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This is VAERS ID 664115

History of Changes from the VAERS Wayback Machine

First Appeared on 12/14/2016

VAERS ID: 664115
VAERS Form:
Age:82.0
Gender:Female
Location:Vermont
Vaccinated:2016-09-02
Onset:2016-09-02
Submitted:2016-11-03
Entered:2016-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR UI659AA / - LA / UN

Administered by: Other      Purchased by: Private
Symptoms: Abdominal pain upper, Chills, Headache, Pneumonia, Red blood cell count, Tremor, X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine; lorazepam; CRESTOR; levothyroxine
Current Illness: None known
Preexisting Conditions: None known
Allergies:
Diagnostic Lab Data: blood work (RBC), x-rays
CDC 'Split Type':

Write-up: Headache, shaking/shivers, stomach aches, went to ER on 9/18, had blood work done treated for pneumonia (with Z-pack) and for RBC.


Changed on 9/14/2017

VAERS ID: 664115 Before After
VAERS Form:(blank) 1
Age:82.0
Gender:Female
Location:Vermont
Vaccinated:2016-09-02
Onset:2016-09-02
Submitted:2016-11-03
Entered:2016-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR UI659AA / - UNK LA / UN

Administered by: Other      Purchased by: Private
Symptoms: Abdominal pain upper, Chills, Headache, Pneumonia, Red blood cell count, Tremor, X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine; lorazepam; CRESTOR; levothyroxine
Current Illness: None known
Preexisting Conditions: None known
Allergies:
Diagnostic Lab Data: blood work (RBC), x-rays
CDC 'Split Type':

Write-up: Headache, shaking/shivers, stomach aches, went to ER on 9/18, had blood work done treated for pneumonia (with Z-pack) and for RBC.


Changed on 2/14/2018

VAERS ID: 664115 Before After
VAERS Form:1
Age:82.0
Gender:Female
Location:Vermont
Vaccinated:2016-09-02
Onset:2016-09-02
Submitted:2016-11-03
Entered:2016-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR UI659AA / UNK LA / UN

Administered by: Other      Purchased by: Private
Symptoms: Abdominal pain upper, Chills, Headache, Pneumonia, Red blood cell count, Tremor, X-ray

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine; lorazepam; CRESTOR; levothyroxine
Current Illness: None known
Preexisting Conditions: None known
Allergies:
Diagnostic Lab Data: blood work (RBC), x-rays
CDC 'Split Type':

Write-up: Headache, shaking/shivers, stomach aches, went to ER on 9/18, had blood work done treated for pneumonia (with Z-pack) and for RBC.


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Link To This Search Result:

http://medalerts.org/vaersdb/findfield.php?IDNUMBER=664115&WAYBACKHISTORY=ON


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