0 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, CSF test abnormal

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prinivil, Lopid, Glucotrol xl, Synthyroid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: protein inc in CSF
CDC 'Split Type':

Write-up: acute Guillain-Barre Synd; hospitalized 5 days-recvd 5 rounds of immune globulin


Changed on 2/14/2017

VAERS ID: 80136 Before After
VAERS Form:
Age:52.1 52.0
Sex:Female
Location:South Carolina
Vaccinated:1995-10-27
Onset:1995-11-04
Submitted:1995-12-06
Entered:1995-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958079 / 0 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, CSF test abnormal

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prinivil, Lopid, Glucotrol xl, Synthyroid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: protein inc in CSF
CDC 'Split Type':

Write-up: acute Guillain-Barre Synd; hospitalized 5 days-recvd 5 rounds of immune globulin


Changed on 5/14/2017

VAERS ID: 80136 Before After
VAERS Form:
Age:52.0
Sex:Female
Location:South Carolina
Vaccinated:1995-10-27
Onset:1995-11-04
Submitted:1995-12-06
Entered:1995-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958079 / 0 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, CSF test abnormal

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prinivil, Lopid, Glucotrol xl, Synthyroid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: protein inc in CSF
CDC 'Split Type':

Write-up: acute Guillain-Barre Synd; hospitalized 5 days-recvd 5 rounds of immune globulin


Changed on 9/14/2017

VAERS ID: 80136 Before After
VAERS Form:(blank) 1
Age:52.0
Sex:Female
Location:South Carolina
Vaccinated:1995-10-27
Onset:1995-11-04
Submitted:1995-12-06
Entered:1995-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958079 / 0 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, CSF test abnormal

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prinivil, Lopid, Glucotrol xl, Synthyroid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: protein inc in CSF
CDC 'Split Type':

Write-up: acute Guillain-Barre Synd; hospitalized 5 days-recvd 5 rounds of immune globulin


Changed on 2/14/2018

VAERS ID: 80136 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:South Carolina
Vaccinated:1995-10-27
Onset:1995-11-04
Submitted:1995-12-06
Entered:1995-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958079 / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, CSF test abnormal

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prinivil, Lopid, Glucotrol xl, Synthyroid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: protein inc in CSF
CDC 'Split Type':

Write-up: acute Guillain-Barre Synd; hospitalized 5 days-recvd 5 rounds of immune globulin


Changed on 6/14/2018

VAERS ID: 80136 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:South Carolina
Vaccinated:1995-10-27
Onset:1995-11-04
Submitted:1995-12-06
Entered:1995-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958079 / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, CSF test abnormal

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prinivil, Lopid, Glucotrol xl, Synthyroid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: protein inc in CSF
CDC 'Split Type':

Write-up: acute Guillain-Barre Synd; hospitalized 5 days-recvd 5 rounds of immune globulin


Changed on 8/14/2018

VAERS ID: 80136 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:South Carolina
Vaccinated:1995-10-27
Onset:1995-11-04
Submitted:1995-12-06
Entered:1995-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958079 / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, CSF test abnormal

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prinivil, Lopid, Glucotrol xl, Synthyroid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: protein inc in CSF
CDC 'Split Type':

Write-up: acute Guillain-Barre Synd; hospitalized 5 days-recvd 5 rounds of immune globulin


Changed on 9/14/2018

VAERS ID: 80136 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:South Carolina
Vaccinated:1995-10-27
Onset:1995-11-04
Submitted:1995-12-06
Entered:1995-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958079 / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, CSF test abnormal

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prinivil, Lopid, Glucotrol xl, Synthyroid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: protein inc in CSF
CDC 'Split Type':

Write-up: acute Guillain-Barre Synd; hospitalized 5 days-recvd 5 rounds of immune globulin


Changed on 10/14/2018

VAERS ID: 80136 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:South Carolina
Vaccinated:1995-10-27
Onset:1995-11-04
Submitted:1995-12-06
Entered:1995-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958079 / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, CSF test abnormal

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prinivil, Lopid, Glucotrol xl, Synthyroid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: protein inc in CSF
CDC 'Split Type':

Write-up: acute Guillain-Barre Synd; hospitalized 5 days-recvd 5 rounds of immune globulin


Changed on 12/24/2020

VAERS ID: 80136 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:South Carolina
Vaccinated:1995-10-27
Onset:1995-11-04
Submitted:1995-12-06
Entered:1995-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958079 / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, CSF test abnormal

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prinivil, Lopid, Glucotrol xl, Synthyroid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: protein inc in CSF
CDC 'Split Type':

Write-up: acute Guillain-Barre Synd; hospitalized 5 days-recvd 5 rounds of immune globulin


Changed on 12/30/2020

VAERS ID: 80136 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:South Carolina
Vaccinated:1995-10-27
Onset:1995-11-04
Submitted:1995-12-06
Entered:1995-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958079 / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, CSF test abnormal

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prinivil, Lopid, Glucotrol xl, Synthyroid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: protein inc in CSF
CDC 'Split Type':

Write-up: acute Guillain-Barre Synd; hospitalized 5 days-recvd 5 rounds of immune globulin


Changed on 5/7/2021

VAERS ID: 80136 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:South Carolina
Vaccinated:1995-10-27
Onset:1995-11-04
Submitted:1995-12-06
Entered:1995-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958079 / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, CSF test abnormal

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prinivil, Lopid, Glucotrol xl, Synthyroid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: protein inc in CSF
CDC 'Split Type':

Write-up: acute Guillain-Barre Synd; hospitalized 5 days-recvd 5 rounds of immune globulin


Changed on 5/14/2021

VAERS ID: 80136 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:South Carolina
Vaccinated:1995-10-27
Onset:1995-11-04
Submitted:1995-12-06
Entered:1995-12-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958079 / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, CSF test abnormal

Life Threatening? Yes
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prinivil, Lopid, Glucotrol xl, Synthyroid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: protein inc in CSF
CDC 'Split Type':

Write-up: acute Guillain-Barre Synd; hospitalized 5 days-recvd 5 rounds of immune globulin

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