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This is VAERS ID 107151

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 107151
VAERS Form:
Age:57.3
Sex:Female
Location:Ohio
Vaccinated:1997-11-04
Onset:1997-11-06
Submitted:1998-01-27
Entered:1998-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1997-1998 / CONNAUGHT LABS 7F81916 / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: FEVER, SOMNOLENCE, ASTHENIA, HYPERCHOLESTEREM, NEOPL BREAST

Life Threatening? Yes
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? No
Previous Vaccinations: NONE
Other Medications: folic acid;MVI;Caltrate;Sulfasalazine
Current Illness: cold
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: mamogram;blood work
CDC 'Split Type': NONE

Write-up: w/in 2 days had lethargy & fatigue w/low grade fever;cont till 3JAN97 & then lifted;mammogram in NOV showed lump;primary MD referred pt to MD-surgeon;dx w/breast cancer;26JAN97 pt had bilat modified mastectomy;c/o cholesterol inc since vax;


Changed on 12/8/2009

VAERS ID: 107151 Before After
VAERS Form:
Age:57.3
Sex:Female
Location:Ohio
Vaccinated:1997-11-04
Onset:1997-11-06
Submitted:1998-01-27
Entered:1998-02-05 1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1997-1998 INFLUENZA (SEASONAL) (FLUZONE 97-98) / CONNAUGHT LABS CONNAUGHT LABORATORIES 7F81916 / - LA / IM

Administered by: Public      Purchased by: Unknown Private
Symptoms: Asthenia, Breast neoplasm, Hypercholesterolaemia, Pyrexia, Somnolence, FEVER, SOMNOLENCE, ASTHENIA, HYPERCHOLESTEREM, NEOPL BREAST

Life Threatening? Yes
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? No
Previous Vaccinations: NONE
Other Medications: folic acid;MVI;Caltrate;Sulfasalazine
Current Illness: cold
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: mamogram;blood work
CDC 'Split Type': NONE (blank)

Write-up: w/in 2 days had lethargy & fatigue w/low grade fever;cont till 3JAN97 & then lifted;mammogram in NOV showed lump;primary MD referred pt to MD-surgeon;dx w/breast cancer;26JAN97 pt had bilat modified mastectomy;c/o cholesterol inc since vax;


Changed on 8/31/2010

VAERS ID: 107151 Before After
VAERS Form:
Age:57.3
Sex:Female
Location:Ohio
Vaccinated:1997-11-04
Onset:1997-11-06
Submitted:1998-01-27
Entered:1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 97-98) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81916 / - LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Asthenia, Breast neoplasm, Hypercholesterolaemia, Pyrexia, Somnolence

Life Threatening? Yes
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? No
Previous Vaccinations: NONE
Other Medications: folic acid;MVI;Caltrate;Sulfasalazine
Current Illness: cold
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: mamogram;blood work
CDC 'Split Type':

Write-up: w/in 2 days had lethargy & fatigue w/low grade fever;cont till 3JAN97 & then lifted;mammogram in NOV showed lump;primary MD referred pt to MD-surgeon;dx w/breast cancer;26JAN97 pt had bilat modified mastectomy;c/o cholesterol inc since vax;


Changed on 7/7/2013

VAERS ID: 107151 Before After
VAERS Form:
Age:57.3
Sex:Female
Location:Ohio
Vaccinated:1997-11-04
Onset:1997-11-06
Submitted:1998-01-27
Entered:1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81916 / - LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81916 / - LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Asthenia, Breast neoplasm, Hypercholesterolaemia, Pyrexia, Somnolence

Life Threatening? Yes
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? No
Previous Vaccinations: NONE
Other Medications: folic acid;MVI;Caltrate;Sulfasalazine
Current Illness: cold
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: mamogram;blood work
CDC 'Split Type':

Write-up: w/in 2 days had lethargy & fatigue w/low grade fever;cont till 3JAN97 & then lifted;mammogram in NOV showed lump;primary MD referred pt to MD-surgeon;dx w/breast cancer;26JAN97 pt had bilat modified mastectomy;c/o cholesterol inc since vax;


