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This is VAERS ID 26246

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26246
VAERS Form:
Age:74.3
Sex:Female
Location:Florida
Vaccinated:1990-10-04
Onset:1990-10-05
Submitted:1990-10-09
Entered:1990-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1989-1990 / CONNAUGHT LABS 0F11209 / - LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: URTICARIA, PRURITUS

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: VB12 Cyanocobalmin; Voltaren 25mg
Current Illness:
Preexisting Conditions: Shellfish
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Fluzone developed itching eyes; welts on body; size of quarter for a few hrs. pt took chlor-trimton


Changed on 12/8/2009

VAERS ID: 26246 Before After
VAERS Form:
Age:74.3
Sex:Female
Location:Florida
Vaccinated:1990-10-04
Onset:1990-10-05
Submitted:1990-10-09
Entered:1990-10-17 1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1989-1990 INFLUENZA (SEASONAL) (FLUZONE 89-90) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0F11209 / - LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Pruritus, Urticaria, URTICARIA, PRURITUS

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: VB12 Cyanocobalmin; Voltaren 25mg
Current Illness:
Preexisting Conditions: Shellfish
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Fluzone developed itching eyes; welts on body; size of quarter for a few hrs. pt took chlor-trimton


Changed on 8/31/2010

VAERS ID: 26246 Before After
VAERS Form:
Age:74.3
Sex:Female
Location:Florida
Vaccinated:1990-10-04
Onset:1990-10-05
Submitted:1990-10-09
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 89-90) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11209 / - LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Urticaria

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: VB12 Cyanocobalmin; Voltaren 25mg
Current Illness:
Preexisting Conditions: Shellfish
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Fluzone developed itching eyes; welts on body; size of quarter for a few hrs. pt took chlor-trimton


Changed on 7/7/2013

VAERS ID: 26246 Before After
VAERS Form:
Age:74.3
Sex:Female
Location:Florida
Vaccinated:1990-10-04
Onset:1990-10-05
Submitted:1990-10-09
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11209 / - LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11209 / - LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Urticaria

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: VB12 Cyanocobalmin; Voltaren 25mg
Current Illness:
Preexisting Conditions: Shellfish
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Fluzone developed itching eyes; welts on body; size of quarter for a few hrs. pt took chlor-trimton


Changed on 2/14/2017

VAERS ID: 26246 Before After
VAERS Form:
Age:74.3 74.0
Sex:Female
Location:Florida
Vaccinated:1990-10-04
Onset:1990-10-05
Submitted:1990-10-09
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11209 / - LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Urticaria

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: VB12 Cyanocobalmin; Voltaren 25mg
Current Illness:
Preexisting Conditions: Shellfish
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Fluzone developed itching eyes; welts on body; size of quarter for a few hrs. pt took chlor-trimton


Changed on 5/14/2017

VAERS ID: 26246 Before After
VAERS Form:
Age:74.0
Sex:Female
Location:Florida
Vaccinated:1990-10-04
Onset:1990-10-05
Submitted:1990-10-09
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11209 / - LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Urticaria

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: VB12 Cyanocobalmin; Voltaren 25mg
Current Illness:
Preexisting Conditions: Shellfish
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Fluzone developed itching eyes; welts on body; size of quarter for a few hrs. pt took chlor-trimton


Changed on 9/14/2017

VAERS ID: 26246 Before After
VAERS Form:(blank) 1
Age:74.0
Sex:Female
Location:Florida
Vaccinated:1990-10-04
Onset:1990-10-05
Submitted:1990-10-09
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11209 / - UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Urticaria

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: VB12 Cyanocobalmin; Voltaren 25mg
Current Illness:
Preexisting Conditions: Shellfish
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Fluzone developed itching eyes; welts on body; size of quarter for a few hrs. pt took chlor-trimton


Changed on 2/14/2018

VAERS ID: 26246 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Florida
Vaccinated:1990-10-04
Onset:1990-10-05
Submitted:1990-10-09
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11209 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Urticaria

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: VB12 Cyanocobalmin; Voltaren 25mg
Current Illness:
Preexisting Conditions: Shellfish
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Fluzone developed itching eyes; welts on body; size of quarter for a few hrs. pt took chlor-trimton


Changed on 6/14/2018

VAERS ID: 26246 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Florida
Vaccinated:1990-10-04
Onset:1990-10-05
Submitted:1990-10-09
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11209 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Urticaria

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: VB12 Cyanocobalmin; Voltaren 25mg
Current Illness:
Preexisting Conditions: Shellfish
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Fluzone developed itching eyes; welts on body; size of quarter for a few hrs. pt took chlor-trimton


Changed on 8/14/2018

VAERS ID: 26246 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Florida
Vaccinated:1990-10-04
Onset:1990-10-05
Submitted:1990-10-09
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11209 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Urticaria

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: VB12 Cyanocobalmin; Voltaren 25mg
Current Illness:
Preexisting Conditions: Shellfish
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Fluzone developed itching eyes; welts on body; size of quarter for a few hrs. pt took chlor-trimton


Changed on 9/14/2018

VAERS ID: 26246 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Florida
Vaccinated:1990-10-04
Onset:1990-10-05
Submitted:1990-10-09
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11209 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Urticaria

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: VB12 Cyanocobalmin; Voltaren 25mg
Current Illness:
Preexisting Conditions: Shellfish
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Fluzone developed itching eyes; welts on body; size of quarter for a few hrs. pt took chlor-trimton


Changed on 10/14/2018

VAERS ID: 26246 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Florida
Vaccinated:1990-10-04
Onset:1990-10-05
Submitted:1990-10-09
Entered:1990-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11209 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Urticaria

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: VB12 Cyanocobalmin; Voltaren 25mg
Current Illness:
Preexisting Conditions: Shellfish
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Fluzone developed itching eyes; welts on body; size of quarter for a few hrs. pt took chlor-trimton

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