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This is VAERS ID 93862

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 93862
VAERS Form:
Age:79.8
Sex:Female
Location:Illinois
Vaccinated:1996-11-01
Onset:1996-11-12
Submitted:1997-01-10
Entered:1997-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1996-1997 / PARKE-DAVIS 00675P / 1 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: HYPOKINESIA, CHILLS, GUILLAIN BARRE SYND, PARESTHESIA, HYPONATREM

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:     Extended hospital stay? Yes
Previous Vaccinations: NA
Other Medications: ASA, Ibuprofen
Current Illness: NONE
Preexisting Conditions: coronary (4-way) bypass 7OCT96;diabetes
Allergies:
Diagnostic Lab Data: EMG (2)
CDC 'Split Type': coronary (4-way) bypass 7OCT96;diabetes

Write-up: 12NOV96 unable to stand or walk;low (125) sodium, hands tingling, no reflex in both knees, GBS;


Changed on 12/8/2009

VAERS ID: 93862 Before After
VAERS Form:
Age:79.8
Sex:Female
Location:Illinois
Vaccinated:1996-11-01
Onset:1996-11-12
Submitted:1997-01-10
Entered:1997-01-19 1997-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1996-1997 INFLUENZA (SEASONAL) (FLUOGEN 96-97) / PARKE-DAVIS 00675P / 1 RA / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Chills, Guillain-Barre syndrome, Hypokinesia, Hyponatraemia, Hyporeflexia, Paraesthesia, HYPOKINESIA, CHILLS, GUILLAIN BARRE SYND, PARESTHESIA, HYPONATREM

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:     Extended hospital stay? Yes
Previous Vaccinations: NA
Other Medications: ASA, Ibuprofen
Current Illness: NONE
Preexisting Conditions: coronary (4-way) bypass 7OCT96;diabetes
Allergies:
Diagnostic Lab Data: EMG (2)
CDC 'Split Type': coronary (4-way) bypass 7OCT96;diabetes (blank)

Write-up: 12NOV96 unable to stand or walk;low (125) sodium, hands tingling, no reflex in both knees, GBS;


Changed on 8/31/2010

VAERS ID: 93862 Before After
VAERS Form:
Age:79.8
Sex:Female
Location:Illinois
Vaccinated:1996-11-01
Onset:1996-11-12
Submitted:1997-01-10
Entered:1997-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 96-97) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00675P / 1 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Chills, Guillain-Barre syndrome, Hypokinesia, Hyponatraemia, Hyporeflexia, Paraesthesia

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:     Extended hospital stay? Yes
Previous Vaccinations: NA
Other Medications: ASA, Ibuprofen
Current Illness: NONE
Preexisting Conditions: coronary (4-way) bypass 7OCT96;diabetes
Allergies:
Diagnostic Lab Data: EMG (2)
CDC 'Split Type':

Write-up: 12NOV96 unable to stand or walk;low (125) sodium, hands tingling, no reflex in both knees, GBS;


Changed on 7/7/2013

VAERS ID: 93862 Before After
VAERS Form:
Age:79.8
Sex:Female
Location:Illinois
Vaccinated:1996-11-01
Onset:1996-11-12
Submitted:1997-01-10
Entered:1997-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00675P / 1 RA / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00675P / 1 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Chills, Guillain-Barre syndrome, Hypokinesia, Hyponatraemia, Hyporeflexia, Paraesthesia

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:     Extended hospital stay? Yes
Previous Vaccinations: NA
Other Medications: ASA, Ibuprofen
Current Illness: NONE
Preexisting Conditions: coronary (4-way) bypass 7OCT96;diabetes
Allergies:
Diagnostic Lab Data: EMG (2)
CDC 'Split Type':

Write-up: 12NOV96 unable to stand or walk;low (125) sodium, hands tingling, no reflex in both knees, GBS;


Changed on 2/14/2017

VAERS ID: 93862 Before After
VAERS Form:
Age:79.8 79.0
Sex:Female
Location:Illinois
Vaccinated:1996-11-01
Onset:1996-11-12
Submitted:1997-01-10
Entered:1997-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00675P / 1 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Chills, Guillain-Barre syndrome, Hypokinesia, Hyponatraemia, Hyporeflexia, Paraesthesia

