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This is VAERS ID 26596

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26596
VAERS Form:
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLU-IMUNE 1990-1991 LEDERLE / LEDERLE 289967 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: CONVULS, STUPOR, ENCEPHALITIS

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza Vaccine 3-4 days after, pt had a seizure like episode at home, was found unresponsive and hospitalized. Admitted to ICU for 5 days. Treatment included oxygen and IV fluids. Discharged, admitted to Nursing Home.


Changed on 12/8/2009

VAERS ID: 26596 Before After
VAERS Form:
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-11-13 1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLU-IMUNE 1990-1991 LEDERLE INFLUENZA (SEASONAL) (FLU-IMUNE 90-91) / LEDERLE LEDERLE LABORATORIES 289967 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Stupor, CONVULS, STUPOR, ENCEPHALITIS

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 900180401

Write-up: Pt vaccinated with Influenza Vaccine 3-4 days after, pt had a seizure like episode at home, was found unresponsive and hospitalized. Admitted to ICU for 5 days. Treatment included oxygen and IV fluids. Discharged, admitted to Nursing Home.


Changed on 8/31/2010

VAERS ID: 26596 Before After
VAERS Form:
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLU-IMUNE 90-91) INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 289967 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Stupor

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900180401

Write-up: Pt vaccinated with Influenza Vaccine 3-4 days after, pt had a seizure like episode at home, was found unresponsive and hospitalized. Admitted to ICU for 5 days. Treatment included oxygen and IV fluids. Discharged, admitted to Nursing Home.


Changed on 7/7/2013

VAERS ID: 26596 Before After
VAERS Form:
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 289967 / - - / IM
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 289967 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Stupor

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900180401

Write-up: Pt vaccinated with Influenza Vaccine 3-4 days after, pt had a seizure like episode at home, was found unresponsive and hospitalized. Admitted to ICU for 5 days. Treatment included oxygen and IV fluids. Discharged, admitted to Nursing Home.


Changed on 5/14/2017

VAERS ID: 26596 Before After
VAERS Form:
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 289967 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Stupor

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900180401

Write-up: Pt vaccinated with Influenza Vaccine 3-4 days after, pt had a seizure like episode at home, was found unresponsive and hospitalized. Admitted to ICU for 5 days. Treatment included oxygen and IV fluids. Discharged, admitted to Nursing Home.


Changed on 9/14/2017

VAERS ID: 26596 Before After
VAERS Form:(blank) 1
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 289967 / - UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Stupor

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900180401

Write-up: Pt vaccinated with Influenza Vaccine 3-4 days after, pt had a seizure like episode at home, was found unresponsive and hospitalized. Admitted to ICU for 5 days. Treatment included oxygen and IV fluids. Discharged, admitted to Nursing Home.


Changed on 2/14/2018

VAERS ID: 26596 Before After
VAERS Form:1
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 289967 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Stupor

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900180401

Write-up: Pt vaccinated with Influenza Vaccine 3-4 days after, pt had a seizure like episode at home, was found unresponsive and hospitalized. Admitted to ICU for 5 days. Treatment included oxygen and IV fluids. Discharged, admitted to Nursing Home.


Changed on 6/14/2018

VAERS ID: 26596 Before After
VAERS Form:1
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 289967 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Stupor

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900180401

Write-up: Pt vaccinated with Influenza Vaccine 3-4 days after, pt had a seizure like episode at home, was found unresponsive and hospitalized. Admitted to ICU for 5 days. Treatment included oxygen and IV fluids. Discharged, admitted to Nursing Home.


Changed on 8/14/2018

VAERS ID: 26596 Before After
VAERS Form:1
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 289967 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Stupor

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900180401

Write-up: Pt vaccinated with Influenza Vaccine 3-4 days after, pt had a seizure like episode at home, was found unresponsive and hospitalized. Admitted to ICU for 5 days. Treatment included oxygen and IV fluids. Discharged, admitted to Nursing Home.


Changed on 9/14/2018

VAERS ID: 26596 Before After
VAERS Form:1
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 289967 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Stupor

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900180401

Write-up: Pt vaccinated with Influenza Vaccine 3-4 days after, pt had a seizure like episode at home, was found unresponsive and hospitalized. Admitted to ICU for 5 days. Treatment included oxygen and IV fluids. Discharged, admitted to Nursing Home.


Changed on 10/14/2018

VAERS ID: 26596 Before After
VAERS Form:1
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 289967 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Convulsion, Encephalitis, Stupor

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 900180401

Write-up: Pt vaccinated with Influenza Vaccine 3-4 days after, pt had a seizure like episode at home, was found unresponsive and hospitalized. Admitted to ICU for 5 days. Treatment included oxygen and IV fluids. Discharged, admitted to Nursing Home.

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