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This is VAERS ID 94044

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 94044
VAERS Form:
Age:
Sex:Male
Location:Kansas
Vaccinated:1994-09-24
Onset:1994-10-19
Submitted:1996-12-16
Entered:1997-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1996-1997 / WYETH - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND, PAIN

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: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax 24SEP94 & allegedly dx w/GBS on 19OCT94;as a result of GBS pt suffered pain & permanent disability;hosp is presumed, although not documented;this is a serious, labelled event;


Changed on 12/8/2009

VAERS ID: 94044 Before After
VAERS Form:
Age:
Sex:Male
Location:Kansas
Vaccinated:1994-09-24
Onset:1994-10-19
Submitted:1996-12-16
Entered:1997-01-31 1997-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1996-1997 INFLUENZA (SEASONAL) (FLUSHIELD 96-97) / WYETH WYETH PHARMACEUTICALS, INC - / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Guillain-Barre syndrome, Pain, GUILLAIN BARRE SYND, PAIN

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: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 897009012L

Write-up: pt recv vax 24SEP94 & allegedly dx w/GBS on 19OCT94;as a result of GBS pt suffered pain & permanent disability;hosp is presumed, although not documented;this is a serious, labelled event;


Changed on 8/31/2010

VAERS ID: 94044 Before After
VAERS Form:
Age:
Sex:Male
Location:Kansas
Vaccinated:1994-09-24
Onset:1994-10-19
Submitted:1996-12-16
Entered:1997-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 96-97) INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Pain

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: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897009012L

Write-up: pt recv vax 24SEP94 & allegedly dx w/GBS on 19OCT94;as a result of GBS pt suffered pain & permanent disability;hosp is presumed, although not documented;this is a serious, labelled event;


Changed on 7/7/2013

VAERS ID: 94044 Before After
VAERS Form:
Age:
Sex:Male
Location:Kansas
Vaccinated:1994-09-24
Onset:1994-10-19
Submitted:1996-12-16
Entered:1997-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Pain

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: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897009012L

Write-up: pt recv vax 24SEP94 & allegedly dx w/GBS on 19OCT94;as a result of GBS pt suffered pain & permanent disability;hosp is presumed, although not documented;this is a serious, labelled event;


Changed on 5/14/2017

VAERS ID: 94044 Before After
VAERS Form:
Age:
Sex:Male
Location:Kansas
Vaccinated:1994-09-24
Onset:1994-10-19
Submitted:1996-12-16
Entered:1997-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Pain

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: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897009012L

Write-up: pt recv vax 24SEP94 & allegedly dx w/GBS on 19OCT94;as a result of GBS pt suffered pain & permanent disability;hosp is presumed, although not documented;this is a serious, labelled event;


Changed on 9/14/2017

VAERS ID: 94044 Before After
VAERS Form:(blank) 1
Age:
Sex:Male
Location:Kansas
Vaccinated:1994-09-24
Onset:1994-10-19
Submitted:1996-12-16
Entered:1997-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / - UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Pain

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: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897009012L

Write-up: pt recv vax 24SEP94 & allegedly dx w/GBS on 19OCT94;as a result of GBS pt suffered pain & permanent disability;hosp is presumed, although not documented;this is a serious, labelled event;


Changed on 2/14/2018

VAERS ID: 94044 Before After
VAERS Form:1
Age:
Sex:Male
Location:Kansas
Vaccinated:1994-09-24
Onset:1994-10-19
Submitted:1996-12-16
Entered:1997-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Pain

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: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897009012L

Write-up: pt recv vax 24SEP94 & allegedly dx w/GBS on 19OCT94;as a result of GBS pt suffered pain & permanent disability;hosp is presumed, although not documented;this is a serious, labelled event;


Changed on 6/14/2018

VAERS ID: 94044 Before After
VAERS Form:1
Age:
Sex:Male
Location:Kansas
Vaccinated:1994-09-24
Onset:1994-10-19
Submitted:1996-12-16
Entered:1997-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Pain

