National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 26667

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26667
VAERS Form:
Age:80.5
Sex:Female
Location:Illinois
Vaccinated:1990-10-18
Onset:1990-10-20
Submitted:1990-10-30
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH 4908196 / 3 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, ASTHENIA, DIARRHEA, GASTROENTERITIS, HYPOVOLEM

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vax w/ flu dev diarrhea & abd cramps two days after vax. Hosp X 4 days; dx = gastroenteritis w/ resultant hypovolemia. Pt also dev fever. Sxs resolved.


Changed on 12/8/2009

VAERS ID: 26667 Before After
VAERS Form:
Age:80.5
Sex:Female
Location:Illinois
Vaccinated:1990-10-18
Onset:1990-10-20
Submitted:1990-10-30
Entered:1990-11-21 1990-11-16
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 4908196 / 3 - / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Abdominal pain, Asthenia, Diarrhoea, Gastroenteritis, Hypovolaemia, Nausea, Pyrexia, FEVER, ASTHENIA, DIARRHEA, GASTROENTERITIS, HYPOVOLEM

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 890303005B

Write-up: Pt vax w/ flu dev diarrhea & abd cramps two days after vax. Hosp X 4 days; dx = gastroenteritis w/ resultant hypovolemia. Pt also dev fever. Sxs resolved.


Changed on 8/31/2010

VAERS ID: 26667 Before After
VAERS Form:
Age:80.5
Sex:Female
Location:Illinois
Vaccinated:1990-10-18
Onset:1990-10-20
Submitted:1990-10-30
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4908196 / 3 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Asthenia, Diarrhoea, Gastroenteritis, Hypovolaemia, Nausea, Pyrexia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890303005B

Write-up: Pt vax w/ flu dev diarrhea & abd cramps two days after vax. Hosp X 4 days; dx = gastroenteritis w/ resultant hypovolemia. Pt also dev fever. Sxs resolved.


Changed on 7/7/2013

VAERS ID: 26667 Before After
VAERS Form:
Age:80.5
Sex:Female
Location:Illinois
Vaccinated:1990-10-18
Onset:1990-10-20
Submitted:1990-10-30
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908196 / 3 - / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908196 / 3 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Asthenia, Diarrhoea, Gastroenteritis, Hypovolaemia, Nausea, Pyrexia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890303005B

Write-up: Pt vax w/ flu dev diarrhea & abd cramps two days after vax. Hosp X 4 days; dx = gastroenteritis w/ resultant hypovolemia. Pt also dev fever. Sxs resolved.


Changed on 12/14/2016

VAERS ID: 26667 Before After
VAERS Form:
Age:80.5
Sex:Female
Location:Illinois
Vaccinated:1990-10-18
Onset:1990-10-20
Submitted:1990-10-30
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908196 / 3 - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908196 / 3 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Asthenia, Diarrhoea, Gastroenteritis, Hypovolaemia, Nausea, Pyrexia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890303005B

Write-up: Pt vax w/ flu dev diarrhea & abd cramps two days after vax. Hosp X 4 days; dx = gastroenteritis w/ resultant hypovolemia. Pt also dev fever. Sxs resolved.


Changed on 2/14/2017

VAERS ID: 26667 Before After
VAERS Form:
Age:80.5 80.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-18
Onset:1990-10-20
Submitted:1990-10-30
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908196 / 3 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Asthenia, Diarrhoea, Gastroenteritis, Hypovolaemia, Nausea, Pyrexia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890303005B

Write-up: Pt vax w/ flu dev diarrhea & abd cramps two days after vax. Hosp X 4 days; dx = gastroenteritis w/ resultant hypovolemia. Pt also dev fever. Sxs resolved.


Changed on 5/14/2017

VAERS ID: 26667 Before After
VAERS Form:
Age:80.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-18
Onset:1990-10-20
Submitted:1990-10-30
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908196 / 3 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Asthenia, Diarrhoea, Gastroenteritis, Hypovolaemia, Nausea, Pyrexia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890303005B

Write-up: Pt vax w/ flu dev diarrhea & abd cramps two days after vax. Hosp X 4 days; dx = gastroenteritis w/ resultant hypovolemia. Pt also dev fever. Sxs resolved.


Changed on 9/14/2017

VAERS ID: 26667 Before After
VAERS Form:(blank) 1
Age:80.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-18
Onset:1990-10-20
Submitted:1990-10-30
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908196 / 3 4 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Asthenia, Diarrhoea, Gastroenteritis, Hypovolaemia, Nausea, Pyrexia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890303005B

Write-up: Pt vax w/ flu dev diarrhea & abd cramps two days after vax. Hosp X 4 days; dx = gastroenteritis w/ resultant hypovolemia. Pt also dev fever. Sxs resolved.


Changed on 2/14/2018

VAERS ID: 26667 Before After
VAERS Form:1
Age:80.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-18
Onset:1990-10-20
Submitted:1990-10-30
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908196 / 4 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Asthenia, Diarrhoea, Gastroenteritis, Hypovolaemia, Nausea, Pyrexia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890303005B

Write-up: Pt vax w/ flu dev diarrhea & abd cramps two days after vax. Hosp X 4 days; dx = gastroenteritis w/ resultant hypovolemia. Pt also dev fever. Sxs resolved.


Changed on 6/14/2018

VAERS ID: 26667 Before After
VAERS Form:1
Age:80.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-18
Onset:1990-10-20
Submitted:1990-10-30
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908196 / 4 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Asthenia, Diarrhoea, Gastroenteritis, Hypovolaemia, Nausea, Pyrexia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890303005B

Write-up: Pt vax w/ flu dev diarrhea & abd cramps two days after vax. Hosp X 4 days; dx = gastroenteritis w/ resultant hypovolemia. Pt also dev fever. Sxs resolved.


Changed on 8/14/2018

VAERS ID: 26667 Before After
VAERS Form:1
Age:80.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-18
Onset:1990-10-20
Submitted:1990-10-30
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908196 / 4 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Asthenia, Diarrhoea, Gastroenteritis, Hypovolaemia, Nausea, Pyrexia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890303005B

Write-up: Pt vax w/ flu dev diarrhea & abd cramps two days after vax. Hosp X 4 days; dx = gastroenteritis w/ resultant hypovolemia. Pt also dev fever. Sxs resolved.


Changed on 9/14/2018

VAERS ID: 26667 Before After
VAERS Form:1
Age:80.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-18
Onset:1990-10-20
Submitted:1990-10-30
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908196 / 4 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Asthenia, Diarrhoea, Gastroenteritis, Hypovolaemia, Nausea, Pyrexia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890303005B

Write-up: Pt vax w/ flu dev diarrhea & abd cramps two days after vax. Hosp X 4 days; dx = gastroenteritis w/ resultant hypovolemia. Pt also dev fever. Sxs resolved.


Changed on 10/14/2018

VAERS ID: 26667 Before After
VAERS Form:1
Age:80.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-18
Onset:1990-10-20
Submitted:1990-10-30
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908196 / 4 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Asthenia, Diarrhoea, Gastroenteritis, Hypovolaemia, Nausea, Pyrexia

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 890303005B

Write-up: Pt vax w/ flu dev diarrhea & abd cramps two days after vax. Hosp X 4 days; dx = gastroenteritis w/ resultant hypovolemia. Pt also dev fever. Sxs resolved.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=26667&WAYBACKHISTORY=ON


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166