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This is VAERS ID 212546

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 212546
VAERS Form:
Age:58.0
Sex:Female
Location:California
Vaccinated:2003-10-20
Onset:2003-10-20
Submitted:2003-11-07
Entered:2003-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUVIRIN) / EVANS VACCINES 765799 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: PAIN INJECT SITE, ECCHYMOSIS

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:
Current Illness:
Preexisting Conditions: End state renal disease; No known allergies; Had flu shots in the past without problems.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 58 year old female with previous history of flu vaccination, developed severe pain and ecchymosis from site of injection from right arm to upper portion of arm (above elbow starting 5 hours after injection). The pain was severe requiring treatment with Vi"codin. After 20 days, pain subsided, but ecchymosis still present.


Changed on 12/8/2009

VAERS ID: 212546 Before After
VAERS Form:
Age:58.0
Sex:Female
Location:California
Vaccinated:2003-10-20
Onset:2003-10-20
Submitted:2003-11-07
Entered:2003-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUVIRIN) INFLUENZA (SEASONAL) (FLUVIRIN) / EVANS VACCINES 765799 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site haemorrhage, Injection site pain, PAIN INJECT SITE, ECCHYMOSIS

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:
Current Illness:
Preexisting Conditions: End state renal disease; No known allergies; Had flu shots in the past without problems.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 58 year old female with previous history of flu vaccination, developed severe pain and ecchymosis from site of injection from right arm to upper portion of arm (above elbow starting 5 hours after injection). The pain was severe requiring treatment with Vi"codin. Vicodin. After 20 days, pain subsided, but ecchymosis still present.


Changed on 7/7/2013

VAERS ID: 212546 Before After
VAERS Form:
Age:58.0
Sex:Female
Location:California
Vaccinated:2003-10-20
Onset:2003-10-20
Submitted:2003-11-07
Entered:2003-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUVIRIN) / EVANS VACCINES 765799 / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / EVANS VACCINES 765799 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site haemorrhage, Injection site pain

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:
Current Illness:
Preexisting Conditions: End state renal disease; No known allergies; Had flu shots in the past without problems.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 58 year old female with previous history of flu vaccination, developed severe pain and ecchymosis from site of injection from right arm to upper portion of arm (above elbow starting 5 hours after injection). The pain was severe requiring treatment with Vicodin. After 20 days, pain subsided, but ecchymosis still present.


Changed on 9/14/2017

VAERS ID: 212546 Before After
VAERS Form:(blank) 1
Age:58.0
Sex:Female
Location:California
Vaccinated:2003-10-20
Onset:2003-10-20
Submitted:2003-11-07
Entered:2003-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / EVANS VACCINES 765799 / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site haemorrhage, Injection site pain

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:
Current Illness:
Preexisting Conditions: End state renal disease; No known allergies; Had flu shots in the past without problems.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 58 year old female with previous history of flu vaccination, developed severe pain and ecchymosis from site of injection from right arm to upper portion of arm (above elbow starting 5 hours after injection). The pain was severe requiring treatment with Vicodin. After 20 days, pain subsided, but ecchymosis still present.


Changed on 2/14/2018

VAERS ID: 212546 Before After
VAERS Form:1
Age:58.0
Sex:Female
Location:California
Vaccinated:2003-10-20
Onset:2003-10-20
Submitted:2003-11-07
Entered:2003-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / EVANS VACCINES 765799 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site haemorrhage, Injection site pain

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:
Current Illness:
Preexisting Conditions: End state renal disease; No known allergies; Had flu shots in the past without problems.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 58 year old female with previous history of flu vaccination, developed severe pain and ecchymosis from site of injection from right arm to upper portion of arm (above elbow starting 5 hours after injection). The pain was severe requiring treatment with Vicodin. After 20 days, pain subsided, but ecchymosis still present.


Changed on 6/14/2018

VAERS ID: 212546 Before After
VAERS Form:1
Age:58.0
Sex:Female
Location:California
Vaccinated:2003-10-20
Onset:2003-10-20
Submitted:2003-11-07
Entered:2003-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / EVANS VACCINES 765799 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site haemorrhage, Injection site pain

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:
Current Illness:
Preexisting Conditions: End state renal disease; No known allergies; Had flu shots in the past without problems.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 58 year old female with previous history of flu vaccination, developed severe pain and ecchymosis from site of injection from right arm to upper portion of arm (above elbow starting 5 hours after injection). The pain was severe requiring treatment with Vicodin. After 20 days, pain subsided, but ecchymosis still present.


