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This is VAERS ID 80782

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 80782
VAERS Form:
Age:55.6
Sex:Male
Location:Washington
Vaccinated:1995-10-09
Onset:1995-11-20
Submitted:1995-12-12
Entered:1996-01-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1995-1996 / WYETH 4958112 / 3 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: HYPOKINESIA, NEUROPATHY, GUILLAIN BARRE SYND, MYASTHENIA, CSF ABNORM

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC 'Split Type':

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;


Changed on 12/8/2009

VAERS ID: 80782 Before After
VAERS Form:
Age:55.6
Sex:Male
Location:Washington
Vaccinated:1995-10-09
Onset:1995-11-20
Submitted:1995-12-12
Entered:1996-01-16 1996-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1995-1996 INFLUENZA (SEASONAL) (FLUSHIELD 95-96) / WYETH WYETH PHARMACEUTICALS, INC 4958112 / 3 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Neuropathy, Pain, CSF test abnormal, HYPOKINESIA, NEUROPATHY, GUILLAIN BARRE SYND, MYASTHENIA, CSF ABNORM

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC 'Split Type':

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;


Changed on 8/31/2010

VAERS ID: 80782 Before After
VAERS Form:
Age:55.6
Sex:Male
Location:Washington
Vaccinated:1995-10-09
Onset:1995-11-20
Submitted:1995-12-12
Entered:1996-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 95-96) INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4958112 / 3 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Neuropathy, Pain, CSF test abnormal

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC 'Split Type':

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;


Changed on 7/7/2013

VAERS ID: 80782 Before After
VAERS Form:
Age:55.6
Sex:Male
Location:Washington
Vaccinated:1995-10-09
Onset:1995-11-20
Submitted:1995-12-12
Entered:1996-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 3 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 3 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Neuropathy, Pain, CSF test abnormal

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC 'Split Type':

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;


Changed on 2/14/2017

VAERS ID: 80782 Before After
VAERS Form:
Age:55.6 55.0
Sex:Male
Location:Washington
Vaccinated:1995-10-09
Onset:1995-11-20
Submitted:1995-12-12
Entered:1996-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 3 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Neuropathy, Pain, CSF test abnormal

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC 'Split Type':

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;


Changed on 5/14/2017

VAERS ID: 80782 Before After
VAERS Form:
Age:55.0
Sex:Male
Location:Washington
Vaccinated:1995-10-09
Onset:1995-11-20
Submitted:1995-12-12
Entered:1996-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 3 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Neuropathy, Pain, CSF test abnormal

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC 'Split Type':

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;


Changed on 9/14/2017

VAERS ID: 80782 Before After
VAERS Form:(blank) 1
Age:55.0
Sex:Male
Location:Washington
Vaccinated:1995-10-09
Onset:1995-11-20
Submitted:1995-12-12
Entered:1996-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 3 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Neuropathy, Pain, CSF test abnormal

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC 'Split Type':

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;


Changed on 2/14/2018

VAERS ID: 80782 Before After
VAERS Form:1
Age:55.0
Sex:Male
Location:Washington
Vaccinated:1995-10-09
Onset:1995-11-20
Submitted:1995-12-12
Entered:1996-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Neuropathy, Pain, CSF test abnormal

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC 'Split Type':

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;


Changed on 6/14/2018

VAERS ID: 80782 Before After
VAERS Form:1
Age:55.0
Sex:Male
Location:Washington
Vaccinated:1995-10-09
Onset:1995-11-20
Submitted:1995-12-12
Entered:1996-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Neuropathy, Pain, CSF test abnormal

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC 'Split Type':

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;


Changed on 8/14/2018

VAERS ID: 80782 Before After
VAERS Form:1
Age:55.0
Sex:Male
Location:Washington
Vaccinated:1995-10-09
Onset:1995-11-20
Submitted:1995-12-12
Entered:1996-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Neuropathy, Pain, CSF test abnormal

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC 'Split Type':

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;


Changed on 9/14/2018

VAERS ID: 80782 Before After
VAERS Form:1
Age:55.0
Sex:Male
Location:Washington
Vaccinated:1995-10-09
Onset:1995-11-20
Submitted:1995-12-12
Entered:1996-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Neuropathy, Pain, CSF test abnormal

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC 'Split Type':

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;


Changed on 10/14/2018

VAERS ID: 80782 Before After
VAERS Form:1
Age:55.0
Sex:Male
Location:Washington
Vaccinated:1995-10-09
Onset:1995-11-20
Submitted:1995-12-12
Entered:1996-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Neuropathy, Pain, CSF test abnormal

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC 'Split Type':

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;


Changed on 12/24/2020

VAERS ID: 80782 Before After
VAERS Form:1
Age:55.0
Sex:Male
Location:Washington
Vaccinated:1995-10-09
Onset:1995-11-20
Submitted:1995-12-12
Entered:1996-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Neuropathy, Pain, CSF test abnormal

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC 'Split Type':

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;


Changed on 12/30/2020

VAERS ID: 80782 Before After
VAERS Form:1
Age:55.0
Sex:Male
Location:Washington
Vaccinated:1995-10-09
Onset:1995-11-20
Submitted:1995-12-12
Entered:1996-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Neuropathy, Pain, CSF test abnormal

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC 'Split Type':

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;


Changed on 5/7/2021

VAERS ID: 80782 Before After
VAERS Form:1
Age:55.0
Sex:Male
Location:Washington
Vaccinated:1995-10-09
Onset:1995-11-20
Submitted:1995-12-12
Entered:1996-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Neuropathy, Pain, CSF test abnormal

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC 'Split Type':

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;


Changed on 5/14/2021

VAERS ID: 80782 Before After
VAERS Form:1
Age:55.0
Sex:Male
Location:Washington
Vaccinated:1995-10-09
Onset:1995-11-20
Submitted:1995-12-12
Entered:1996-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4958112 / 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Neuropathy, Pain, CSF test abnormal

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: hiv positive in 1987 w/ burkitt''s symphoma;tx w/ xrt & no occurence since;a symptomatic inc amylase due to alcohol;
Allergies:
Diagnostic Lab Data: CSF:0cells, prot=225;CMV pcr neg;EMG consistent w/GBS or severe multifocal mononeuropathy multiplex w/ underlying peripheral sensorimotor poly neuropathy
CDC 'Split Type':

Write-up: pt recvd vax;30 days later,foot pain,trouble walking;weakness progressed;by day 50 unable to walk;unable to crawl,dress,roll over in bed;EMG consistent w/ GBS or severe non neuropathy multiplex;

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