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This is VAERS ID 25675

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25675
VAERS Form:
Age:62.0
Sex:Male
Location:Maryland
Vaccinated:1989-10-12
Onset:1989-10-13
Submitted:0000-00-00
Entered:1990-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1989-1990 TRIVALENT TYPES A&B / WYETH 4898171 / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: CONFUS, ASTHENIA

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: Pt has previously received Influenza vaccine every yr /w out rxn.
Other Medications: Prednisone, K-Lor, Lasix, Feledene, Bronkosol, NSS Nebulizer, Alupent Inhaler, Zaroxolyn
Current Illness:
Preexisting Conditions: Pt has hx of connective tissue disorder
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': Pt has hx of connective tissue disorder

Write-up: Pt received Influenza vaccine when awoke on the day after was in a semi-conscious state, grossly confused & weak; unable to recognize his wife or his doctor. This reaction has been previously reported to USP.


Changed on 12/8/2009

VAERS ID: 25675 Before After
VAERS Form:
Age:62.0
Sex:Male
Location:Maryland
Vaccinated:1989-10-12
Onset:1989-10-13
Submitted:0000-00-00
Entered:1990-08-17 1990-08-13
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 4898171 / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Confusional state, CONFUS, ASTHENIA

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: Pt has previously received Influenza vaccine every yr /w out rxn.
Other Medications: Prednisone, K-Lor, Lasix, Feledene, Bronkosol, NSS Nebulizer, Alupent Inhaler, Zaroxolyn
Current Illness:
Preexisting Conditions: Pt has hx of connective tissue disorder
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': Pt has hx of connective tissue disorder 890211001B

Write-up: Pt received Influenza vaccine when awoke on the day after was in a semi-conscious state, grossly confused & weak; unable to recognize his wife or his doctor. This reaction has been previously reported to USP.


Changed on 8/31/2010

VAERS ID: 25675 Before After
VAERS Form:
Age:62.0
Sex:Male
Location:Maryland
Vaccinated:1989-10-12
Onset:1989-10-13
Submitted:0000-00-00
Entered:1990-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 89-90) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4898171 / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Confusional state

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: Pt has previously received Influenza vaccine every yr /w out rxn.
Other Medications: Prednisone, K-Lor, Lasix, Feledene, Bronkosol, NSS Nebulizer, Alupent Inhaler, Zaroxolyn
Current Illness:
Preexisting Conditions: Pt has hx of connective tissue disorder
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890211001B

Write-up: Pt received Influenza vaccine when awoke on the day after was in a semi-conscious state, grossly confused & weak; unable to recognize his wife or his doctor. This reaction has been previously reported to USP.


Changed on 7/7/2013

VAERS ID: 25675 Before After
VAERS Form:
Age:62.0
Sex:Male
Location:Maryland
Vaccinated:1989-10-12
Onset:1989-10-13
Submitted:0000-00-00
Entered:1990-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898171 / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898171 / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Confusional state

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: Pt has previously received Influenza vaccine every yr /w out rxn.
Other Medications: Prednisone, K-Lor, Lasix, Feledene, Bronkosol, NSS Nebulizer, Alupent Inhaler, Zaroxolyn
Current Illness:
Preexisting Conditions: Pt has hx of connective tissue disorder
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890211001B

Write-up: Pt received Influenza vaccine when awoke on the day after was in a semi-conscious state, grossly confused & weak; unable to recognize his wife or his doctor. This reaction has been previously reported to USP.


Changed on 12/14/2016

VAERS ID: 25675 Before After
VAERS Form:
Age:62.0
Sex:Male
Location:Maryland
Vaccinated:1989-10-12
Onset:1989-10-13
Submitted:0000-00-00
Entered:1990-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898171 / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898171 / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Confusional state

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: Pt has previously received Influenza vaccine every yr /w out rxn.
Other Medications: Prednisone, K-Lor, Lasix, Feledene, Bronkosol, NSS Nebulizer, Alupent Inhaler, Zaroxolyn
Current Illness:
Preexisting Conditions: Pt has hx of connective tissue disorder
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890211001B

Write-up: Pt received Influenza vaccine when awoke on the day after was in a semi-conscious state, grossly confused & weak; unable to recognize his wife or his doctor. This reaction has been previously reported to USP.


Changed on 5/14/2017

VAERS ID: 25675 Before After
VAERS Form:
Age:62.0
Sex:Male
Location:Maryland
Vaccinated:1989-10-12
Onset:1989-10-13
Submitted:0000-00-00
Entered:1990-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898171 / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Confusional state

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: Pt has previously received Influenza vaccine every yr /w out rxn. rxn.~ ()~~~In patient
Other Medications: Prednisone, K-Lor, Lasix, Feledene, Bronkosol, NSS Nebulizer, Alupent Inhaler, Zaroxolyn
Current Illness:
Preexisting Conditions: Pt has hx of connective tissue disorder
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890211001B

Write-up: Pt received Influenza vaccine when awoke on the day after was in a semi-conscious state, grossly confused & weak; unable to recognize his wife or his doctor. This reaction has been previously reported to USP.


