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This is VAERS ID 105751

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 105751
VAERS Form:
Age:34.4
Sex:Female
Location:California
Vaccinated:1995-10-03
Onset:1995-10-04
Submitted:0000-00-00
Entered:1997-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1997-1998 / CONNAUGHT LABS 5F61113 / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: MALAISE, PARESTHESIA, LAB TEST ABNORM, MYASTHENIA, ARTHRITIS RHEUMAT

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: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC 'Split Type':

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;


Changed on 12/8/2009

VAERS ID: 105751 Before After
VAERS Form:
Age:34.4
Sex:Female
Location:California
Vaccinated:1995-10-03
Onset:1995-10-04
Submitted:0000-00-00
Entered:1997-12-18 1997-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1997-1998 INFLUENZA (SEASONAL) (FLUZONE 97-98) / CONNAUGHT LABS CONNAUGHT LABORATORIES 5F61113 / 2 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Condition aggravated, Laboratory test abnormal, Malaise, Myasthenic syndrome, Paraesthesia, Rheumatoid arthritis, Tenosynovitis, Thrombocytopenia, MALAISE, PARESTHESIA, LAB TEST ABNORM, MYASTHENIA, ARTHRITIS RHEUMAT

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: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC 'Split Type':

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;


Changed on 8/31/2010

VAERS ID: 105751 Before After
VAERS Form:
Age:34.4
Sex:Female
Location:California
Vaccinated:1995-10-03
Onset:1995-10-04
Submitted:0000-00-00
Entered:1997-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 97-98) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61113 / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Laboratory test abnormal, Malaise, Myasthenic syndrome, Paraesthesia, Rheumatoid arthritis, Tenosynovitis, Thrombocytopenia

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: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC 'Split Type':

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;


Changed on 7/7/2013

VAERS ID: 105751 Before After
VAERS Form:
Age:34.4
Sex:Female
Location:California
Vaccinated:1995-10-03
Onset:1995-10-04
Submitted:0000-00-00
Entered:1997-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61113 / 2 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61113 / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Laboratory test abnormal, Malaise, Myasthenic syndrome, Paraesthesia, Rheumatoid arthritis, Tenosynovitis, Thrombocytopenia

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: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC 'Split Type':

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;


Changed on 2/14/2017

VAERS ID: 105751 Before After
VAERS Form:
Age:34.4 34.0
Sex:Female
Location:California
Vaccinated:1995-10-03
Onset:1995-10-04
Submitted:0000-00-00
Entered:1997-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61113 / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Laboratory test abnormal, Malaise, Myasthenic syndrome, Paraesthesia, Rheumatoid arthritis, Tenosynovitis, Thrombocytopenia

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: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC 'Split Type':

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;


Changed on 5/14/2017

VAERS ID: 105751 Before After
VAERS Form:
Age:34.0
Sex:Female
Location:California
Vaccinated:1995-10-03
Onset:1995-10-04
Submitted:0000-00-00
Entered:1997-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61113 / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Laboratory test abnormal, Malaise, Myasthenic syndrome, Paraesthesia, Rheumatoid arthritis, Tenosynovitis, Thrombocytopenia

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: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC 'Split Type':

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;


Changed on 9/14/2017

VAERS ID: 105751 Before After
VAERS Form:(blank) 1
Age:34.0
Sex:Female
Location:California
Vaccinated:1995-10-03
Onset:1995-10-04
Submitted:0000-00-00
Entered:1997-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61113 / 2 3 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Laboratory test abnormal, Malaise, Myasthenic syndrome, Paraesthesia, Rheumatoid arthritis, Tenosynovitis, Thrombocytopenia

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: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC 'Split Type':

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;


Changed on 2/14/2018

VAERS ID: 105751 Before After
VAERS Form:1
Age:34.0
Sex:Female
Location:California
Vaccinated:1995-10-03
Onset:1995-10-04
Submitted:0000-00-00
Entered:1997-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61113 / 3 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Laboratory test abnormal, Malaise, Myasthenic syndrome, Paraesthesia, Rheumatoid arthritis, Tenosynovitis, Thrombocytopenia

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: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC 'Split Type':

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;