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:     Extended hospital stay? Yes
Previous Vaccinations: NA
Other Medications: ASA, Ibuprofen
Current Illness: NONE
Preexisting Conditions: coronary (4-way) bypass 7OCT96;diabetes
Allergies:
Diagnostic Lab Data: EMG (2)
CDC 'Split Type':

Write-up: 12NOV96 unable to stand or walk;low (125) sodium, hands tingling, no reflex in both knees, GBS;


Changed on 5/14/2017

VAERS ID: 93862 Before After
VAERS Form:
Age:79.0
Sex:Female
Location:Illinois
Vaccinated:1996-11-01
Onset:1996-11-12
Submitted:1997-01-10
Entered:1997-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00675P / 1 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Chills, Guillain-Barre syndrome, Hypokinesia, Hyponatraemia, Hyporeflexia, Paraesthesia

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:     Extended hospital stay? Yes
Previous Vaccinations: NA NA~ ()~~~In patient
Other Medications: ASA, Ibuprofen
Current Illness: NONE
Preexisting Conditions: coronary (4-way) bypass 7OCT96;diabetes
Allergies:
Diagnostic Lab Data: EMG (2)
CDC 'Split Type':

Write-up: 12NOV96 unable to stand or walk;low (125) sodium, hands tingling, no reflex in both knees, GBS;


Changed on 9/14/2017

VAERS ID: 93862 Before After
VAERS Form:(blank) 1
Age:79.0
Sex:Female
Location:Illinois
Vaccinated:1996-11-01
Onset:1996-11-12
Submitted:1997-01-10
Entered:1997-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00675P / 1 2 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Chills, Guillain-Barre syndrome, Hypokinesia, Hyponatraemia, Hyporeflexia, Paraesthesia

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:     Extended hospital stay? Yes
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: ASA, Ibuprofen
Current Illness: NONE
Preexisting Conditions: coronary (4-way) bypass 7OCT96;diabetes
Allergies:
Diagnostic Lab Data: EMG (2)
CDC 'Split Type':

Write-up: 12NOV96 unable to stand or walk;low (125) sodium, hands tingling, no reflex in both knees, GBS;


Changed on 2/14/2018

VAERS ID: 93862 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Illinois
Vaccinated:1996-11-01
Onset:1996-11-12
Submitted:1997-01-10
Entered:1997-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00675P / 2 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Chills, Guillain-Barre syndrome, Hypokinesia, Hyponatraemia, Hyporeflexia, Paraesthesia

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:     Extended hospital stay? Yes
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: ASA, Ibuprofen
Current Illness: NONE
Preexisting Conditions: coronary (4-way) bypass 7OCT96;diabetes
Allergies:
Diagnostic Lab Data: EMG (2)
CDC 'Split Type':

Write-up: 12NOV96 unable to stand or walk;low (125) sodium, hands tingling, no reflex in both knees, GBS;


Changed on 6/14/2018

VAERS ID: 93862 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Illinois
Vaccinated:1996-11-01
Onset:1996-11-12
Submitted:1997-01-10
Entered:1997-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00675P / 2 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Chills, Guillain-Barre syndrome, Hypokinesia, Hyponatraemia, Hyporeflexia, Paraesthesia

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:     Extended hospital stay? Yes
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: ASA, Ibuprofen
Current Illness: NONE
Preexisting Conditions: coronary (4-way) bypass 7OCT96;diabetes
Allergies:
Diagnostic Lab Data: EMG (2)
CDC 'Split Type':

Write-up: 12NOV96 unable to stand or walk;low (125) sodium, hands tingling, no reflex in both knees, GBS;


Changed on 8/14/2018

VAERS ID: 93862 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Illinois
Vaccinated:1996-11-01
Onset:1996-11-12
Submitted:1997-01-10
Entered:1997-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00675P / 2 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Chills, Guillain-Barre syndrome, Hypokinesia, Hyponatraemia, Hyporeflexia, Paraesthesia

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:     Extended hospital stay? Yes
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: ASA, Ibuprofen
Current Illness: NONE
Preexisting Conditions: coronary (4-way) bypass 7OCT96;diabetes
Allergies:
Diagnostic Lab Data: EMG (2)
CDC 'Split Type':

Write-up: 12NOV96 unable to stand or walk;low (125) sodium, hands tingling, no reflex in both knees, GBS;


