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This is VAERS ID 25075

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25075
VAERS Form:
Age:43.5
Sex:Female
Location:New Jersey
Vaccinated:1989-11-07
Onset:1989-11-07
Submitted:1989-11-09
Entered:1990-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1989-1990 TRIVALENT TYPES A&B / WYETH 4898169 / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: HYPOKINESIA, ARTHRITIS, HYSN INJECT SITE, ARTHRALGIA, LYMPHADENO

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt exp swelling & pain of her lt arm, neck, elbow, wrist & shoulder immediately p/receiving flu vax; also exp arthritis & lymphadenopathy which required hospitalization & 2 surgical operations; exp numbness, dec movement & pain;


Changed on 12/8/2009

VAERS ID: 25075 Before After
VAERS Form:
Age:43.5
Sex:Female
Location:New Jersey
Vaccinated:1989-11-07
Onset:1989-11-07
Submitted:1989-11-09
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 4898169 / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Back pain, Hypokinesia, Injection site hypersensitivity, Lymphadenopathy, Neck pain, Paraesthesia, HYPOKINESIA, ARTHRITIS, HYSN INJECT SITE, ARTHRALGIA, LYMPHADENO

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) B073089147

Write-up: Pt exp swelling & pain of her lt arm, neck, elbow, wrist & shoulder immediately p/receiving flu vax; also exp arthritis & lymphadenopathy which required hospitalization & 2 surgical operations; exp numbness, dec movement & pain;


Changed on 8/31/2010

VAERS ID: 25075 Before After
VAERS Form:
Age:43.5
Sex:Female
Location:New Jersey
Vaccinated:1989-11-07
Onset:1989-11-07
Submitted:1989-11-09
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 4898169 / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Back pain, Hypokinesia, Injection site hypersensitivity, Lymphadenopathy, Neck pain, Paraesthesia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073089147

Write-up: Pt exp swelling & pain of her lt arm, neck, elbow, wrist & shoulder immediately p/receiving flu vax; also exp arthritis & lymphadenopathy which required hospitalization & 2 surgical operations; exp numbness, dec movement & pain;


Changed on 7/7/2013

VAERS ID: 25075 Before After
VAERS Form:
Age:43.5
Sex:Female
Location:New Jersey
Vaccinated:1989-11-07
Onset:1989-11-07
Submitted:1989-11-09
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898169 / - - / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898169 / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Back pain, Hypokinesia, Injection site hypersensitivity, Lymphadenopathy, Neck pain, Paraesthesia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073089147

Write-up: Pt exp swelling & pain of her lt arm, neck, elbow, wrist & shoulder immediately p/receiving flu vax; also exp arthritis & lymphadenopathy which required hospitalization & 2 surgical operations; exp numbness, dec movement & pain;


Changed on 12/14/2016

VAERS ID: 25075 Before After
VAERS Form:
Age:43.5
Sex:Female
Location:New Jersey
Vaccinated:1989-11-07
Onset:1989-11-07
Submitted:1989-11-09
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898169 / - - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898169 / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Back pain, Hypokinesia, Injection site hypersensitivity, Lymphadenopathy, Neck pain, Paraesthesia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073089147

Write-up: Pt exp swelling & pain of her lt arm, neck, elbow, wrist & shoulder immediately p/receiving flu vax; also exp arthritis & lymphadenopathy which required hospitalization & 2 surgical operations; exp numbness, dec movement & pain;


Changed on 2/14/2017

VAERS ID: 25075 Before After
VAERS Form:
Age:43.5 43.0
Sex:Female
Location:New Jersey
Vaccinated:1989-11-07
Onset:1989-11-07
Submitted:1989-11-09
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898169 / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Back pain, Hypokinesia, Injection site hypersensitivity, Lymphadenopathy, Neck pain, Paraesthesia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073089147

Write-up: Pt exp swelling & pain of her lt arm, neck, elbow, wrist & shoulder immediately p/receiving flu vax; also exp arthritis & lymphadenopathy which required hospitalization & 2 surgical operations; exp numbness, dec movement & pain;