Changed on 6/14/2018

VAERS ID: 105751 Before After
VAERS Form:1
Age:34.0
Sex:Female
Location:California
Vaccinated:1995-10-03
Onset:1995-10-04
Submitted:0000-00-00
Entered:1997-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61113 / 3 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Laboratory test abnormal, Malaise, Myasthenic syndrome, Paraesthesia, Rheumatoid arthritis, Tenosynovitis, Thrombocytopenia

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: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC 'Split Type':

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;


Changed on 8/14/2018

VAERS ID: 105751 Before After
VAERS Form:1
Age:34.0
Sex:Female
Location:California
Vaccinated:1995-10-03
Onset:1995-10-04
Submitted:0000-00-00
Entered:1997-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61113 / 3 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Laboratory test abnormal, Malaise, Myasthenic syndrome, Paraesthesia, Rheumatoid arthritis, Tenosynovitis, Thrombocytopenia

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: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC 'Split Type':

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;


Changed on 9/14/2018

VAERS ID: 105751 Before After
VAERS Form:1
Age:34.0
Sex:Female
Location:California
Vaccinated:1995-10-03
Onset:1995-10-04
Submitted:0000-00-00
Entered:1997-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61113 / 3 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Laboratory test abnormal, Malaise, Myasthenic syndrome, Paraesthesia, Rheumatoid arthritis, Tenosynovitis, Thrombocytopenia

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: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC 'Split Type':

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;


Changed on 10/14/2018

VAERS ID: 105751 Before After
VAERS Form:1
Age:34.0
Sex:Female
Location:California
Vaccinated:1995-10-03
Onset:1995-10-04
Submitted:0000-00-00
Entered:1997-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61113 / 3 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Laboratory test abnormal, Malaise, Myasthenic syndrome, Paraesthesia, Rheumatoid arthritis, Tenosynovitis, Thrombocytopenia

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: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC 'Split Type':

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;


Changed on 12/24/2020

VAERS ID: 105751 Before After
VAERS Form:1
Age:34.0
Sex:Female
Location:California
Vaccinated:1995-10-03
Onset:1995-10-04
Submitted:0000-00-00
Entered:1997-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61113 / 3 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Laboratory test abnormal, Malaise, Myasthenic syndrome, Paraesthesia, Rheumatoid arthritis, Tenosynovitis, Thrombocytopenia

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: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC 'Split Type':

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;


Changed on 12/30/2020

VAERS ID: 105751 Before After
VAERS Form:1
Age:34.0
Sex:Female
Location:California
Vaccinated:1995-10-03
Onset:1995-10-04
Submitted:0000-00-00
Entered:1997-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61113 / 3 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Laboratory test abnormal, Malaise, Myasthenic syndrome, Paraesthesia, Rheumatoid arthritis, Tenosynovitis, Thrombocytopenia

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: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC 'Split Type':

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;


Changed on 5/7/2021

VAERS ID: 105751 Before After
VAERS Form:1
Age:34.0
Sex:Female
Location:California
Vaccinated:1995-10-03
Onset:1995-10-04
Submitted:0000-00-00
Entered:1997-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61113 / 3 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Laboratory test abnormal, Malaise, Myasthenic syndrome, Paraesthesia, Rheumatoid arthritis, Tenosynovitis, Thrombocytopenia

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: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC 'Split Type':

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;


Changed on 5/14/2021

VAERS ID: 105751 Before After
VAERS Form:1
Age:34.0
Sex:Female
Location:California
Vaccinated:1995-10-03
Onset:1995-10-04
Submitted:0000-00-00
Entered:1997-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 5F61113 / 3 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Condition aggravated, Laboratory test abnormal, Malaise, Myasthenic syndrome, Paraesthesia, Rheumatoid arthritis, Tenosynovitis, Thrombocytopenia

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: NONE
Preexisting Conditions: rheumatoid arthritis;
Allergies:
Diagnostic Lab Data: low blood platelets;elevated rheumatoid factor;carpal tunnel synd
CDC 'Split Type':

Write-up: muscle fatigue/overall malaise poss rheumatoid arthritis recently dx;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=105751&WAYBACKHISTORY=ON


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