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This is VAERS ID 116125

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 116125
VAERS Form:
Age:24.3
Sex:Male
Location:Unknown
Vaccinated:1998-10-16
Onset:1998-10-17
Submitted:1998-10-21
Entered:1998-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX ADSORBED / MICHIGAN DPH FAV017 / 2 LA / SC
FLU: FLUSHIELD 1998-1999 / WYETH 4988247 / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: EDEMA INJECT SITE, PAIN INJECT SITE, HYSN INJECT SITE, VASODILAT

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax & exp large swelling from the site of inj down to mid forearm;redness from site of inj down to the elbow;pt given med;pt was adm to hosp on 20OCT98;inj site erythema, 1-5cm diameter mild tenderness w/in24hr;


Changed on 12/8/2009

VAERS ID: 116125 Before After
VAERS Form:
Age:24.3
Sex:Male
Location:Unknown
Vaccinated:1998-10-16
Onset:1998-10-17
Submitted:1998-10-21
Entered:1998-11-12 1998-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX ADSORBED ANTHRAX (NO BRAND NAME) / MICHIGAN DPH MICHIGAN DEPT PUB HLTH FAV017 / 2 LA / SC
FLU: FLUSHIELD 1998-1999 INFLUENZA (SEASONAL) (FLUSHIELD 98-99) / WYETH WYETH PHARMACEUTICALS, INC 4988247 / - - / IM

Administered by: Other      Purchased by: Unknown Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation, EDEMA INJECT SITE, PAIN INJECT SITE, HYSN INJECT SITE, VASODILAT

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax & exp large swelling from the site of inj down to mid forearm;redness from site of inj down to the elbow;pt given med;pt was adm to hosp on 20OCT98;inj site erythema, 1-5cm diameter mild tenderness w/in24hr;


Changed on 8/31/2010

VAERS ID: 116125 Before After
VAERS Form:
Age:24.3
Sex:Male
Location:Unknown
Vaccinated:1998-10-16
Onset:1998-10-17
Submitted:1998-10-21
Entered:1998-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV017 / 2 LA / SC
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 98-99) INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4988247 / - - / IM

Administered by: Other      Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax & exp large swelling from the site of inj down to mid forearm;redness from site of inj down to the elbow;pt given med;pt was adm to hosp on 20OCT98;inj site erythema, 1-5cm diameter mild tenderness w/in24hr;


Changed on 11/14/2011

VAERS ID: 116125 Before After
VAERS Form:
Age:24.3 24.0
Sex:Male
Location:Unknown
Vaccinated:1998-10-16
Onset:1998-10-17
Submitted:1998-10-21
Entered:1998-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV017 / 2 LA / SC
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4988247 / - - UN / IM

Administered by: Other      Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax & exp large swelling from the site of inj down to mid forearm;redness from site of inj down to the elbow;pt given med;pt was adm to hosp on 20OCT98;inj site erythema, 1-5cm diameter mild tenderness w/in24hr;


Changed on 7/7/2013

VAERS ID: 116125 Before After
VAERS Form:
Age:24.0
Sex:Male
Location:Unknown
Vaccinated:1998-10-16
Onset:1998-10-17
Submitted:1998-10-21
Entered:1998-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV017 / 2 LA / SC
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4988247 / - UN / IM
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4988247 / - UN / IM

Administered by: Other      Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax & exp large swelling from the site of inj down to mid forearm;redness from site of inj down to the elbow;pt given med;pt was adm to hosp on 20OCT98;inj site erythema, 1-5cm diameter mild tenderness w/in24hr;


Changed on 6/14/2014

VAERS ID: 116125 Before After
VAERS Form:
Age:24.0
Sex:Male
Location:Unknown
Vaccinated:1998-10-16
Onset:1998-10-17
Submitted:1998-10-21
Entered:1998-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV017 / 2 LA / SC
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4988247 / - UN / IM

Administered by: Other      Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax & exp large swelling from the site of inj down to mid forearm;redness from site of inj down to the elbow;pt given med;pt was adm to hosp on 20OCT98;inj site erythema, 1-5cm diameter mild tenderness w/in24hr;


