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This is VAERS ID 172356

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 172356
VAERS Form:
Age:79.0
Sex:Female
Location:Arizona
Vaccinated:1998-12-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:2001-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE 98-99) / CONNAUGHT LABS - / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, DYSPNEA, DIARRHEA, ANAPHYL, ELECTROLYTE DEPLET

Life Threatening? No
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: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electrolyte drop, and more, etc.
CDC 'Split Type':

Write-up: General paralysis, cloudiness of mind, breathing difficulties, bloating, chronic colds, flu, runny nose, phlegm, aches, pains in muscles, excessive diarrhea, nervousness, headaches, fever, anaphylaxis and more, etc.


Changed on 12/8/2009

VAERS ID: 172356 Before After
VAERS Form:
Age:79.0
Sex:Female
Location:Arizona
Vaccinated:1998-12-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:2001-06-26 2001-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE 98-99) INFLUENZA (SEASONAL) (FLUZONE 98-99) / CONNAUGHT LABS CONNAUGHT LABORATORIES - / - - / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Abdominal distension, Anaphylactic reaction, Diarrhoea, Dyspnoea, Electrolyte depletion, Headache, Influenza, Nasopharyngitis, Nervousness, Pain, Paralysis, Pyrexia, Rhinorrhoea, Bradyphrenia, FEVER, DYSPNEA, DIARRHEA, ANAPHYL, ELECTROLYTE DEPLET

Life Threatening? No
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: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electrolyte drop, and more, etc.
CDC 'Split Type':

Write-up: General paralysis, cloudiness of mind, breathing difficulties, bloating, chronic colds, flu, runny nose, phlegm, aches, pains in muscles, excessive diarrhea, nervousness, headaches, fever, anaphylaxis and more, etc.


Changed on 8/31/2010

VAERS ID: 172356 Before After
VAERS Form:
Age:79.0
Sex:Female
Location:Arizona
Vaccinated:1998-12-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:2001-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 98-99) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Anaphylactic reaction, Diarrhoea, Dyspnoea, Electrolyte depletion, Headache, Influenza, Nasopharyngitis, Nervousness, Pain, Paralysis, Pyrexia, Rhinorrhoea, Bradyphrenia

Life Threatening? No
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: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electrolyte drop, and more, etc.
CDC 'Split Type':

Write-up: General paralysis, cloudiness of mind, breathing difficulties, bloating, chronic colds, flu, runny nose, phlegm, aches, pains in muscles, excessive diarrhea, nervousness, headaches, fever, anaphylaxis and more, etc.


Changed on 7/7/2013

VAERS ID: 172356 Before After
VAERS Form:
Age:79.0
Sex:Female
Location:Arizona
Vaccinated:1998-12-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:2001-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - - / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Anaphylactic reaction, Diarrhoea, Dyspnoea, Electrolyte depletion, Headache, Influenza, Nasopharyngitis, Nervousness, Pain, Paralysis, Pyrexia, Rhinorrhoea, Bradyphrenia

Life Threatening? No
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: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electrolyte drop, and more, etc.
CDC 'Split Type':

Write-up: General paralysis, cloudiness of mind, breathing difficulties, bloating, chronic colds, flu, runny nose, phlegm, aches, pains in muscles, excessive diarrhea, nervousness, headaches, fever, anaphylaxis and more, etc.


Changed on 9/14/2017

VAERS ID: 172356 Before After
VAERS Form:(blank) 1
Age:79.0
Sex:Female
Location:Arizona
Vaccinated:1998-12-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:2001-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Anaphylactic reaction, Diarrhoea, Dyspnoea, Electrolyte depletion, Headache, Influenza, Nasopharyngitis, Nervousness, Pain, Paralysis, Pyrexia, Rhinorrhoea, Bradyphrenia

Life Threatening? No
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: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electrolyte drop, and more, etc.
CDC 'Split Type':

Write-up: General paralysis, cloudiness of mind, breathing difficulties, bloating, chronic colds, flu, runny nose, phlegm, aches, pains in muscles, excessive diarrhea, nervousness, headaches, fever, anaphylaxis and more, etc.


Changed on 2/14/2018

VAERS ID: 172356 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Arizona
Vaccinated:1998-12-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:2001-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Anaphylactic reaction, Diarrhoea, Dyspnoea, Electrolyte depletion, Headache, Influenza, Nasopharyngitis, Nervousness, Pain, Paralysis, Pyrexia, Rhinorrhoea, Bradyphrenia

Life Threatening? No
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: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electrolyte drop, and more, etc.
CDC 'Split Type':

Write-up: General paralysis, cloudiness of mind, breathing difficulties, bloating, chronic colds, flu, runny nose, phlegm, aches, pains in muscles, excessive diarrhea, nervousness, headaches, fever, anaphylaxis and more, etc.


Changed on 6/14/2018

VAERS ID: 172356 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Arizona
Vaccinated:1998-12-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:2001-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Anaphylactic reaction, Diarrhoea, Dyspnoea, Electrolyte depletion, Headache, Influenza, Nasopharyngitis, Nervousness, Pain, Paralysis, Pyrexia, Rhinorrhoea, Bradyphrenia

Life Threatening? No
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: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electrolyte drop, and more, etc.
CDC 'Split Type':

Write-up: General paralysis, cloudiness of mind, breathing difficulties, bloating, chronic colds, flu, runny nose, phlegm, aches, pains in muscles, excessive diarrhea, nervousness, headaches, fever, anaphylaxis and more, etc.