Changed on 8/14/2018

VAERS ID: 212546 Before After
VAERS Form:1
Age:58.0
Sex:Female
Location:California
Vaccinated:2003-10-20
Onset:2003-10-20
Submitted:2003-11-07
Entered:2003-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / EVANS VACCINES 765799 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site haemorrhage, Injection site pain

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:
Current Illness:
Preexisting Conditions: End state renal disease; No known allergies; Had flu shots in the past without problems.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 58 year old female with previous history of flu vaccination, developed severe pain and ecchymosis from site of injection from right arm to upper portion of arm (above elbow starting 5 hours after injection). The pain was severe requiring treatment with Vicodin. After 20 days, pain subsided, but ecchymosis still present.


Changed on 9/14/2018

VAERS ID: 212546 Before After
VAERS Form:1
Age:58.0
Sex:Female
Location:California
Vaccinated:2003-10-20
Onset:2003-10-20
Submitted:2003-11-07
Entered:2003-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / EVANS VACCINES 765799 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site haemorrhage, Injection site pain

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:
Current Illness:
Preexisting Conditions: End state renal disease; No known allergies; Had flu shots in the past without problems.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 58 year old female with previous history of flu vaccination, developed severe pain and ecchymosis from site of injection from right arm to upper portion of arm (above elbow starting 5 hours after injection). The pain was severe requiring treatment with Vicodin. After 20 days, pain subsided, but ecchymosis still present.


Changed on 10/14/2018

VAERS ID: 212546 Before After
VAERS Form:1
Age:58.0
Sex:Female
Location:California
Vaccinated:2003-10-20
Onset:2003-10-20
Submitted:2003-11-07
Entered:2003-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / EVANS VACCINES 765799 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site haemorrhage, Injection site pain

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:
Current Illness:
Preexisting Conditions: End state renal disease; No known allergies; Had flu shots in the past without problems.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 58 year old female with previous history of flu vaccination, developed severe pain and ecchymosis from site of injection from right arm to upper portion of arm (above elbow starting 5 hours after injection). The pain was severe requiring treatment with Vicodin. After 20 days, pain subsided, but ecchymosis still present.


Changed on 12/24/2020

VAERS ID: 212546 Before After
VAERS Form:1
Age:58.0
Sex:Female
Location:California
Vaccinated:2003-10-20
Onset:2003-10-20
Submitted:2003-11-07
Entered:2003-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / EVANS VACCINES 765799 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site haemorrhage, Injection site pain

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:
Current Illness:
Preexisting Conditions: End state renal disease; No known allergies; Had flu shots in the past without problems.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 58 year old female with previous history of flu vaccination, developed severe pain and ecchymosis from site of injection from right arm to upper portion of arm (above elbow starting 5 hours after injection). The pain was severe requiring treatment with Vicodin. After 20 days, pain subsided, but ecchymosis still present.


Changed on 12/30/2020

VAERS ID: 212546 Before After
VAERS Form:1
Age:58.0
Sex:Female
Location:California
Vaccinated:2003-10-20
Onset:2003-10-20
Submitted:2003-11-07
Entered:2003-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / EVANS VACCINES 765799 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site haemorrhage, Injection site pain

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:
Current Illness:
Preexisting Conditions: End state renal disease; No known allergies; Had flu shots in the past without problems.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 58 year old female with previous history of flu vaccination, developed severe pain and ecchymosis from site of injection from right arm to upper portion of arm (above elbow starting 5 hours after injection). The pain was severe requiring treatment with Vicodin. After 20 days, pain subsided, but ecchymosis still present.


Changed on 5/7/2021

VAERS ID: 212546 Before After
VAERS Form:1
Age:58.0
Sex:Female
Location:California
Vaccinated:2003-10-20
Onset:2003-10-20
Submitted:2003-11-07
Entered:2003-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / EVANS VACCINES 765799 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site haemorrhage, Injection site pain

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:
Current Illness:
Preexisting Conditions: End state renal disease; No known allergies; Had flu shots in the past without problems.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 58 year old female with previous history of flu vaccination, developed severe pain and ecchymosis from site of injection from right arm to upper portion of arm (above elbow starting 5 hours after injection). The pain was severe requiring treatment with Vicodin. After 20 days, pain subsided, but ecchymosis still present.


Changed on 5/21/2021

VAERS ID: 212546 Before After
VAERS Form:1
Age:58.0
Sex:Female
Location:California
Vaccinated:2003-10-20
Onset:2003-10-20
Submitted:2003-11-07
Entered:2003-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / EVANS VACCINES 765799 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site haemorrhage, Injection site pain

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:
Current Illness:
Preexisting Conditions: End state renal disease; No known allergies; Had flu shots in the past without problems.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 58 year old female with previous history of flu vaccination, developed severe pain and ecchymosis from site of injection from right arm to upper portion of arm (above elbow starting 5 hours after injection). The pain was severe requiring treatment with Vicodin. After 20 days, pain subsided, but ecchymosis still present.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=212546&WAYBACKHISTORY=ON


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