National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

This is VAERS ID 195042

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 195042
VAERS Form:
Age:9.0
Sex:Female
Location:North Carolina
Vaccinated:2002-10-29
Onset:2002-10-31
Submitted:2002-12-06
Entered:2002-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) / AVENTIS PASTEUR, U0880AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: ACIDOSIS, HYPERGLYCEM, KETOSIS

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Hyperglycemia/ketones/acidosis
CDC 'Split Type':

Write-up: Within 2-3 days of flu shot, developed symptoms of diabetic which progressed over 3 weeks to diabetic ketoacidosis.


Changed on 12/8/2009

VAERS ID: 195042 Before After
VAERS Form:
Age:9.0
Sex:Female
Location:North Carolina
Vaccinated:2002-10-29
Onset:2002-10-31
Submitted:2002-12-06
Entered:2002-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR, AVENTIS PASTEUR U0880AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Acidosis, Hyperglycaemia, Ketoacidosis, ACIDOSIS, HYPERGLYCEM, KETOSIS

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Hyperglycemia/ketones/acidosis
CDC 'Split Type':

Write-up: Within 2-3 days of flu shot, developed symptoms of diabetic which progressed over 3 weeks to diabetic ketoacidosis.


Changed on 7/7/2013

VAERS ID: 195042 Before After
VAERS Form:
Age:9.0
Sex:Female
Location:North Carolina
Vaccinated:2002-10-29
Onset:2002-10-31
Submitted:2002-12-06
Entered:2002-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U0880AA / 0 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U0880AA / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Acidosis, Hyperglycaemia, Ketoacidosis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Hyperglycemia/ketones/acidosis
CDC 'Split Type':

Write-up: Within 2-3 days of flu shot, developed symptoms of diabetic which progressed over 3 weeks to diabetic ketoacidosis.


Changed on 5/14/2017

VAERS ID: 195042 Before After
VAERS Form:
Age:9.0
Sex:Female
Location:North Carolina
Vaccinated:2002-10-29
Onset:2002-10-31
Submitted:2002-12-06
Entered:2002-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR SANOFI PASTEUR U0880AA / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Acidosis, Hyperglycaemia, Ketoacidosis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Hyperglycemia/ketones/acidosis
CDC 'Split Type':

Write-up: Within 2-3 days of flu shot, developed symptoms of diabetic which progressed over 3 weeks to diabetic ketoacidosis.


Changed on 9/14/2017

VAERS ID: 195042 Before After
VAERS Form:(blank) 1
Age:9.0
Sex:Female
Location:North Carolina
Vaccinated:2002-10-29
Onset:2002-10-31
Submitted:2002-12-06
Entered:2002-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U0880AA / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Acidosis, Hyperglycaemia, Ketoacidosis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Hyperglycemia/ketones/acidosis
CDC 'Split Type':

Write-up: Within 2-3 days of flu shot, developed symptoms of diabetic which progressed over 3 weeks to diabetic ketoacidosis.


Changed on 2/14/2018

VAERS ID: 195042 Before After
VAERS Form:1
Age:9.0
Sex:Female
Location:North Carolina
Vaccinated:2002-10-29
Onset:2002-10-31
Submitted:2002-12-06
Entered:2002-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U0880AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Acidosis, Hyperglycaemia, Ketoacidosis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Hyperglycemia/ketones/acidosis
CDC 'Split Type':

Write-up: Within 2-3 days of flu shot, developed symptoms of diabetic which progressed over 3 weeks to diabetic ketoacidosis.


Changed on 6/14/2018

VAERS ID: 195042 Before After
VAERS Form:1
Age:9.0
Sex:Female
Location:North Carolina
Vaccinated:2002-10-29
Onset:2002-10-31
Submitted:2002-12-06
Entered:2002-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U0880AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Acidosis, Hyperglycaemia, Ketoacidosis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Hyperglycemia/ketones/acidosis
CDC 'Split Type':

Write-up: Within 2-3 days of flu shot, developed symptoms of diabetic which progressed over 3 weeks to diabetic ketoacidosis.


