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This is VAERS ID 25074

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25074
VAERS Form:
Age:73.4
Sex:Female
Location:Washington
Vaccinated:1989-11-06
Onset:1989-11-07
Submitted:0000-00-00
Entered:1990-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1989-1990 TRIVALENT TYPES A&B / WYETH - / - - / -
PPV: UNK. PNEUMOCOCCAL POLYVALENT / UNCLASSIFIED - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, EDEMA, PAIN

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt experienced severe pain & edema in lt arm from shoulder to hand, & fever /p receiving Influenza Virus. Symptoms persisted for approx. 2 wks & pt recovered


Changed on 12/8/2009

VAERS ID: 25074 Before After
VAERS Form:
Age:73.4
Sex:Female
Location:Washington
Vaccinated:1989-11-06
Onset:1989-11-07
Submitted:0000-00-00
Entered:1990-07-12 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1989-1990 TRIVALENT TYPES A&B INFLUENZA (SEASONAL) (NO BRAND NAME, 89-90) / WYETH WYETH PHARMACEUTICALS, INC - / - - / -
PPV: UNK. PNEUMOCOCCAL POLYVALENT PNEUMO (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Oedema, Pain, Pyrexia, FEVER, EDEMA, PAIN

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) B073090004

Write-up: Pt experienced severe pain & edema in lt arm from shoulder to hand, & fever /p receiving Influenza Virus. Symptoms persisted for approx. 2 wks & pt recovered


Changed on 8/31/2010

VAERS ID: 25074 Before After
VAERS Form:
Age:73.4
Sex:Female
Location:Washington
Vaccinated:1989-11-06
Onset:1989-11-07
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 89-90) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - - / -
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Oedema, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090004

Write-up: Pt experienced severe pain & edema in lt arm from shoulder to hand, & fever /p receiving Influenza Virus. Symptoms persisted for approx. 2 wks & pt recovered


Changed on 7/7/2013

VAERS ID: 25074 Before After
VAERS Form:
Age:73.4
Sex:Female
Location:Washington
Vaccinated:1989-11-06
Onset:1989-11-07
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Oedema, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090004

Write-up: Pt experienced severe pain & edema in lt arm from shoulder to hand, & fever /p receiving Influenza Virus. Symptoms persisted for approx. 2 wks & pt recovered


Changed on 12/14/2016

VAERS ID: 25074 Before After
VAERS Form:
Age:73.4
Sex:Female
Location:Washington
Vaccinated:1989-11-06
Onset:1989-11-07
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Oedema, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090004

Write-up: Pt experienced severe pain & edema in lt arm from shoulder to hand, & fever /p receiving Influenza Virus. Symptoms persisted for approx. 2 wks & pt recovered


Changed on 2/14/2017

VAERS ID: 25074 Before After
VAERS Form:
Age:73.4 73.0
Sex:Female
Location:Washington
Vaccinated:1989-11-06
Onset:1989-11-07
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Oedema, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090004

Write-up: Pt experienced severe pain & edema in lt arm from shoulder to hand, & fever /p receiving Influenza Virus. Symptoms persisted for approx. 2 wks & pt recovered


Changed on 5/14/2017

VAERS ID: 25074 Before After
VAERS Form:
Age:73.0
Sex:Female
Location:Washington
Vaccinated:1989-11-06
Onset:1989-11-07
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Oedema, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090004

Write-up: Pt experienced severe pain & edema in lt arm from shoulder to hand, & fever /p receiving Influenza Virus. Symptoms persisted for approx. 2 wks & pt recovered


Changed on 9/14/2017

VAERS ID: 25074 Before After
VAERS Form:(blank) 1
Age:73.0
Sex:Female
Location:Washington
Vaccinated:1989-11-06
Onset:1989-11-07
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - UNK - / -
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Oedema, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090004

Write-up: Pt experienced severe pain & edema in lt arm from shoulder to hand, & fever /p receiving Influenza Virus. Symptoms persisted for approx. 2 wks & pt recovered


Changed on 2/14/2018

VAERS ID: 25074 Before After
VAERS Form:1
Age:73.0
Sex:Female
Location:Washington
Vaccinated:1989-11-06
Onset:1989-11-07
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Oedema, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090004

Write-up: Pt experienced severe pain & edema in lt arm from shoulder to hand, & fever /p receiving Influenza Virus. Symptoms persisted for approx. 2 wks & pt recovered


Changed on 6/14/2018

VAERS ID: 25074 Before After
VAERS Form:1
Age:73.0
Sex:Female
Location:Washington
Vaccinated:1989-11-06
Onset:1989-11-07
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Oedema, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090004

Write-up: Pt experienced severe pain & edema in lt arm from shoulder to hand, & fever /p receiving Influenza Virus. Symptoms persisted for approx. 2 wks & pt recovered


Changed on 8/14/2018

VAERS ID: 25074 Before After
VAERS Form:1
Age:73.0
Sex:Female
Location:Washington
Vaccinated:1989-11-06
Onset:1989-11-07
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Oedema, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090004

Write-up: Pt experienced severe pain & edema in lt arm from shoulder to hand, & fever /p receiving Influenza Virus. Symptoms persisted for approx. 2 wks & pt recovered


Changed on 9/14/2018

VAERS ID: 25074 Before After
VAERS Form:1
Age:73.0
Sex:Female
Location:Washington
Vaccinated:1989-11-06
Onset:1989-11-07
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Oedema, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090004

Write-up: Pt experienced severe pain & edema in lt arm from shoulder to hand, & fever /p receiving Influenza Virus. Symptoms persisted for approx. 2 wks & pt recovered


Changed on 10/14/2018

VAERS ID: 25074 Before After
VAERS Form:1
Age:73.0
Sex:Female
Location:Washington
Vaccinated:1989-11-06
Onset:1989-11-07
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Oedema, Pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090004

Write-up: Pt experienced severe pain & edema in lt arm from shoulder to hand, & fever /p receiving Influenza Virus. Symptoms persisted for approx. 2 wks & pt recovered

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=25074&WAYBACKHISTORY=ON


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