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This is VAERS ID 26619

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26619
VAERS Form:
Age:54.7
Sex:Female
Location:Arizona
Vaccinated:1990-10-31
Onset:1990-11-01
Submitted:1990-11-06
Entered:1990-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE / UNCLASSIFIED - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: INJECT SITE REACT, MASS INJECT SITE, NAUSEA

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: Tenormin, Prop
Current Illness: Peptic Ulcer, Back Pain
Preexisting Conditions: Lower back (L3, L4) surgery 2OCT90 Demerol in Hosp.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated next day redness 2in X 1 1/2in, 1/4in raised, hard not reported until 2NOV90 still red 6NOV, swelling down. Pt was unsure if nausea was from injection or from her ulcer.


Changed on 12/8/2009

VAERS ID: 26619 Before After
VAERS Form:
Age:54.7
Sex:Female
Location:Arizona
Vaccinated:1990-10-31
Onset:1990-11-01
Submitted:1990-11-06
Entered:1990-11-14 1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE INFLUENZA (SEASONAL) (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Injection site mass, Injection site reaction, Nausea, INJECT SITE REACT, MASS INJECT SITE, NAUSEA

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: Tenormin, Prop
Current Illness: Peptic Ulcer, Back Pain
Preexisting Conditions: Lower back (L3, L4) surgery 2OCT90 Demerol in Hosp.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated next day redness 2in X 1 1/2in, 1/4in raised, hard not reported until 2NOV90 still red 6NOV, swelling down. Pt was unsure if nausea was from injection or from her ulcer.


Changed on 7/7/2013

VAERS ID: 26619 Before After
VAERS Form:
Age:54.7
Sex:Female
Location:Arizona
Vaccinated:1990-10-31
Onset:1990-11-01
Submitted:1990-11-06
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Injection site mass, Injection site reaction, Nausea

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: Tenormin, Prop
Current Illness: Peptic Ulcer, Back Pain
Preexisting Conditions: Lower back (L3, L4) surgery 2OCT90 Demerol in Hosp.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated next day redness 2in X 1 1/2in, 1/4in raised, hard not reported until 2NOV90 still red 6NOV, swelling down. Pt was unsure if nausea was from injection or from her ulcer.


Changed on 12/14/2016

VAERS ID: 26619 Before After
VAERS Form:
Age:54.7
Sex:Female
Location:Arizona
Vaccinated:1990-10-31
Onset:1990-11-01
Submitted:1990-11-06
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Injection site mass, Injection site reaction, Nausea

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: Tenormin, Prop
Current Illness: Peptic Ulcer, Back Pain
Preexisting Conditions: Lower back (L3, L4) surgery 2OCT90 Demerol in Hosp.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated next day redness 2in X 1 1/2in, 1/4in raised, hard not reported until 2NOV90 still red 6NOV, swelling down. Pt was unsure if nausea was from injection or from her ulcer.


Changed on 2/14/2017

VAERS ID: 26619 Before After
VAERS Form:
Age:54.7 54.0
Sex:Female
Location:Arizona
Vaccinated:1990-10-31
Onset:1990-11-01
Submitted:1990-11-06
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Injection site mass, Injection site reaction, Nausea

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: Tenormin, Prop
Current Illness: Peptic Ulcer, Back Pain
Preexisting Conditions: Lower back (L3, L4) surgery 2OCT90 Demerol in Hosp.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated next day redness 2in X 1 1/2in, 1/4in raised, hard not reported until 2NOV90 still red 6NOV, swelling down. Pt was unsure if nausea was from injection or from her ulcer.


Changed on 5/14/2017

VAERS ID: 26619 Before After
VAERS Form:
Age:54.0
Sex:Female
Location:Arizona
Vaccinated:1990-10-31
Onset:1990-11-01
Submitted:1990-11-06
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Injection site mass, Injection site reaction, Nausea

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: Tenormin, Prop
Current Illness: Peptic Ulcer, Back Pain
Preexisting Conditions: Lower back (L3, L4) surgery 2OCT90 Demerol in Hosp.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated next day redness 2in X 1 1/2in, 1/4in raised, hard not reported until 2NOV90 still red 6NOV, swelling down. Pt was unsure if nausea was from injection or from her ulcer.