Changed on 5/14/2017

VAERS ID: 116125 Before After
VAERS Form:
Age:24.0
Sex:Male
Location:Unknown
Vaccinated:1998-10-16
Onset:1998-10-17
Submitted:1998-10-21
Entered:1998-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV017 / 2 LA / SC
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4988247 / - UN / IM

Administered by: Other      Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax & exp large swelling from the site of inj down to mid forearm;redness from site of inj down to the elbow;pt given med;pt was adm to hosp on 20OCT98;inj site erythema, 1-5cm diameter mild tenderness w/in24hr;


Changed on 9/14/2017

VAERS ID: 116125 Before After
VAERS Form:(blank) 1
Age:24.0
Sex:Male
Location:Unknown
Vaccinated:1998-10-16
Onset:1998-10-17
Submitted:1998-10-21
Entered:1998-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV017 / 2 3 LA / SC
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4988247 / - UNK UN / IM

Administered by: Other      Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax & exp large swelling from the site of inj down to mid forearm;redness from site of inj down to the elbow;pt given med;pt was adm to hosp on 20OCT98;inj site erythema, 1-5cm diameter mild tenderness w/in24hr;


Changed on 2/14/2018

VAERS ID: 116125 Before After
VAERS Form:1
Age:24.0
Sex:Male
Location:Unknown
Vaccinated:1998-10-16
Onset:1998-10-17
Submitted:1998-10-21
Entered:1998-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV017 / 3 LA / SC
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4988247 / UNK UN / IM

Administered by: Other      Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax & exp large swelling from the site of inj down to mid forearm;redness from site of inj down to the elbow;pt given med;pt was adm to hosp on 20OCT98;inj site erythema, 1-5cm diameter mild tenderness w/in24hr;


Changed on 6/14/2018

VAERS ID: 116125 Before After
VAERS Form:1
Age:24.0
Sex:Male
Location:Unknown
Vaccinated:1998-10-16
Onset:1998-10-17
Submitted:1998-10-21
Entered:1998-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV017 / 3 LA / SC
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4988247 / UNK UN / IM

Administered by: Other      Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax & exp large swelling from the site of inj down to mid forearm;redness from site of inj down to the elbow;pt given med;pt was adm to hosp on 20OCT98;inj site erythema, 1-5cm diameter mild tenderness w/in24hr;


Changed on 8/14/2018

VAERS ID: 116125 Before After
VAERS Form:1
Age:24.0
Sex:Male
Location:Unknown
Vaccinated:1998-10-16
Onset:1998-10-17
Submitted:1998-10-21
Entered:1998-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV017 / 3 LA / SC
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4988247 / UNK UN / IM

Administered by: Other      Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax & exp large swelling from the site of inj down to mid forearm;redness from site of inj down to the elbow;pt given med;pt was adm to hosp on 20OCT98;inj site erythema, 1-5cm diameter mild tenderness w/in24hr;


Changed on 9/14/2018

VAERS ID: 116125 Before After
VAERS Form:1
Age:24.0
Sex:Male
Location:Unknown
Vaccinated:1998-10-16
Onset:1998-10-17
Submitted:1998-10-21
Entered:1998-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV017 / 3 LA / SC
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4988247 / UNK UN / IM

Administered by: Other      Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax & exp large swelling from the site of inj down to mid forearm;redness from site of inj down to the elbow;pt given med;pt was adm to hosp on 20OCT98;inj site erythema, 1-5cm diameter mild tenderness w/in24hr;


Changed on 10/14/2018

VAERS ID: 116125 Before After
VAERS Form:1
Age:24.0
Sex:Male
Location:Unknown
Vaccinated:1998-10-16
Onset:1998-10-17
Submitted:1998-10-21
Entered:1998-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV017 / 3 LA / SC
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4988247 / UNK UN / IM

Administered by: Other      Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax & exp large swelling from the site of inj down to mid forearm;redness from site of inj down to the elbow;pt given med;pt was adm to hosp on 20OCT98;inj site erythema, 1-5cm diameter mild tenderness w/in24hr;

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