Changed on 5/14/2017

VAERS ID: 25075 Before After
VAERS Form:
Age:43.0
Sex:Female
Location:New Jersey
Vaccinated:1989-11-07
Onset:1989-11-07
Submitted:1989-11-09
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898169 / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Back pain, Hypokinesia, Injection site hypersensitivity, Lymphadenopathy, Neck pain, Paraesthesia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073089147

Write-up: Pt exp experienced a local reaction within 24 hrs at the site of injection, described as a bullseye, after receiving influenza virus vaccine. Also observed was supraclavicular swelling & pain of her lt arm, neck, elbow, wrist & shoulder immediately p/receiving flu vax; also exp arthritis & lymphadenopathy which required hospitalization & 2 surgical operations; exp numbness, dec movement & pain; including lymph nodes.


Changed on 9/14/2017

VAERS ID: 25075 Before After
VAERS Form:(blank) 1
Age:43.0
Sex:Female
Location:New Jersey
Vaccinated:1989-11-07
Onset:1989-11-07
Submitted:1989-11-09
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898169 / - UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Back pain, Hypokinesia, Injection site hypersensitivity, Lymphadenopathy, Neck pain, Paraesthesia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073089147

Write-up: Pt experienced a local reaction within 24 hrs at the site of injection, described as a bullseye, after receiving influenza virus vaccine. Also observed was supraclavicular swelling including lymph nodes.


Changed on 2/14/2018

VAERS ID: 25075 Before After
VAERS Form:1
Age:43.0
Sex:Female
Location:New Jersey
Vaccinated:1989-11-07
Onset:1989-11-07
Submitted:1989-11-09
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898169 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Back pain, Hypokinesia, Injection site hypersensitivity, Lymphadenopathy, Neck pain, Paraesthesia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073089147

Write-up: Pt experienced a local reaction within 24 hrs at the site of injection, described as a bullseye, after receiving influenza virus vaccine. Also observed was supraclavicular swelling including lymph nodes.


Changed on 6/14/2018

VAERS ID: 25075 Before After
VAERS Form:1
Age:43.0
Sex:Female
Location:New Jersey
Vaccinated:1989-11-07
Onset:1989-11-07
Submitted:1989-11-09
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898169 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Back pain, Hypokinesia, Injection site hypersensitivity, Lymphadenopathy, Neck pain, Paraesthesia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073089147

Write-up: Pt experienced a local reaction within 24 hrs at the site of injection, described as a bullseye, after receiving influenza virus vaccine. Also observed was supraclavicular swelling including lymph nodes.


Changed on 8/14/2018

VAERS ID: 25075 Before After
VAERS Form:1
Age:43.0
Sex:Female
Location:New Jersey
Vaccinated:1989-11-07
Onset:1989-11-07
Submitted:1989-11-09
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898169 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Back pain, Hypokinesia, Injection site hypersensitivity, Lymphadenopathy, Neck pain, Paraesthesia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073089147

Write-up: Pt experienced a local reaction within 24 hrs at the site of injection, described as a bullseye, after receiving influenza virus vaccine. Also observed was supraclavicular swelling including lymph nodes.


Changed on 9/14/2018

VAERS ID: 25075 Before After
VAERS Form:1
Age:43.0
Sex:Female
Location:New Jersey
Vaccinated:1989-11-07
Onset:1989-11-07
Submitted:1989-11-09
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898169 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Back pain, Hypokinesia, Injection site hypersensitivity, Lymphadenopathy, Neck pain, Paraesthesia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073089147

Write-up: Pt experienced a local reaction within 24 hrs at the site of injection, described as a bullseye, after receiving influenza virus vaccine. Also observed was supraclavicular swelling including lymph nodes.


Changed on 10/14/2018

VAERS ID: 25075 Before After
VAERS Form:1
Age:43.0
Sex:Female
Location:New Jersey
Vaccinated:1989-11-07
Onset:1989-11-07
Submitted:1989-11-09
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898169 / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Back pain, Hypokinesia, Injection site hypersensitivity, Lymphadenopathy, Neck pain, Paraesthesia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073089147

Write-up: Pt experienced a local reaction within 24 hrs at the site of injection, described as a bullseye, after receiving influenza virus vaccine. Also observed was supraclavicular swelling including lymph nodes.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=25075&WAYBACKHISTORY=ON


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