Changed on 8/14/2018

VAERS ID: 195042 Before After
VAERS Form:1
Age:9.0
Sex:Female
Location:North Carolina
Vaccinated:2002-10-29
Onset:2002-10-31
Submitted:2002-12-06
Entered:2002-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U0880AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Acidosis, Hyperglycaemia, Ketoacidosis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Hyperglycemia/ketones/acidosis
CDC 'Split Type':

Write-up: Within 2-3 days of flu shot, developed symptoms of diabetic which progressed over 3 weeks to diabetic ketoacidosis.


Changed on 9/14/2018

VAERS ID: 195042 Before After
VAERS Form:1
Age:9.0
Sex:Female
Location:North Carolina
Vaccinated:2002-10-29
Onset:2002-10-31
Submitted:2002-12-06
Entered:2002-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U0880AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Acidosis, Hyperglycaemia, Ketoacidosis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Hyperglycemia/ketones/acidosis
CDC 'Split Type':

Write-up: Within 2-3 days of flu shot, developed symptoms of diabetic which progressed over 3 weeks to diabetic ketoacidosis.


Changed on 10/14/2018

VAERS ID: 195042 Before After
VAERS Form:1
Age:9.0
Sex:Female
Location:North Carolina
Vaccinated:2002-10-29
Onset:2002-10-31
Submitted:2002-12-06
Entered:2002-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U0880AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Acidosis, Hyperglycaemia, Ketoacidosis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Hyperglycemia/ketones/acidosis
CDC 'Split Type':

Write-up: Within 2-3 days of flu shot, developed symptoms of diabetic which progressed over 3 weeks to diabetic ketoacidosis.


Changed on 12/24/2020

VAERS ID: 195042 Before After
VAERS Form:1
Age:9.0
Sex:Female
Location:North Carolina
Vaccinated:2002-10-29
Onset:2002-10-31
Submitted:2002-12-06
Entered:2002-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U0880AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Acidosis, Hyperglycaemia, Ketoacidosis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Hyperglycemia/ketones/acidosis
CDC 'Split Type':

Write-up: Within 2-3 days of flu shot, developed symptoms of diabetic which progressed over 3 weeks to diabetic ketoacidosis.


Changed on 12/30/2020

VAERS ID: 195042 Before After
VAERS Form:1
Age:9.0
Sex:Female
Location:North Carolina
Vaccinated:2002-10-29
Onset:2002-10-31
Submitted:2002-12-06
Entered:2002-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U0880AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Acidosis, Hyperglycaemia, Ketoacidosis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Hyperglycemia/ketones/acidosis
CDC 'Split Type':

Write-up: Within 2-3 days of flu shot, developed symptoms of diabetic which progressed over 3 weeks to diabetic ketoacidosis.


Changed on 5/7/2021

VAERS ID: 195042 Before After
VAERS Form:1
Age:9.0
Sex:Female
Location:North Carolina
Vaccinated:2002-10-29
Onset:2002-10-31
Submitted:2002-12-06
Entered:2002-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U0880AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Acidosis, Hyperglycaemia, Ketoacidosis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Hyperglycemia/ketones/acidosis
CDC 'Split Type':

Write-up: Within 2-3 days of flu shot, developed symptoms of diabetic which progressed over 3 weeks to diabetic ketoacidosis.


Changed on 5/21/2021

VAERS ID: 195042 Before After
VAERS Form:1
Age:9.0
Sex:Female
Location:North Carolina
Vaccinated:2002-10-29
Onset:2002-10-31
Submitted:2002-12-06
Entered:2002-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U0880AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Acidosis, Hyperglycaemia, Ketoacidosis

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
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:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Hyperglycemia/ketones/acidosis
CDC 'Split Type':

Write-up: Within 2-3 days of flu shot, developed symptoms of diabetic which progressed over 3 weeks to diabetic ketoacidosis.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=195042&WAYBACKHISTORY=ON


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166