Changed on 9/14/2017

VAERS ID: 26619 Before After
VAERS Form:(blank) 1
Age:54.0
Sex:Female
Location:Arizona
Vaccinated:1990-10-31
Onset:1990-11-01
Submitted:1990-11-06
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Injection site mass, Injection site reaction, Nausea

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: Tenormin, Prop
Current Illness: Peptic Ulcer, Back Pain
Preexisting Conditions: Lower back (L3, L4) surgery 2OCT90 Demerol in Hosp.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated next day redness 2in X 1 1/2in, 1/4in raised, hard not reported until 2NOV90 still red 6NOV, swelling down. Pt was unsure if nausea was from injection or from her ulcer.


Changed on 2/14/2018

VAERS ID: 26619 Before After
VAERS Form:1
Age:54.0
Sex:Female
Location:Arizona
Vaccinated:1990-10-31
Onset:1990-11-01
Submitted:1990-11-06
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Injection site mass, Injection site reaction, Nausea

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: Tenormin, Prop
Current Illness: Peptic Ulcer, Back Pain
Preexisting Conditions: Lower back (L3, L4) surgery 2OCT90 Demerol in Hosp.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated next day redness 2in X 1 1/2in, 1/4in raised, hard not reported until 2NOV90 still red 6NOV, swelling down. Pt was unsure if nausea was from injection or from her ulcer.


Changed on 6/14/2018

VAERS ID: 26619 Before After
VAERS Form:1
Age:54.0
Sex:Female
Location:Arizona
Vaccinated:1990-10-31
Onset:1990-11-01
Submitted:1990-11-06
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Injection site mass, Injection site reaction, Nausea

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: Tenormin, Prop
Current Illness: Peptic Ulcer, Back Pain
Preexisting Conditions: Lower back (L3, L4) surgery 2OCT90 Demerol in Hosp.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated next day redness 2in X 1 1/2in, 1/4in raised, hard not reported until 2NOV90 still red 6NOV, swelling down. Pt was unsure if nausea was from injection or from her ulcer.


Changed on 8/14/2018

VAERS ID: 26619 Before After
VAERS Form:1
Age:54.0
Sex:Female
Location:Arizona
Vaccinated:1990-10-31
Onset:1990-11-01
Submitted:1990-11-06
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Injection site mass, Injection site reaction, Nausea

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: Tenormin, Prop
Current Illness: Peptic Ulcer, Back Pain
Preexisting Conditions: Lower back (L3, L4) surgery 2OCT90 Demerol in Hosp.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated next day redness 2in X 1 1/2in, 1/4in raised, hard not reported until 2NOV90 still red 6NOV, swelling down. Pt was unsure if nausea was from injection or from her ulcer.


Changed on 9/14/2018

VAERS ID: 26619 Before After
VAERS Form:1
Age:54.0
Sex:Female
Location:Arizona
Vaccinated:1990-10-31
Onset:1990-11-01
Submitted:1990-11-06
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Injection site mass, Injection site reaction, Nausea

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: Tenormin, Prop
Current Illness: Peptic Ulcer, Back Pain
Preexisting Conditions: Lower back (L3, L4) surgery 2OCT90 Demerol in Hosp.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated next day redness 2in X 1 1/2in, 1/4in raised, hard not reported until 2NOV90 still red 6NOV, swelling down. Pt was unsure if nausea was from injection or from her ulcer.


Changed on 10/14/2018

VAERS ID: 26619 Before After
VAERS Form:1
Age:54.0
Sex:Female
Location:Arizona
Vaccinated:1990-10-31
Onset:1990-11-01
Submitted:1990-11-06
Entered:1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Injection site mass, Injection site reaction, Nausea

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: Tenormin, Prop
Current Illness: Peptic Ulcer, Back Pain
Preexisting Conditions: Lower back (L3, L4) surgery 2OCT90 Demerol in Hosp.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated next day redness 2in X 1 1/2in, 1/4in raised, hard not reported until 2NOV90 still red 6NOV, swelling down. Pt was unsure if nausea was from injection or from her ulcer.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=26619&WAYBACKHISTORY=ON


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