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This is VAERS ID 80345

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 80345
VAERS Form:
Age:59.3
Sex:Female
Location:Washington
Vaccinated:1995-10-12
Onset:1995-10-23
Submitted:1995-12-12
Entered:1996-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1995-1996 / WYETH 4958112 / 0 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: HYPOKINESIA, HEADACHE, GUILLAIN BARRE SYND, DRY MOUTH, EDEMA TONGUE

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt left WA state on 23OCT95 11 days p/vax to travel by car-1st sxs dry throat, lips tingling, tongue felt thick;3NOV h/a, legs shaky, legs gave out-hosp 20NOV-27NOV ascending paralysis;


Changed on 12/8/2009

VAERS ID: 80345 Before After
VAERS Form:
Age:59.3
Sex:Female
Location:Washington
Vaccinated:1995-10-12
Onset:1995-10-23
Submitted:1995-12-12
Entered:1996-01-02 1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1995-1996 INFLUENZA (SEASONAL) (FLUSHIELD 95-96) / WYETH WYETH PHARMACEUTICALS, INC 4958112 / 0 RA / IM

Administered by: Public      Purchased by: Unknown Private
Symptoms: Dry mouth, Guillain-Barre syndrome, Headache, Hypokinesia, Myasthenic syndrome, Paraesthesia, Paralysis, Tongue oedema, HYPOKINESIA, HEADACHE, GUILLAIN BARRE SYND, DRY MOUTH, EDEMA TONGUE

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WA951192

Write-up: pt left WA state on 23OCT95 11 days p/vax to travel by car-1st sxs dry throat, lips tingling, tongue felt thick;3NOV h/a, legs shaky, legs gave out-hosp 20NOV-27NOV ascending paralysis;


Changed on 8/31/2010

VAERS ID: 80345 Before After
VAERS Form:
Age:59.3
Sex:Female
Location:Washington
Vaccinated:1995-10-12
Onset:1995-10-23
Submitted:1995-12-12
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 95-96) INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4958112 / 0 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Dry mouth, Guillain-Barre syndrome, Headache, Hypokinesia, Myasthenic syndrome, Paraesthesia, Paralysis, Tongue oedema

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WA951192

Write-up: pt left WA state on 23OCT95 11 days p/vax to travel by car-1st sxs dry throat, lips tingling, tongue felt thick;3NOV h/a, legs shaky, legs gave out-hosp 20NOV-27NOV ascending paralysis;


Changed on 7/7/2013

VAERS ID: 80345 Before After
VAERS Form:
Age:59.3
Sex:Female
Location:Washington
Vaccinated:1995-10-12
Onset:1995-10-23
Submitted:1995-12-12
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 0 RA / IM
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 0 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Dry mouth, Guillain-Barre syndrome, Headache, Hypokinesia, Myasthenic syndrome, Paraesthesia, Paralysis, Tongue oedema

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WA951192

Write-up: pt left WA state on 23OCT95 11 days p/vax to travel by car-1st sxs dry throat, lips tingling, tongue felt thick;3NOV h/a, legs shaky, legs gave out-hosp 20NOV-27NOV ascending paralysis;


Changed on 2/14/2017

VAERS ID: 80345 Before After
VAERS Form:
Age:59.3 59.0
Sex:Female
Location:Washington
Vaccinated:1995-10-12
Onset:1995-10-23
Submitted:1995-12-12
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 0 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Dry mouth, Guillain-Barre syndrome, Headache, Hypokinesia, Myasthenic syndrome, Paraesthesia, Paralysis, Tongue oedema

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WA951192

Write-up: pt left WA state on 23OCT95 11 days p/vax to travel by car-1st sxs dry throat, lips tingling, tongue felt thick;3NOV h/a, legs shaky, legs gave out-hosp 20NOV-27NOV ascending paralysis;


Changed on 5/14/2017

VAERS ID: 80345 Before After
VAERS Form:
Age:59.0
Sex:Female
Location:Washington
Vaccinated:1995-10-12
Onset:1995-10-23
Submitted:1995-12-12
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 0 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Dry mouth, Guillain-Barre syndrome, Headache, Hypokinesia, Myasthenic syndrome, Paraesthesia, Paralysis, Tongue oedema

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WA951192

Write-up: pt left WA state on 23OCT95 11 days p/vax to travel by car-1st sxs dry throat, lips tingling, tongue felt thick;3NOV h/a, legs shaky, legs gave out-hosp 20NOV-27NOV ascending paralysis;


Changed on 9/14/2017

VAERS ID: 80345 Before After
VAERS Form:(blank) 1
Age:59.0
Sex:Female
Location:Washington
Vaccinated:1995-10-12
Onset:1995-10-23
Submitted:1995-12-12
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 0 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Dry mouth, Guillain-Barre syndrome, Headache, Hypokinesia, Myasthenic syndrome, Paraesthesia, Paralysis, Tongue oedema

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WA951192

Write-up: pt left WA state on 23OCT95 11 days p/vax to travel by car-1st sxs dry throat, lips tingling, tongue felt thick;3NOV h/a, legs shaky, legs gave out-hosp 20NOV-27NOV ascending paralysis;


