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This is VAERS ID 26159

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26159
VAERS Form:
Age:52.0
Sex:Female
Location:Arizona
Vaccinated:1990-09-20
Onset:1990-09-20
Submitted:0000-00-00
Entered:1990-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1989-1990 / PARKE-DAVIS - / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: APNEA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-20
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: Methyprednisolone, Verapamil, Proventil, Albuterol, Anhydrous Theophylline
Current Illness: Severe Bronchial Asthma
Preexisting Conditions: Pt was hospitalized 2-3 yrs ago for hypertensive Crisis & Severe Bronchial Asthma.
Allergies:
Diagnostic Lab Data: HGT=5''6"; WGT=99lbs; Morning of 20SEP90 BP=142/86;P=72/min®.
CDC 'Split Type':

Write-up: Pt vaccinated with FLUOGEN who has severe bronchial asthma seen in MD ofc well VS stable & chest clear, death & respiratory arrest.


Changed on 12/30/2006

VAERS ID: 26159 Before After
VAERS Form:
Age:52.0
Sex:Female
Location:Arizona
Vaccinated:1990-09-20
Onset:1990-09-20
Submitted:0000-00-00
Entered:1990-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1989-1990 / PARKE-DAVIS - / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: APNEA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-20
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: Methyprednisolone, Verapamil, Proventil, Albuterol, Anhydrous Theophylline
Current Illness: Severe Bronchial Asthma
Preexisting Conditions: Pt was hospitalized 2-3 yrs ago for hypertensive Crisis & Severe Bronchial Asthma.
Allergies:
Diagnostic Lab Data: HGT=5''6"; HGT=5''''6/"; WGT=99lbs; Morning of 20SEP90 BP=142/86;P=72/min®.
CDC 'Split Type':

Write-up: Pt vaccinated with FLUOGEN who has severe bronchial asthma seen in MD ofc well VS stable & chest clear, death & respiratory arrest.


Changed on 12/8/2009

VAERS ID: 26159 Before After
VAERS Form:
Age:52.0
Sex:Female
Location:Arizona
Vaccinated:1990-09-20
Onset:1990-09-20
Submitted:0000-00-00
Entered:1990-10-05 1990-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1989-1990 INFLUENZA (SEASONAL) (FLUOGEN 89-90) / PARKE-DAVIS - / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea, APNEA

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-20
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: Methyprednisolone, Verapamil, Proventil, Albuterol, Anhydrous Theophylline
Current Illness: Severe Bronchial Asthma
Preexisting Conditions: Pt was hospitalized 2-3 yrs ago for hypertensive Crisis & Severe Bronchial Asthma.
Allergies:
Diagnostic Lab Data: HGT=5''''6/"; HGT=5''6"; WGT=99lbs; Morning of 20SEP90 BP=142/86;P=72/min®.
CDC 'Split Type': (blank) 904090001

Write-up: Pt vaccinated with FLUOGEN who has severe bronchial asthma seen in MD ofc well VS stable & chest clear, death & respiratory arrest.


Changed on 8/31/2010

VAERS ID: 26159 Before After
VAERS Form:
Age:52.0
Sex:Female
Location:Arizona
Vaccinated:1990-09-20
Onset:1990-09-20
Submitted:0000-00-00
Entered:1990-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 89-90) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-20
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: Methyprednisolone, Verapamil, Proventil, Albuterol, Anhydrous Theophylline
Current Illness: Severe Bronchial Asthma
Preexisting Conditions: Pt was hospitalized 2-3 yrs ago for hypertensive Crisis & Severe Bronchial Asthma.
Allergies:
Diagnostic Lab Data: HGT=5''6"; WGT=99lbs; Morning of 20SEP90 BP=142/86;P=72/min®.
CDC 'Split Type': 904090001

Write-up: Pt vaccinated with FLUOGEN who has severe bronchial asthma seen in MD ofc well VS stable & chest clear, death & respiratory arrest.


Changed on 7/7/2013

VAERS ID: 26159 Before After
VAERS Form:
Age:52.0
Sex:Female
Location:Arizona
Vaccinated:1990-09-20
Onset:1990-09-20
Submitted:0000-00-00
Entered:1990-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-20
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: Methyprednisolone, Verapamil, Proventil, Albuterol, Anhydrous Theophylline
Current Illness: Severe Bronchial Asthma
Preexisting Conditions: Pt was hospitalized 2-3 yrs ago for hypertensive Crisis & Severe Bronchial Asthma.
Allergies:
Diagnostic Lab Data: HGT=5''6"; WGT=99lbs; Morning of 20SEP90 BP=142/86;P=72/min®.
CDC 'Split Type': 904090001

Write-up: Pt vaccinated with FLUOGEN who has severe bronchial asthma seen in MD ofc well VS stable & chest clear, death & respiratory arrest.


Changed on 5/14/2017

VAERS ID: 26159 Before After
VAERS Form:
Age:52.0
Sex:Female
Location:Arizona
Vaccinated:1990-09-20
Onset:1990-09-20
Submitted:0000-00-00
Entered:1990-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-20
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: Methyprednisolone, Verapamil, Proventil, Albuterol, Anhydrous Theophylline
Current Illness: Severe Bronchial Asthma
Preexisting Conditions: Pt was hospitalized 2-3 yrs ago for hypertensive Crisis & Severe Bronchial Asthma.
Allergies:
Diagnostic Lab Data: HGT=5''6"; WGT=99lbs; Morning of 20SEP90 BP=142/86;P=72/min®.
CDC 'Split Type': 904090001

Write-up: Pt vaccinated with FLUOGEN who has severe bronchial asthma seen in MD ofc well VS stable & chest clear, death & respiratory arrest.