Changed on 2/14/2017

VAERS ID: 107151 Before After
VAERS Form:
Age:57.3 57.0
Sex:Female
Location:Ohio
Vaccinated:1997-11-04
Onset:1997-11-06
Submitted:1998-01-27
Entered:1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81916 / - LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Asthenia, Breast neoplasm, Hypercholesterolaemia, Pyrexia, Somnolence

Life Threatening? Yes
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? No
Previous Vaccinations: NONE
Other Medications: folic acid;MVI;Caltrate;Sulfasalazine
Current Illness: cold
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: mamogram;blood work
CDC 'Split Type':

Write-up: w/in 2 days had lethargy & fatigue w/low grade fever;cont till 3JAN97 & then lifted;mammogram in NOV showed lump;primary MD referred pt to MD-surgeon;dx w/breast cancer;26JAN97 pt had bilat modified mastectomy;c/o cholesterol inc since vax;


Changed on 5/14/2017

VAERS ID: 107151 Before After
VAERS Form:
Age:57.0
Sex:Female
Location:Ohio
Vaccinated:1997-11-04
Onset:1997-11-06
Submitted:1998-01-27
Entered:1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81916 / - LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Asthenia, Breast neoplasm, Hypercholesterolaemia, Pyrexia, Somnolence

Life Threatening? Yes
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? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: folic acid;MVI;Caltrate;Sulfasalazine
Current Illness: cold
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: mamogram;blood work
CDC 'Split Type':

Write-up: w/in 2 days had lethargy & fatigue w/low grade fever;cont till 3JAN97 & then lifted;mammogram in NOV showed lump;primary MD referred pt to MD-surgeon;dx w/breast cancer;26JAN97 pt had bilat modified mastectomy;c/o cholesterol inc since vax;


Changed on 9/14/2017

VAERS ID: 107151 Before After
VAERS Form:(blank) 1
Age:57.0
Sex:Female
Location:Ohio
Vaccinated:1997-11-04
Onset:1997-11-06
Submitted:1998-01-27
Entered:1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81916 / - UNK LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Asthenia, Breast neoplasm, Hypercholesterolaemia, Pyrexia, Somnolence

Life Threatening? Yes
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: folic acid;MVI;Caltrate;Sulfasalazine
Current Illness: cold
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: mamogram;blood work
CDC 'Split Type':

Write-up: w/in 2 days had lethargy & fatigue w/low grade fever;cont till 3JAN97 & then lifted;mammogram in NOV showed lump;primary MD referred pt to MD-surgeon;dx w/breast cancer;26JAN97 pt had bilat modified mastectomy;c/o cholesterol inc since vax;


Changed on 2/14/2018

VAERS ID: 107151 Before After
VAERS Form:1
Age:57.0
Sex:Female
Location:Ohio
Vaccinated:1997-11-04
Onset:1997-11-06
Submitted:1998-01-27
Entered:1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81916 / UNK LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Asthenia, Breast neoplasm, Hypercholesterolaemia, Pyrexia, Somnolence

Life Threatening? Yes
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: folic acid;MVI;Caltrate;Sulfasalazine
Current Illness: cold
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: mamogram;blood work
CDC 'Split Type':

Write-up: w/in 2 days had lethargy & fatigue w/low grade fever;cont till 3JAN97 & then lifted;mammogram in NOV showed lump;primary MD referred pt to MD-surgeon;dx w/breast cancer;26JAN97 pt had bilat modified mastectomy;c/o cholesterol inc since vax;


Changed on 6/14/2018

VAERS ID: 107151 Before After
VAERS Form:1
Age:57.0
Sex:Female
Location:Ohio
Vaccinated:1997-11-04
Onset:1997-11-06
Submitted:1998-01-27
Entered:1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81916 / UNK LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Asthenia, Breast neoplasm, Hypercholesterolaemia, Pyrexia, Somnolence

Life Threatening? Yes
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: folic acid;MVI;Caltrate;Sulfasalazine
Current Illness: cold
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: mamogram;blood work
CDC 'Split Type':

Write-up: w/in 2 days had lethargy & fatigue w/low grade fever;cont till 3JAN97 & then lifted;mammogram in NOV showed lump;primary MD referred pt to MD-surgeon;dx w/breast cancer;26JAN97 pt had bilat modified mastectomy;c/o cholesterol inc since vax;


