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This is VAERS ID 183890

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 183890
VAERS Form:
Age:
Sex:Female
Location:Kentucky
Vaccinated:2000-11-03
Onset:0000-00-00
Submitted:2002-05-20
Entered:2002-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUSHIELD) / WYETH LABORATORI U0421AA / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: PAIN, ANXIETY

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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up: An attorney alleges that a female received an injection of Flu Shield (200-2001 formula) on or about 11/03/2000 and subsequently suffered an unspecified serious and permanent bodily injury. It is alleged that she subsequently suffered physical and mental"pain, permanent bodily disfigurement, and permanent impairment of her ability to labor and earn money. No further info was available at the date of this report. The follow up states this report was determined to be a duplicate of report HQ5486904SEP2001.


Changed on 12/8/2009

VAERS ID: 183890 Before After
VAERS Form:
Age:
Sex:Female
Location:Kentucky
Vaccinated:2000-11-03
Onset:0000-00-00
Submitted:2002-05-20
Entered:2002-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUSHIELD) INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH LABORATORI WYETH PHARMACEUTICALS, INC U0421AA / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Pain, Emotional distress, PAIN, ANXIETY

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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) HQ1939019APR2002

Write-up: An attorney alleges that a female received an injection of Flu Shield (200-2001 formula) on or about 11/03/2000 and subsequently suffered an unspecified serious and permanent bodily injury. It is alleged that she subsequently suffered physical and mental"pain, mental pain, permanent bodily disfigurement, and permanent impairment of her ability to labor and earn money. No further info was available at the date of this report. The follow up states this report was determined to be a duplicate of report HQ5486904SEP2001.


Changed on 8/31/2010

VAERS ID: 183890 Before After
VAERS Form:
Age:
Sex:Female
Location:Kentucky
Vaccinated:2000-11-03
Onset:0000-00-00
Submitted:2002-05-20
Entered:2002-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH U0421AA / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Pain, Emotional distress

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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ1939019APR2002

Write-up: An attorney alleges that a female received an injection of Flu Shield (200-2001 formula) on or about 11/03/2000 and subsequently suffered an unspecified serious and permanent bodily injury. It is alleged that she subsequently suffered physical and mental pain, permanent bodily disfigurement, and permanent impairment of her ability to labor and earn money. No further info was available at the date of this report. The follow up states this report was determined to be a duplicate of report HQ5486904SEP2001.


Changed on 7/7/2013

VAERS ID: 183890 Before After
VAERS Form:
Age:
Sex:Female
Location:Kentucky
Vaccinated:2000-11-03
Onset:0000-00-00
Submitted:2002-05-20
Entered:2002-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH U0421AA / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH U0421AA / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Pain, Emotional distress

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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ1939019APR2002

Write-up: An attorney alleges that a female received an injection of Flu Shield (200-2001 formula) on or about 11/03/2000 and subsequently suffered an unspecified serious and permanent bodily injury. It is alleged that she subsequently suffered physical and mental pain, permanent bodily disfigurement, and permanent impairment of her ability to labor and earn money. No further info was available at the date of this report. The follow up states this report was determined to be a duplicate of report HQ5486904SEP2001.


Changed on 9/14/2017

VAERS ID: 183890 Before After
VAERS Form:(blank) 1
Age:
Sex:Female
Location:Kentucky
Vaccinated:2000-11-03
Onset:0000-00-00
Submitted:2002-05-20
Entered:2002-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH U0421AA / - UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Pain, Emotional distress

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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ1939019APR2002

Write-up: An attorney alleges that a female received an injection of Flu Shield (200-2001 formula) on or about 11/03/2000 and subsequently suffered an unspecified serious and permanent bodily injury. It is alleged that she subsequently suffered physical and mental pain, permanent bodily disfigurement, and permanent impairment of her ability to labor and earn money. No further info was available at the date of this report. The follow up states this report was determined to be a duplicate of report HQ5486904SEP2001.


Changed on 2/14/2018

VAERS ID: 183890 Before After
VAERS Form:1
Age:
Sex:Female
Location:Kentucky
Vaccinated:2000-11-03
Onset:0000-00-00
Submitted:2002-05-20
Entered:2002-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH U0421AA / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Pain, Emotional distress

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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ1939019APR2002

Write-up: An attorney alleges that a female received an injection of Flu Shield (200-2001 formula) on or about 11/03/2000 and subsequently suffered an unspecified serious and permanent bodily injury. It is alleged that she subsequently suffered physical and mental pain, permanent bodily disfigurement, and permanent impairment of her ability to labor and earn money. No further info was available at the date of this report. The follow up states this report was determined to be a duplicate of report HQ5486904SEP2001.


Changed on 6/14/2018

VAERS ID: 183890 Before After
VAERS Form:1
Age:
Sex:Female
Location:Kentucky
Vaccinated:2000-11-03
Onset:0000-00-00
Submitted:2002-05-20
Entered:2002-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH U0421AA / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Pain, Emotional distress

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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ1939019APR2002

Write-up: An attorney alleges that a female received an injection of Flu Shield (200-2001 formula) on or about 11/03/2000 and subsequently suffered an unspecified serious and permanent bodily injury. It is alleged that she subsequently suffered physical and mental pain, permanent bodily disfigurement, and permanent impairment of her ability to labor and earn money. No further info was available at the date of this report. The follow up states this report was determined to be a duplicate of report HQ5486904SEP2001.