Changed on 9/14/2017

VAERS ID: 26159 Before After
VAERS Form:(blank) 1
Age:52.0
Sex:Female
Location:Arizona
Vaccinated:1990-09-20
Onset:1990-09-20
Submitted:0000-00-00
Entered:1990-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-20
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: Methyprednisolone, Verapamil, Proventil, Albuterol, Anhydrous Theophylline
Current Illness: Severe Bronchial Asthma
Preexisting Conditions: Pt was hospitalized 2-3 yrs ago for hypertensive Crisis & Severe Bronchial Asthma.
Allergies:
Diagnostic Lab Data: HGT=5''6"; WGT=99lbs; Morning of 20SEP90 BP=142/86;P=72/min®.
CDC 'Split Type': 904090001

Write-up: Pt vaccinated with FLUOGEN who has severe bronchial asthma seen in MD ofc well VS stable & chest clear, death & respiratory arrest.


Changed on 2/14/2018

VAERS ID: 26159 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:Arizona
Vaccinated:1990-09-20
Onset:1990-09-20
Submitted:0000-00-00
Entered:1990-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-20
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: Methyprednisolone, Verapamil, Proventil, Albuterol, Anhydrous Theophylline
Current Illness: Severe Bronchial Asthma
Preexisting Conditions: Pt was hospitalized 2-3 yrs ago for hypertensive Crisis & Severe Bronchial Asthma.
Allergies:
Diagnostic Lab Data: HGT=5''6"; WGT=99lbs; Morning of 20SEP90 BP=142/86;P=72/min®.
CDC 'Split Type': 904090001

Write-up: Pt vaccinated with FLUOGEN who has severe bronchial asthma seen in MD ofc well VS stable & chest clear, death & respiratory arrest.


Changed on 6/14/2018

VAERS ID: 26159 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:Arizona
Vaccinated:1990-09-20
Onset:1990-09-20
Submitted:0000-00-00
Entered:1990-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-20
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: Methyprednisolone, Verapamil, Proventil, Albuterol, Anhydrous Theophylline
Current Illness: Severe Bronchial Asthma
Preexisting Conditions: Pt was hospitalized 2-3 yrs ago for hypertensive Crisis & Severe Bronchial Asthma.
Allergies:
Diagnostic Lab Data: HGT=5''6"; WGT=99lbs; Morning of 20SEP90 BP=142/86;P=72/min®.
CDC 'Split Type': 904090001

Write-up: Pt vaccinated with FLUOGEN who has severe bronchial asthma seen in MD ofc well VS stable & chest clear, death & respiratory arrest.


Changed on 8/14/2018

VAERS ID: 26159 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:Arizona
Vaccinated:1990-09-20
Onset:1990-09-20
Submitted:0000-00-00
Entered:1990-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-20
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: Methyprednisolone, Verapamil, Proventil, Albuterol, Anhydrous Theophylline
Current Illness: Severe Bronchial Asthma
Preexisting Conditions: Pt was hospitalized 2-3 yrs ago for hypertensive Crisis & Severe Bronchial Asthma.
Allergies:
Diagnostic Lab Data: HGT=5''6"; WGT=99lbs; Morning of 20SEP90 BP=142/86;P=72/min®.
CDC 'Split Type': 904090001

Write-up: Pt vaccinated with FLUOGEN who has severe bronchial asthma seen in MD ofc well VS stable & chest clear, death & respiratory arrest.


Changed on 9/14/2018

VAERS ID: 26159 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:Arizona
Vaccinated:1990-09-20
Onset:1990-09-20
Submitted:0000-00-00
Entered:1990-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-20
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: Methyprednisolone, Verapamil, Proventil, Albuterol, Anhydrous Theophylline
Current Illness: Severe Bronchial Asthma
Preexisting Conditions: Pt was hospitalized 2-3 yrs ago for hypertensive Crisis & Severe Bronchial Asthma.
Allergies:
Diagnostic Lab Data: HGT=5''6"; WGT=99lbs; Morning of 20SEP90 BP=142/86;P=72/min®.
CDC 'Split Type': 904090001

Write-up: Pt vaccinated with FLUOGEN who has severe bronchial asthma seen in MD ofc well VS stable & chest clear, death & respiratory arrest.


Changed on 10/14/2018

VAERS ID: 26159 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:Arizona
Vaccinated:1990-09-20
Onset:1990-09-20
Submitted:0000-00-00
Entered:1990-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Apnoea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-09-20
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: Methyprednisolone, Verapamil, Proventil, Albuterol, Anhydrous Theophylline
Current Illness: Severe Bronchial Asthma
Preexisting Conditions: Pt was hospitalized 2-3 yrs ago for hypertensive Crisis & Severe Bronchial Asthma.
Allergies:
Diagnostic Lab Data: HGT=5''6"; WGT=99lbs; Morning of 20SEP90 BP=142/86;P=72/min®.
CDC 'Split Type': 904090001

Write-up: Pt vaccinated with FLUOGEN who has severe bronchial asthma seen in MD ofc well VS stable & chest clear, death & respiratory arrest.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=26159&WAYBACKHISTORY=ON


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