Changed on 9/14/2018

VAERS ID: 93862 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Illinois
Vaccinated:1996-11-01
Onset:1996-11-12
Submitted:1997-01-10
Entered:1997-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00675P / 2 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Chills, Guillain-Barre syndrome, Hypokinesia, Hyponatraemia, Hyporeflexia, Paraesthesia

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:     Extended hospital stay? Yes
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: ASA, Ibuprofen
Current Illness: NONE
Preexisting Conditions: coronary (4-way) bypass 7OCT96;diabetes
Allergies:
Diagnostic Lab Data: EMG (2)
CDC 'Split Type':

Write-up: 12NOV96 unable to stand or walk;low (125) sodium, hands tingling, no reflex in both knees, GBS;


Changed on 10/14/2018

VAERS ID: 93862 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Illinois
Vaccinated:1996-11-01
Onset:1996-11-12
Submitted:1997-01-10
Entered:1997-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00675P / 2 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Chills, Guillain-Barre syndrome, Hypokinesia, Hyponatraemia, Hyporeflexia, Paraesthesia

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:     Extended hospital stay? Yes
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: ASA, Ibuprofen
Current Illness: NONE
Preexisting Conditions: coronary (4-way) bypass 7OCT96;diabetes
Allergies:
Diagnostic Lab Data: EMG (2)
CDC 'Split Type':

Write-up: 12NOV96 unable to stand or walk;low (125) sodium, hands tingling, no reflex in both knees, GBS;


Changed on 12/24/2020

VAERS ID: 93862 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Illinois
Vaccinated:1996-11-01
Onset:1996-11-12
Submitted:1997-01-10
Entered:1997-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00675P / 2 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Chills, Guillain-Barre syndrome, Hypokinesia, Hyponatraemia, Hyporeflexia, Paraesthesia

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:     Extended hospital stay? Yes
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: ASA, Ibuprofen
Current Illness: NONE
Preexisting Conditions: coronary (4-way) bypass 7OCT96;diabetes
Allergies:
Diagnostic Lab Data: EMG (2)
CDC 'Split Type':

Write-up: 12NOV96 unable to stand or walk;low (125) sodium, hands tingling, no reflex in both knees, GBS;


Changed on 12/30/2020

VAERS ID: 93862 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Illinois
Vaccinated:1996-11-01
Onset:1996-11-12
Submitted:1997-01-10
Entered:1997-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00675P / 2 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Chills, Guillain-Barre syndrome, Hypokinesia, Hyponatraemia, Hyporeflexia, Paraesthesia

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:     Extended hospital stay? Yes
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: ASA, Ibuprofen
Current Illness: NONE
Preexisting Conditions: coronary (4-way) bypass 7OCT96;diabetes
Allergies:
Diagnostic Lab Data: EMG (2)
CDC 'Split Type':

Write-up: 12NOV96 unable to stand or walk;low (125) sodium, hands tingling, no reflex in both knees, GBS;


Changed on 5/7/2021

VAERS ID: 93862 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Illinois
Vaccinated:1996-11-01
Onset:1996-11-12
Submitted:1997-01-10
Entered:1997-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00675P / 2 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Chills, Guillain-Barre syndrome, Hypokinesia, Hyponatraemia, Hyporeflexia, Paraesthesia

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:     Extended hospital stay? Yes
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: ASA, Ibuprofen
Current Illness: NONE
Preexisting Conditions: coronary (4-way) bypass 7OCT96;diabetes
Allergies:
Diagnostic Lab Data: EMG (2)
CDC 'Split Type':

Write-up: 12NOV96 unable to stand or walk;low (125) sodium, hands tingling, no reflex in both knees, GBS;


Changed on 5/14/2021

VAERS ID: 93862 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Illinois
Vaccinated:1996-11-01
Onset:1996-11-12
Submitted:1997-01-10
Entered:1997-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00675P / 2 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Chills, Guillain-Barre syndrome, Hypokinesia, Hyponatraemia, Hyporeflexia, Paraesthesia

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:     Extended hospital stay? Yes
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: ASA, Ibuprofen
Current Illness: NONE
Preexisting Conditions: coronary (4-way) bypass 7OCT96;diabetes
Allergies:
Diagnostic Lab Data: EMG (2)
CDC 'Split Type':

Write-up: 12NOV96 unable to stand or walk;low (125) sodium, hands tingling, no reflex in both knees, GBS;

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