Changed on 8/14/2018

VAERS ID: 107151 Before After
VAERS Form:1
Age:57.0
Sex:Female
Location:Ohio
Vaccinated:1997-11-04
Onset:1997-11-06
Submitted:1998-01-27
Entered:1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81916 / UNK LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Asthenia, Breast neoplasm, Hypercholesterolaemia, Pyrexia, Somnolence

Life Threatening? Yes
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: folic acid;MVI;Caltrate;Sulfasalazine
Current Illness: cold
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: mamogram;blood work
CDC 'Split Type':

Write-up: w/in 2 days had lethargy & fatigue w/low grade fever;cont till 3JAN97 & then lifted;mammogram in NOV showed lump;primary MD referred pt to MD-surgeon;dx w/breast cancer;26JAN97 pt had bilat modified mastectomy;c/o cholesterol inc since vax;


Changed on 9/14/2018

VAERS ID: 107151 Before After
VAERS Form:1
Age:57.0
Sex:Female
Location:Ohio
Vaccinated:1997-11-04
Onset:1997-11-06
Submitted:1998-01-27
Entered:1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81916 / UNK LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Asthenia, Breast neoplasm, Hypercholesterolaemia, Pyrexia, Somnolence

Life Threatening? Yes
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: folic acid;MVI;Caltrate;Sulfasalazine
Current Illness: cold
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: mamogram;blood work
CDC 'Split Type':

Write-up: w/in 2 days had lethargy & fatigue w/low grade fever;cont till 3JAN97 & then lifted;mammogram in NOV showed lump;primary MD referred pt to MD-surgeon;dx w/breast cancer;26JAN97 pt had bilat modified mastectomy;c/o cholesterol inc since vax;


Changed on 10/14/2018

VAERS ID: 107151 Before After
VAERS Form:1
Age:57.0
Sex:Female
Location:Ohio
Vaccinated:1997-11-04
Onset:1997-11-06
Submitted:1998-01-27
Entered:1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81916 / UNK LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Asthenia, Breast neoplasm, Hypercholesterolaemia, Pyrexia, Somnolence

Life Threatening? Yes
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: folic acid;MVI;Caltrate;Sulfasalazine
Current Illness: cold
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: mamogram;blood work
CDC 'Split Type':

Write-up: w/in 2 days had lethargy & fatigue w/low grade fever;cont till 3JAN97 & then lifted;mammogram in NOV showed lump;primary MD referred pt to MD-surgeon;dx w/breast cancer;26JAN97 pt had bilat modified mastectomy;c/o cholesterol inc since vax;


Changed on 12/24/2020

VAERS ID: 107151 Before After
VAERS Form:1
Age:57.0
Sex:Female
Location:Ohio
Vaccinated:1997-11-04
Onset:1997-11-06
Submitted:1998-01-27
Entered:1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81916 / UNK LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Asthenia, Breast neoplasm, Hypercholesterolaemia, Pyrexia, Somnolence

Life Threatening? Yes
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: folic acid;MVI;Caltrate;Sulfasalazine
Current Illness: cold
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: mamogram;blood work
CDC 'Split Type':

Write-up: w/in 2 days had lethargy & fatigue w/low grade fever;cont till 3JAN97 & then lifted;mammogram in NOV showed lump;primary MD referred pt to MD-surgeon;dx w/breast cancer;26JAN97 pt had bilat modified mastectomy;c/o cholesterol inc since vax;


Changed on 12/30/2020

VAERS ID: 107151 Before After
VAERS Form:1
Age:57.0
Sex:Female
Location:Ohio
Vaccinated:1997-11-04
Onset:1997-11-06
Submitted:1998-01-27
Entered:1998-02-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 7F81916 / UNK LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Asthenia, Breast neoplasm, Hypercholesterolaemia, Pyrexia, Somnolence

Life Threatening? Yes
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: folic acid;MVI;Caltrate;Sulfasalazine
Current Illness: cold
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: mamogram;blood work
CDC 'Split Type':

Write-up: w/in 2 days had lethargy & fatigue w/low grade fever;cont till 3JAN97 & then lifted;mammogram in NOV showed lump;primary MD referred pt to MD-surgeon;dx w/breast cancer;26JAN97 pt had bilat modified mastectomy;c/o cholesterol inc since vax;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=107151&WAYBACKHISTORY=ON


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