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This is VAERS ID 26614

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26614
VAERS Form:
Age:44.1
Sex:Female
Location:Michigan
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-03
Entered:1990-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH 4908509 / - LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: INJECT SITE REACT, MASS INJECT SITE

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

Write-up: Pt vaccinated with Influenza Vaccine became itchy in area lt arm; hard in area; sl swollen, red & warm started evening 1NOV90 has continued stated less red & swollen today 3NOV90.


Changed on 12/8/2009

VAERS ID: 26614 Before After
VAERS Form:
Age:44.1
Sex:Female
Location:Michigan
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-03
Entered:1990-11-14 1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) / WYETH WYETH PHARMACEUTICALS, INC 4908509 / - LA / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site mass, Injection site reaction, INJECT SITE REACT, MASS INJECT SITE

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

Write-up: Pt vaccinated with Influenza Vaccine became itchy in area lt arm; hard in area; sl swollen, red & warm started evening 1NOV90 has continued stated less red & swollen today 3NOV90.


Changed on 8/31/2010

VAERS ID: 26614 Before After
VAERS Form:
Age:44.1
Sex:Female
Location:Michigan
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-03
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4908509 / - LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site mass, Injection site reaction

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

Write-up: Pt vaccinated with Influenza Vaccine became itchy in area lt arm; hard in area; sl swollen, red & warm started evening 1NOV90 has continued stated less red & swollen today 3NOV90.


Changed on 7/7/2013

VAERS ID: 26614 Before After
VAERS Form:
Age:44.1
Sex:Female
Location:Michigan
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-03
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908509 / - LA / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908509 / - LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site mass, Injection site reaction

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

Write-up: Pt vaccinated with Influenza Vaccine became itchy in area lt arm; hard in area; sl swollen, red & warm started evening 1NOV90 has continued stated less red & swollen today 3NOV90.


Changed on 12/14/2016

VAERS ID: 26614 Before After
VAERS Form:
Age:44.1
Sex:Female
Location:Michigan
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-03
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908509 / - LA / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908509 / - LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site mass, Injection site reaction

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

Write-up: Pt vaccinated with Influenza Vaccine became itchy in area lt arm; hard in area; sl swollen, red & warm started evening 1NOV90 has continued stated less red & swollen today 3NOV90.


Changed on 2/14/2017

VAERS ID: 26614 Before After
VAERS Form:
Age:44.1 44.0
Sex:Female
Location:Michigan
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-03
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908509 / - LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site mass, Injection site reaction

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

Write-up: Pt vaccinated with Influenza Vaccine became itchy in area lt arm; hard in area; sl swollen, red & warm started evening 1NOV90 has continued stated less red & swollen today 3NOV90.


Changed on 5/14/2017

VAERS ID: 26614 Before After
VAERS Form:
Age:44.0
Sex:Female
Location:Michigan
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-03
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908509 / - LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site mass, Injection site reaction

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

Write-up: Pt vaccinated with Influenza Vaccine became itchy in area lt arm; hard in area; sl swollen, red & warm started evening 1NOV90 has continued stated less red & swollen today 3NOV90.


Changed on 9/14/2017

VAERS ID: 26614 Before After
VAERS Form:(blank) 1
Age:44.0
Sex:Female
Location:Michigan
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-03
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908509 / - UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site mass, Injection site reaction

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

Write-up: Pt vaccinated with Influenza Vaccine became itchy in area lt arm; hard in area; sl swollen, red & warm started evening 1NOV90 has continued stated less red & swollen today 3NOV90.


Changed on 2/14/2018

VAERS ID: 26614 Before After
VAERS Form:1
Age:44.0
Sex:Female
Location:Michigan
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-03
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908509 / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site mass, Injection site reaction

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

Write-up: Pt vaccinated with Influenza Vaccine became itchy in area lt arm; hard in area; sl swollen, red & warm started evening 1NOV90 has continued stated less red & swollen today 3NOV90.


Changed on 6/14/2018

VAERS ID: 26614 Before After
VAERS Form:1
Age:44.0
Sex:Female
Location:Michigan
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-03
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908509 / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site mass, Injection site reaction

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

Write-up: Pt vaccinated with Influenza Vaccine became itchy in area lt arm; hard in area; sl swollen, red & warm started evening 1NOV90 has continued stated less red & swollen today 3NOV90.


Changed on 8/14/2018

VAERS ID: 26614 Before After
VAERS Form:1
Age:44.0
Sex:Female
Location:Michigan
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-03
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908509 / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site mass, Injection site reaction

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

Write-up: Pt vaccinated with Influenza Vaccine became itchy in area lt arm; hard in area; sl swollen, red & warm started evening 1NOV90 has continued stated less red & swollen today 3NOV90.


Changed on 9/14/2018

VAERS ID: 26614 Before After
VAERS Form:1
Age:44.0
Sex:Female
Location:Michigan
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-03
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908509 / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site mass, Injection site reaction

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

Write-up: Pt vaccinated with Influenza Vaccine became itchy in area lt arm; hard in area; sl swollen, red & warm started evening 1NOV90 has continued stated less red & swollen today 3NOV90.


Changed on 10/14/2018

VAERS ID: 26614 Before After
VAERS Form:1
Age:44.0
Sex:Female
Location:Michigan
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-03
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908509 / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site mass, Injection site reaction

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

Write-up: Pt vaccinated with Influenza Vaccine became itchy in area lt arm; hard in area; sl swollen, red & warm started evening 1NOV90 has continued stated less red & swollen today 3NOV90.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=26614&WAYBACKHISTORY=ON


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