Changed on 9/14/2017

VAERS ID: 25675 Before After
VAERS Form:(blank) 1
Age:62.0
Sex:Male
Location:Maryland
Vaccinated:1989-10-12
Onset:1989-10-13
Submitted:0000-00-00
Entered:1990-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898171 / - UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Confusional state

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: Pt has previously received Influenza vaccine every yr /w out rxn.~ ()~~~In patient
Other Medications: Prednisone, K-Lor, Lasix, Feledene, Bronkosol, NSS Nebulizer, Alupent Inhaler, Zaroxolyn
Current Illness:
Preexisting Conditions: Pt has hx of connective tissue disorder
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890211001B

Write-up: Pt received Influenza vaccine when awoke on the day after was in a semi-conscious state, grossly confused & weak; unable to recognize his wife or his doctor. This reaction has been previously reported to USP.


Changed on 2/14/2018

VAERS ID: 25675 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:Maryland
Vaccinated:1989-10-12
Onset:1989-10-13
Submitted:0000-00-00
Entered:1990-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898171 / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Confusional state

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: Pt has previously received Influenza vaccine every yr /w out rxn.~ ()~~~In patient
Other Medications: Prednisone, K-Lor, Lasix, Feledene, Bronkosol, NSS Nebulizer, Alupent Inhaler, Zaroxolyn
Current Illness:
Preexisting Conditions: Pt has hx of connective tissue disorder
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890211001B

Write-up: Pt received Influenza vaccine when awoke on the day after was in a semi-conscious state, grossly confused & weak; unable to recognize his wife or his doctor. This reaction has been previously reported to USP.


Changed on 6/14/2018

VAERS ID: 25675 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:Maryland
Vaccinated:1989-10-12
Onset:1989-10-13
Submitted:0000-00-00
Entered:1990-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898171 / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Confusional state

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: Pt has previously received Influenza vaccine every yr /w out rxn.~ ()~~~In patient
Other Medications: Prednisone, K-Lor, Lasix, Feledene, Bronkosol, NSS Nebulizer, Alupent Inhaler, Zaroxolyn
Current Illness:
Preexisting Conditions: Pt has hx of connective tissue disorder
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890211001B

Write-up: Pt received Influenza vaccine when awoke on the day after was in a semi-conscious state, grossly confused & weak; unable to recognize his wife or his doctor. This reaction has been previously reported to USP.


Changed on 8/14/2018

VAERS ID: 25675 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:Maryland
Vaccinated:1989-10-12
Onset:1989-10-13
Submitted:0000-00-00
Entered:1990-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898171 / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Confusional state

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: Pt has previously received Influenza vaccine every yr /w out rxn.~ ()~~~In patient
Other Medications: Prednisone, K-Lor, Lasix, Feledene, Bronkosol, NSS Nebulizer, Alupent Inhaler, Zaroxolyn
Current Illness:
Preexisting Conditions: Pt has hx of connective tissue disorder
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890211001B

Write-up: Pt received Influenza vaccine when awoke on the day after was in a semi-conscious state, grossly confused & weak; unable to recognize his wife or his doctor. This reaction has been previously reported to USP.


Changed on 9/14/2018

VAERS ID: 25675 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:Maryland
Vaccinated:1989-10-12
Onset:1989-10-13
Submitted:0000-00-00
Entered:1990-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898171 / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Confusional state

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: Pt has previously received Influenza vaccine every yr /w out rxn.~ ()~~~In patient
Other Medications: Prednisone, K-Lor, Lasix, Feledene, Bronkosol, NSS Nebulizer, Alupent Inhaler, Zaroxolyn
Current Illness:
Preexisting Conditions: Pt has hx of connective tissue disorder
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890211001B

Write-up: Pt received Influenza vaccine when awoke on the day after was in a semi-conscious state, grossly confused & weak; unable to recognize his wife or his doctor. This reaction has been previously reported to USP.


Changed on 10/14/2018

VAERS ID: 25675 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:Maryland
Vaccinated:1989-10-12
Onset:1989-10-13
Submitted:0000-00-00
Entered:1990-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898171 / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Confusional state

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: Pt has previously received Influenza vaccine every yr /w out rxn.~ ()~~~In patient
Other Medications: Prednisone, K-Lor, Lasix, Feledene, Bronkosol, NSS Nebulizer, Alupent Inhaler, Zaroxolyn
Current Illness:
Preexisting Conditions: Pt has hx of connective tissue disorder
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890211001B

Write-up: Pt received Influenza vaccine when awoke on the day after was in a semi-conscious state, grossly confused & weak; unable to recognize his wife or his doctor. This reaction has been previously reported to USP.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=25675&WAYBACKHISTORY=ON


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