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This is VAERS ID 26638

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26638
VAERS Form:
Age:21.6
Sex:Female
Location:Washington
Vaccinated:1990-11-09
Onset:1990-11-09
Submitted:1990-11-12
Entered:1990-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH 02280P / 0 A / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: CHILLS, SWEAT, HEADACHE, MALAISE, ASTHENIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit C, Zantac, A cyclored
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza A/B first time got flu shot. General malaise, headache, fatigue, cold, clammy.


Changed on 12/8/2009

VAERS ID: 26638 Before After
VAERS Form:
Age:21.6
Sex:Female
Location:Washington
Vaccinated:1990-11-09
Onset:1990-11-09
Submitted:1990-11-12
Entered:1990-11-20 1990-11-14
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 02280P / 0 A / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Headache, Hyperhidrosis, Malaise, CHILLS, SWEAT, HEADACHE, MALAISE, ASTHENIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit C, Zantac, A cyclored
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza A/B first time got flu shot. General malaise, headache, fatigue, cold, clammy.


Changed on 8/31/2010

VAERS ID: 26638 Before After
VAERS Form:
Age:21.6
Sex:Female
Location:Washington
Vaccinated:1990-11-09
Onset:1990-11-09
Submitted:1990-11-12
Entered:1990-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 02280P / 0 A / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Headache, Hyperhidrosis, Malaise

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit C, Zantac, A cyclored
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza A/B first time got flu shot. General malaise, headache, fatigue, cold, clammy.


Changed on 7/7/2013

VAERS ID: 26638 Before After
VAERS Form:
Age:21.6
Sex:Female
Location:Washington
Vaccinated:1990-11-09
Onset:1990-11-09
Submitted:1990-11-12
Entered:1990-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 02280P / 0 A / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 02280P / 0 A / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Headache, Hyperhidrosis, Malaise

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit C, Zantac, A cyclored
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza A/B first time got flu shot. General malaise, headache, fatigue, cold, clammy.


Changed on 12/14/2016

VAERS ID: 26638 Before After
VAERS Form:
Age:21.6
Sex:Female
Location:Washington
Vaccinated:1990-11-09
Onset:1990-11-09
Submitted:1990-11-12
Entered:1990-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 02280P / 0 A / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 02280P / 0 A / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Headache, Hyperhidrosis, Malaise

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit C, Zantac, A cyclored
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza A/B first time got flu shot. General malaise, headache, fatigue, cold, clammy.


Changed on 2/14/2017

VAERS ID: 26638 Before After
VAERS Form:
Age:21.6 21.0
Sex:Female
Location:Washington
Vaccinated:1990-11-09
Onset:1990-11-09
Submitted:1990-11-12
Entered:1990-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 02280P / 0 A / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Headache, Hyperhidrosis, Malaise

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit C, Zantac, A cyclored
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza A/B first time got flu shot. General malaise, headache, fatigue, cold, clammy.


Changed on 5/14/2017

VAERS ID: 26638 Before After
VAERS Form:
Age:21.0
Sex:Female
Location:Washington
Vaccinated:1990-11-09
Onset:1990-11-09
Submitted:1990-11-12
Entered:1990-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 02280P / 0 A - / IM IM A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Headache, Hyperhidrosis, Malaise

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Vit C, Zantac, A cyclored
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza A/B first time got flu shot. General malaise, headache, fatigue, cold, clammy.


Changed on 9/14/2017

VAERS ID: 26638 Before After
VAERS Form:(blank) 1
Age:21.0
Sex:Female
Location:Washington
Vaccinated:1990-11-09
Onset:1990-11-09
Submitted:1990-11-12
Entered:1990-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 02280P / 0 1 - / IM A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Headache, Hyperhidrosis, Malaise

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Vit C, Zantac, A cyclored
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza A/B first time got flu shot. General malaise, headache, fatigue, cold, clammy.


Changed on 2/14/2018

VAERS ID: 26638 Before After
VAERS Form:1
Age:21.0
Sex:Female
Location:Washington
Vaccinated:1990-11-09
Onset:1990-11-09
Submitted:1990-11-12
Entered:1990-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 02280P / 1 - / IM A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Headache, Hyperhidrosis, Malaise

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Vit C, Zantac, A cyclored
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza A/B first time got flu shot. General malaise, headache, fatigue, cold, clammy.


Changed on 6/14/2018

VAERS ID: 26638 Before After
VAERS Form:1
Age:21.0
Sex:Female
Location:Washington
Vaccinated:1990-11-09
Onset:1990-11-09
Submitted:1990-11-12
Entered:1990-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 02280P / 1 - / IM A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Headache, Hyperhidrosis, Malaise

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Vit C, Zantac, A cyclored
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza A/B first time got flu shot. General malaise, headache, fatigue, cold, clammy.


Changed on 8/14/2018

VAERS ID: 26638 Before After
VAERS Form:1
Age:21.0
Sex:Female
Location:Washington
Vaccinated:1990-11-09
Onset:1990-11-09
Submitted:1990-11-12
Entered:1990-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 02280P / 1 - / IM A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Headache, Hyperhidrosis, Malaise

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Vit C, Zantac, A cyclored
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza A/B first time got flu shot. General malaise, headache, fatigue, cold, clammy.


Changed on 9/14/2018

VAERS ID: 26638 Before After
VAERS Form:1
Age:21.0
Sex:Female
Location:Washington
Vaccinated:1990-11-09
Onset:1990-11-09
Submitted:1990-11-12
Entered:1990-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 02280P / 1 - / IM A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Headache, Hyperhidrosis, Malaise

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Vit C, Zantac, A cyclored
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza A/B first time got flu shot. General malaise, headache, fatigue, cold, clammy.


Changed on 10/14/2018

VAERS ID: 26638 Before After
VAERS Form:1
Age:21.0
Sex:Female
Location:Washington
Vaccinated:1990-11-09
Onset:1990-11-09
Submitted:1990-11-12
Entered:1990-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 02280P / 1 - / IM A

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Chills, Headache, Hyperhidrosis, Malaise

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Vit C, Zantac, A cyclored
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza A/B first time got flu shot. General malaise, headache, fatigue, cold, clammy.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=26638&WAYBACKHISTORY=ON


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