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This is VAERS ID 25171

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25171
VAERS Form:
Age:
Sex:Female
Location:New Jersey
Vaccinated:1989-12-01
Onset:1989-12-01
Submitted:0000-00-00
Entered:1990-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE / UNCLASSIFIED - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: ARTHRALGIA, NEUROPATHY

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: NONE---IVV WAS A TRIVALENT A&B 1989-1990 FORMULA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PT EXPER.ARTHRITIC PAIN AND POLYNEUROPATHY AFTER ADMIN OF INFLUENZA VIRUS VACCINE. REPORTER NOT SURE IF WYETH OF PARKE-DAVIS PRODUCT WAS USED.


Changed on 12/8/2009

VAERS ID: 25171 Before After
VAERS Form:
Age:
Sex:Female
Location:New Jersey
Vaccinated:1989-12-01
Onset:1989-12-01
Submitted:0000-00-00
Entered:1990-07-17 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE INFLUENZA (SEASONAL) (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Arthralgia, Neuropathy, ARTHRALGIA, NEUROPATHY

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: NONE---IVV WAS A TRIVALENT A&B 1989-1990 FORMULA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) B073090037

Write-up: PT EXPER.ARTHRITIC PAIN AND POLYNEUROPATHY AFTER ADMIN OF INFLUENZA VIRUS VACCINE. REPORTER NOT SURE IF WYETH OF PARKE-DAVIS PRODUCT WAS USED.


Changed on 7/7/2013

VAERS ID: 25171 Before After
VAERS Form:
Age:
Sex:Female
Location:New Jersey
Vaccinated:1989-12-01
Onset:1989-12-01
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Neuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: NONE---IVV WAS A TRIVALENT A&B 1989-1990 FORMULA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090037

Write-up: PT EXPER.ARTHRITIC PAIN AND POLYNEUROPATHY AFTER ADMIN OF INFLUENZA VIRUS VACCINE. REPORTER NOT SURE IF WYETH OF PARKE-DAVIS PRODUCT WAS USED.


Changed on 12/14/2016

VAERS ID: 25171 Before After
VAERS Form:
Age:
Sex:Female
Location:New Jersey
Vaccinated:1989-12-01
Onset:1989-12-01
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Neuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: NONE---IVV WAS A TRIVALENT A&B 1989-1990 FORMULA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090037

Write-up: PT EXPER.ARTHRITIC PAIN AND POLYNEUROPATHY AFTER ADMIN OF INFLUENZA VIRUS VACCINE. REPORTER NOT SURE IF WYETH OF PARKE-DAVIS PRODUCT WAS USED.


Changed on 5/14/2017

VAERS ID: 25171 Before After
VAERS Form:
Age:
Sex:Female
Location:New Jersey
Vaccinated:1989-12-01
Onset:1989-12-01
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Neuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: ~ ()~~~In patient
Other Medications: NONE---IVV WAS A TRIVALENT A&B 1989-1990 FORMULA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090037

Write-up: PT EXPER.ARTHRITIC PAIN AND POLYNEUROPATHY AFTER ADMIN OF INFLUENZA VIRUS VACCINE. REPORTER NOT SURE IF WYETH OF PARKE-DAVIS PRODUCT WAS USED.


Changed on 9/14/2017

VAERS ID: 25171 Before After
VAERS Form:(blank) 1
Age:
Sex:Female
Location:New Jersey
Vaccinated:1989-12-01
Onset:1989-12-01
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Neuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: ~ ()~~~In patient
Other Medications: NONE---IVV WAS A TRIVALENT A&B 1989-1990 FORMULA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090037

Write-up: PT EXPER.ARTHRITIC PAIN AND POLYNEUROPATHY AFTER ADMIN OF INFLUENZA VIRUS VACCINE. REPORTER NOT SURE IF WYETH OF PARKE-DAVIS PRODUCT WAS USED.


Changed on 2/14/2018

VAERS ID: 25171 Before After
VAERS Form:1
Age:
Sex:Female
Location:New Jersey
Vaccinated:1989-12-01
Onset:1989-12-01
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Neuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: ~ ()~~~In patient
Other Medications: NONE---IVV WAS A TRIVALENT A&B 1989-1990 FORMULA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090037

Write-up: PT EXPER.ARTHRITIC PAIN AND POLYNEUROPATHY AFTER ADMIN OF INFLUENZA VIRUS VACCINE. REPORTER NOT SURE IF WYETH OF PARKE-DAVIS PRODUCT WAS USED.


Changed on 6/14/2018

VAERS ID: 25171 Before After
VAERS Form:1
Age:
Sex:Female
Location:New Jersey
Vaccinated:1989-12-01
Onset:1989-12-01
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Neuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: ~ ()~~~In patient
Other Medications: NONE---IVV WAS A TRIVALENT A&B 1989-1990 FORMULA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090037

Write-up: PT EXPER.ARTHRITIC PAIN AND POLYNEUROPATHY AFTER ADMIN OF INFLUENZA VIRUS VACCINE. REPORTER NOT SURE IF WYETH OF PARKE-DAVIS PRODUCT WAS USED.


Changed on 8/14/2018

VAERS ID: 25171 Before After
VAERS Form:1
Age:
Sex:Female
Location:New Jersey
Vaccinated:1989-12-01
Onset:1989-12-01
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Neuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: ~ ()~~~In patient
Other Medications: NONE---IVV WAS A TRIVALENT A&B 1989-1990 FORMULA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090037

Write-up: PT EXPER.ARTHRITIC PAIN AND POLYNEUROPATHY AFTER ADMIN OF INFLUENZA VIRUS VACCINE. REPORTER NOT SURE IF WYETH OF PARKE-DAVIS PRODUCT WAS USED.


Changed on 9/14/2018

VAERS ID: 25171 Before After
VAERS Form:1
Age:
Sex:Female
Location:New Jersey
Vaccinated:1989-12-01
Onset:1989-12-01
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Neuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: ~ ()~~~In patient
Other Medications: NONE---IVV WAS A TRIVALENT A&B 1989-1990 FORMULA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090037

Write-up: PT EXPER.ARTHRITIC PAIN AND POLYNEUROPATHY AFTER ADMIN OF INFLUENZA VIRUS VACCINE. REPORTER NOT SURE IF WYETH OF PARKE-DAVIS PRODUCT WAS USED.


Changed on 10/14/2018

VAERS ID: 25171 Before After
VAERS Form:1
Age:
Sex:Female
Location:New Jersey
Vaccinated:1989-12-01
Onset:1989-12-01
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Neuropathy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: ~ ()~~~In patient
Other Medications: NONE---IVV WAS A TRIVALENT A&B 1989-1990 FORMULA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': B073090037

Write-up: PT EXPER.ARTHRITIC PAIN AND POLYNEUROPATHY AFTER ADMIN OF INFLUENZA VIRUS VACCINE. REPORTER NOT SURE IF WYETH OF PARKE-DAVIS PRODUCT WAS USED.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=25171&WAYBACKHISTORY=ON


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