Changed on 2/14/2018

VAERS ID: 80345 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:Washington
Vaccinated:1995-10-12
Onset:1995-10-23
Submitted:1995-12-12
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Dry mouth, Guillain-Barre syndrome, Headache, Hypokinesia, Myasthenic syndrome, Paraesthesia, Paralysis, Tongue oedema

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WA951192

Write-up: pt left WA state on 23OCT95 11 days p/vax to travel by car-1st sxs dry throat, lips tingling, tongue felt thick;3NOV h/a, legs shaky, legs gave out-hosp 20NOV-27NOV ascending paralysis;


Changed on 6/14/2018

VAERS ID: 80345 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:Washington
Vaccinated:1995-10-12
Onset:1995-10-23
Submitted:1995-12-12
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Dry mouth, Guillain-Barre syndrome, Headache, Hypokinesia, Myasthenic syndrome, Paraesthesia, Paralysis, Tongue oedema

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WA951192

Write-up: pt left WA state on 23OCT95 11 days p/vax to travel by car-1st sxs dry throat, lips tingling, tongue felt thick;3NOV h/a, legs shaky, legs gave out-hosp 20NOV-27NOV ascending paralysis;


Changed on 8/14/2018

VAERS ID: 80345 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:Washington
Vaccinated:1995-10-12
Onset:1995-10-23
Submitted:1995-12-12
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Dry mouth, Guillain-Barre syndrome, Headache, Hypokinesia, Myasthenic syndrome, Paraesthesia, Paralysis, Tongue oedema

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WA951192

Write-up: pt left WA state on 23OCT95 11 days p/vax to travel by car-1st sxs dry throat, lips tingling, tongue felt thick;3NOV h/a, legs shaky, legs gave out-hosp 20NOV-27NOV ascending paralysis;


Changed on 9/14/2018

VAERS ID: 80345 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:Washington
Vaccinated:1995-10-12
Onset:1995-10-23
Submitted:1995-12-12
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Dry mouth, Guillain-Barre syndrome, Headache, Hypokinesia, Myasthenic syndrome, Paraesthesia, Paralysis, Tongue oedema

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WA951192

Write-up: pt left WA state on 23OCT95 11 days p/vax to travel by car-1st sxs dry throat, lips tingling, tongue felt thick;3NOV h/a, legs shaky, legs gave out-hosp 20NOV-27NOV ascending paralysis;


Changed on 10/14/2018

VAERS ID: 80345 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:Washington
Vaccinated:1995-10-12
Onset:1995-10-23
Submitted:1995-12-12
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Dry mouth, Guillain-Barre syndrome, Headache, Hypokinesia, Myasthenic syndrome, Paraesthesia, Paralysis, Tongue oedema

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WA951192

Write-up: pt left WA state on 23OCT95 11 days p/vax to travel by car-1st sxs dry throat, lips tingling, tongue felt thick;3NOV h/a, legs shaky, legs gave out-hosp 20NOV-27NOV ascending paralysis;


Changed on 12/24/2020

VAERS ID: 80345 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:Washington
Vaccinated:1995-10-12
Onset:1995-10-23
Submitted:1995-12-12
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Dry mouth, Guillain-Barre syndrome, Headache, Hypokinesia, Myasthenic syndrome, Paraesthesia, Paralysis, Tongue oedema

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WA951192

Write-up: pt left WA state on 23OCT95 11 days p/vax to travel by car-1st sxs dry throat, lips tingling, tongue felt thick;3NOV h/a, legs shaky, legs gave out-hosp 20NOV-27NOV ascending paralysis;


Changed on 12/30/2020

VAERS ID: 80345 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:Washington
Vaccinated:1995-10-12
Onset:1995-10-23
Submitted:1995-12-12
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Dry mouth, Guillain-Barre syndrome, Headache, Hypokinesia, Myasthenic syndrome, Paraesthesia, Paralysis, Tongue oedema

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WA951192

Write-up: pt left WA state on 23OCT95 11 days p/vax to travel by car-1st sxs dry throat, lips tingling, tongue felt thick;3NOV h/a, legs shaky, legs gave out-hosp 20NOV-27NOV ascending paralysis;


Changed on 5/7/2021

VAERS ID: 80345 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:Washington
Vaccinated:1995-10-12
Onset:1995-10-23
Submitted:1995-12-12
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Dry mouth, Guillain-Barre syndrome, Headache, Hypokinesia, Myasthenic syndrome, Paraesthesia, Paralysis, Tongue oedema

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WA951192

Write-up: pt left WA state on 23OCT95 11 days p/vax to travel by car-1st sxs dry throat, lips tingling, tongue felt thick;3NOV h/a, legs shaky, legs gave out-hosp 20NOV-27NOV ascending paralysis;


Changed on 5/14/2021

VAERS ID: 80345 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:Washington
Vaccinated:1995-10-12
Onset:1995-10-23
Submitted:1995-12-12
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 1 RA / IM

Administered by: Public      Purchased by: Private
Symptoms: Dry mouth, Guillain-Barre syndrome, Headache, Hypokinesia, Myasthenic syndrome, Paraesthesia, Paralysis, Tongue oedema

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WA951192

Write-up: pt left WA state on 23OCT95 11 days p/vax to travel by car-1st sxs dry throat, lips tingling, tongue felt thick;3NOV h/a, legs shaky, legs gave out-hosp 20NOV-27NOV ascending paralysis;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=80345&WAYBACKHISTORY=ON


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