Changed on 8/14/2018

VAERS ID: 172356 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Arizona
Vaccinated:1998-12-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:2001-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Anaphylactic reaction, Diarrhoea, Dyspnoea, Electrolyte depletion, Headache, Influenza, Nasopharyngitis, Nervousness, Pain, Paralysis, Pyrexia, Rhinorrhoea, Bradyphrenia

Life Threatening? No
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: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electrolyte drop, and more, etc.
CDC 'Split Type':

Write-up: General paralysis, cloudiness of mind, breathing difficulties, bloating, chronic colds, flu, runny nose, phlegm, aches, pains in muscles, excessive diarrhea, nervousness, headaches, fever, anaphylaxis and more, etc.


Changed on 9/14/2018

VAERS ID: 172356 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Arizona
Vaccinated:1998-12-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:2001-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Anaphylactic reaction, Diarrhoea, Dyspnoea, Electrolyte depletion, Headache, Influenza, Nasopharyngitis, Nervousness, Pain, Paralysis, Pyrexia, Rhinorrhoea, Bradyphrenia

Life Threatening? No
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: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electrolyte drop, and more, etc.
CDC 'Split Type':

Write-up: General paralysis, cloudiness of mind, breathing difficulties, bloating, chronic colds, flu, runny nose, phlegm, aches, pains in muscles, excessive diarrhea, nervousness, headaches, fever, anaphylaxis and more, etc.


Changed on 10/14/2018

VAERS ID: 172356 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Arizona
Vaccinated:1998-12-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:2001-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Anaphylactic reaction, Diarrhoea, Dyspnoea, Electrolyte depletion, Headache, Influenza, Nasopharyngitis, Nervousness, Pain, Paralysis, Pyrexia, Rhinorrhoea, Bradyphrenia

Life Threatening? No
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: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electrolyte drop, and more, etc.
CDC 'Split Type':

Write-up: General paralysis, cloudiness of mind, breathing difficulties, bloating, chronic colds, flu, runny nose, phlegm, aches, pains in muscles, excessive diarrhea, nervousness, headaches, fever, anaphylaxis and more, etc.


Changed on 12/24/2020

VAERS ID: 172356 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Arizona
Vaccinated:1998-12-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:2001-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Anaphylactic reaction, Diarrhoea, Dyspnoea, Electrolyte depletion, Headache, Influenza, Nasopharyngitis, Nervousness, Pain, Paralysis, Pyrexia, Rhinorrhoea, Bradyphrenia

Life Threatening? No
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: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electrolyte drop, and more, etc.
CDC 'Split Type':

Write-up: General paralysis, cloudiness of mind, breathing difficulties, bloating, chronic colds, flu, runny nose, phlegm, aches, pains in muscles, excessive diarrhea, nervousness, headaches, fever, anaphylaxis and more, etc.


Changed on 12/30/2020

VAERS ID: 172356 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Arizona
Vaccinated:1998-12-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:2001-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Anaphylactic reaction, Diarrhoea, Dyspnoea, Electrolyte depletion, Headache, Influenza, Nasopharyngitis, Nervousness, Pain, Paralysis, Pyrexia, Rhinorrhoea, Bradyphrenia

Life Threatening? No
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: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electrolyte drop, and more, etc.
CDC 'Split Type':

Write-up: General paralysis, cloudiness of mind, breathing difficulties, bloating, chronic colds, flu, runny nose, phlegm, aches, pains in muscles, excessive diarrhea, nervousness, headaches, fever, anaphylaxis and more, etc.


Changed on 5/7/2021

VAERS ID: 172356 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Arizona
Vaccinated:1998-12-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:2001-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Anaphylactic reaction, Diarrhoea, Dyspnoea, Electrolyte depletion, Headache, Influenza, Nasopharyngitis, Nervousness, Pain, Paralysis, Pyrexia, Rhinorrhoea, Bradyphrenia

Life Threatening? No
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: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electrolyte drop, and more, etc.
CDC 'Split Type':

Write-up: General paralysis, cloudiness of mind, breathing difficulties, bloating, chronic colds, flu, runny nose, phlegm, aches, pains in muscles, excessive diarrhea, nervousness, headaches, fever, anaphylaxis and more, etc.


Changed on 5/14/2021

VAERS ID: 172356 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:Arizona
Vaccinated:1998-12-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:2001-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Anaphylactic reaction, Diarrhoea, Dyspnoea, Electrolyte depletion, Headache, Influenza, Nasopharyngitis, Nervousness, Pain, Paralysis, Pyrexia, Rhinorrhoea, Bradyphrenia

Life Threatening? No
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: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electrolyte drop, and more, etc.
CDC 'Split Type':

Write-up: General paralysis, cloudiness of mind, breathing difficulties, bloating, chronic colds, flu, runny nose, phlegm, aches, pains in muscles, excessive diarrhea, nervousness, headaches, fever, anaphylaxis and more, etc.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=172356&WAYBACKHISTORY=ON


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