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: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897009012L

Write-up: pt recv vax 24SEP94 & allegedly dx w/GBS on 19OCT94;as a result of GBS pt suffered pain & permanent disability;hosp is presumed, although not documented;this is a serious, labelled event;


Changed on 8/14/2018

VAERS ID: 94044 Before After
VAERS Form:1
Age:
Sex:Male
Location:Kansas
Vaccinated:1994-09-24
Onset:1994-10-19
Submitted:1996-12-16
Entered:1997-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Pain

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: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897009012L

Write-up: pt recv vax 24SEP94 & allegedly dx w/GBS on 19OCT94;as a result of GBS pt suffered pain & permanent disability;hosp is presumed, although not documented;this is a serious, labelled event;


Changed on 9/14/2018

VAERS ID: 94044 Before After
VAERS Form:1
Age:
Sex:Male
Location:Kansas
Vaccinated:1994-09-24
Onset:1994-10-19
Submitted:1996-12-16
Entered:1997-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Pain

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: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897009012L

Write-up: pt recv vax 24SEP94 & allegedly dx w/GBS on 19OCT94;as a result of GBS pt suffered pain & permanent disability;hosp is presumed, although not documented;this is a serious, labelled event;


Changed on 10/14/2018

VAERS ID: 94044 Before After
VAERS Form:1
Age:
Sex:Male
Location:Kansas
Vaccinated:1994-09-24
Onset:1994-10-19
Submitted:1996-12-16
Entered:1997-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Pain

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: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897009012L

Write-up: pt recv vax 24SEP94 & allegedly dx w/GBS on 19OCT94;as a result of GBS pt suffered pain & permanent disability;hosp is presumed, although not documented;this is a serious, labelled event;


Changed on 12/24/2020

VAERS ID: 94044 Before After
VAERS Form:1
Age:
Sex:Male
Location:Kansas
Vaccinated:1994-09-24
Onset:1994-10-19
Submitted:1996-12-16
Entered:1997-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Pain

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: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897009012L

Write-up: pt recv vax 24SEP94 & allegedly dx w/GBS on 19OCT94;as a result of GBS pt suffered pain & permanent disability;hosp is presumed, although not documented;this is a serious, labelled event;


Changed on 12/30/2020

VAERS ID: 94044 Before After
VAERS Form:1
Age:
Sex:Male
Location:Kansas
Vaccinated:1994-09-24
Onset:1994-10-19
Submitted:1996-12-16
Entered:1997-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Pain

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: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897009012L

Write-up: pt recv vax 24SEP94 & allegedly dx w/GBS on 19OCT94;as a result of GBS pt suffered pain & permanent disability;hosp is presumed, although not documented;this is a serious, labelled event;


Changed on 5/7/2021

VAERS ID: 94044 Before After
VAERS Form:1
Age:
Sex:Male
Location:Kansas
Vaccinated:1994-09-24
Onset:1994-10-19
Submitted:1996-12-16
Entered:1997-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Pain

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: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897009012L

Write-up: pt recv vax 24SEP94 & allegedly dx w/GBS on 19OCT94;as a result of GBS pt suffered pain & permanent disability;hosp is presumed, although not documented;this is a serious, labelled event;


Changed on 5/14/2021

VAERS ID: 94044 Before After
VAERS Form:1
Age:
Sex:Male
Location:Kansas
Vaccinated:1994-09-24
Onset:1994-10-19
Submitted:1996-12-16
Entered:1997-01-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Guillain-Barre syndrome, Pain

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: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 897009012L

Write-up: pt recv vax 24SEP94 & allegedly dx w/GBS on 19OCT94;as a result of GBS pt suffered pain & permanent disability;hosp is presumed, although not documented;this is a serious, labelled event;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=94044&WAYBACKHISTORY=ON


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