Changed on 8/14/2018

VAERS ID: 183890 Before After
VAERS Form:1
Age:
Sex:Female
Location:Kentucky
Vaccinated:2000-11-03
Onset:0000-00-00
Submitted:2002-05-20
Entered:2002-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH U0421AA / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Pain, Emotional distress

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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ1939019APR2002

Write-up: An attorney alleges that a female received an injection of Flu Shield (200-2001 formula) on or about 11/03/2000 and subsequently suffered an unspecified serious and permanent bodily injury. It is alleged that she subsequently suffered physical and mental pain, permanent bodily disfigurement, and permanent impairment of her ability to labor and earn money. No further info was available at the date of this report. The follow up states this report was determined to be a duplicate of report HQ5486904SEP2001.


Changed on 9/14/2018

VAERS ID: 183890 Before After
VAERS Form:1
Age:
Sex:Female
Location:Kentucky
Vaccinated:2000-11-03
Onset:0000-00-00
Submitted:2002-05-20
Entered:2002-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH U0421AA / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Pain, Emotional distress

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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ1939019APR2002

Write-up: An attorney alleges that a female received an injection of Flu Shield (200-2001 formula) on or about 11/03/2000 and subsequently suffered an unspecified serious and permanent bodily injury. It is alleged that she subsequently suffered physical and mental pain, permanent bodily disfigurement, and permanent impairment of her ability to labor and earn money. No further info was available at the date of this report. The follow up states this report was determined to be a duplicate of report HQ5486904SEP2001.


Changed on 10/14/2018

VAERS ID: 183890 Before After
VAERS Form:1
Age:
Sex:Female
Location:Kentucky
Vaccinated:2000-11-03
Onset:0000-00-00
Submitted:2002-05-20
Entered:2002-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH U0421AA / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Pain, Emotional distress

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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ1939019APR2002

Write-up: An attorney alleges that a female received an injection of Flu Shield (200-2001 formula) on or about 11/03/2000 and subsequently suffered an unspecified serious and permanent bodily injury. It is alleged that she subsequently suffered physical and mental pain, permanent bodily disfigurement, and permanent impairment of her ability to labor and earn money. No further info was available at the date of this report. The follow up states this report was determined to be a duplicate of report HQ5486904SEP2001.


Changed on 12/24/2020

VAERS ID: 183890 Before After
VAERS Form:1
Age:
Sex:Female
Location:Kentucky
Vaccinated:2000-11-03
Onset:0000-00-00
Submitted:2002-05-20
Entered:2002-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH U0421AA / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Pain, Emotional distress

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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ1939019APR2002

Write-up: An attorney alleges that a female received an injection of Flu Shield (200-2001 formula) on or about 11/03/2000 and subsequently suffered an unspecified serious and permanent bodily injury. It is alleged that she subsequently suffered physical and mental pain, permanent bodily disfigurement, and permanent impairment of her ability to labor and earn money. No further info was available at the date of this report. The follow up states this report was determined to be a duplicate of report HQ5486904SEP2001.


Changed on 12/30/2020

VAERS ID: 183890 Before After
VAERS Form:1
Age:
Sex:Female
Location:Kentucky
Vaccinated:2000-11-03
Onset:0000-00-00
Submitted:2002-05-20
Entered:2002-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH U0421AA / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Pain, Emotional distress

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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ1939019APR2002

Write-up: An attorney alleges that a female received an injection of Flu Shield (200-2001 formula) on or about 11/03/2000 and subsequently suffered an unspecified serious and permanent bodily injury. It is alleged that she subsequently suffered physical and mental pain, permanent bodily disfigurement, and permanent impairment of her ability to labor and earn money. No further info was available at the date of this report. The follow up states this report was determined to be a duplicate of report HQ5486904SEP2001.


Changed on 5/7/2021

VAERS ID: 183890 Before After
VAERS Form:1
Age:
Sex:Female
Location:Kentucky
Vaccinated:2000-11-03
Onset:0000-00-00
Submitted:2002-05-20
Entered:2002-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH U0421AA / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Pain, Emotional distress

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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ1939019APR2002

Write-up: An attorney alleges that a female received an injection of Flu Shield (200-2001 formula) on or about 11/03/2000 and subsequently suffered an unspecified serious and permanent bodily injury. It is alleged that she subsequently suffered physical and mental pain, permanent bodily disfigurement, and permanent impairment of her ability to labor and earn money. No further info was available at the date of this report. The follow up states this report was determined to be a duplicate of report HQ5486904SEP2001.


Changed on 5/21/2021

VAERS ID: 183890 Before After
VAERS Form:1
Age:
Sex:Female
Location:Kentucky
Vaccinated:2000-11-03
Onset:0000-00-00
Submitted:2002-05-20
Entered:2002-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH U0421AA / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Pain, Emotional distress

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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ1939019APR2002

Write-up: An attorney alleges that a female received an injection of Flu Shield (200-2001 formula) on or about 11/03/2000 and subsequently suffered an unspecified serious and permanent bodily injury. It is alleged that she subsequently suffered physical and mental pain, permanent bodily disfigurement, and permanent impairment of her ability to labor and earn money. No further info was available at the date of this report. The follow up states this report was determined to be a duplicate of report HQ5486904SEP2001.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=183890&WAYBACKHISTORY=ON


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