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This is VAERS ID 26669

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26669
VAERS Form:
Age:39.7
Sex:Male
Location:Ohio
Vaccinated:1990-11-05
Onset:1990-11-05
Submitted:1990-11-12
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS / PARKE-DAVIS 02580P / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: CHILLS, FEVER, NAUSEA, HEADACHE, EDEMA FACE

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: Librium, Tenex, Aspirin, Procardia XL
Current Illness:
Preexisting Conditions: Alcoholism, hypertension, coronary artery dis, demerol allergy causes Increased BP
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza developed nausea, headache, swelling in eyes & face, fever & chills. Treated w/Benadryl & Prednisone.


Changed on 12/8/2009

VAERS ID: 26669 Before After
VAERS Form:
Age:39.7
Sex:Male
Location:Ohio
Vaccinated:1990-11-05
Onset:1990-11-05
Submitted:1990-11-12
Entered:1990-11-21 1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS INFLUENZA (SEASONAL) (FLUOGEN 90-91) / PARKE-DAVIS 02580P / 0 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Chills, Face oedema, Headache, Nausea, Pyrexia, CHILLS, FEVER, NAUSEA, HEADACHE, EDEMA FACE

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: Librium, Tenex, Aspirin, Procardia XL
Current Illness:
Preexisting Conditions: Alcoholism, hypertension, coronary artery dis, demerol allergy causes Increased BP
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza developed nausea, headache, swelling in eyes & face, fever & chills. Treated w/Benadryl & Prednisone.


Changed on 8/31/2010

VAERS ID: 26669 Before After
VAERS Form:
Age:39.7
Sex:Male
Location:Ohio
Vaccinated:1990-11-05
Onset:1990-11-05
Submitted:1990-11-12
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 90-91) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chills, Face oedema, Headache, Nausea, Pyrexia

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: Librium, Tenex, Aspirin, Procardia XL
Current Illness:
Preexisting Conditions: Alcoholism, hypertension, coronary artery dis, demerol allergy causes Increased BP
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza developed nausea, headache, swelling in eyes & face, fever & chills. Treated w/Benadryl & Prednisone.


Changed on 7/7/2013

VAERS ID: 26669 Before After
VAERS Form:
Age:39.7
Sex:Male
Location:Ohio
Vaccinated:1990-11-05
Onset:1990-11-05
Submitted:1990-11-12
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 0 RA / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chills, Face oedema, Headache, Nausea, Pyrexia

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: Librium, Tenex, Aspirin, Procardia XL
Current Illness:
Preexisting Conditions: Alcoholism, hypertension, coronary artery dis, demerol allergy causes Increased BP
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza developed nausea, headache, swelling in eyes & face, fever & chills. Treated w/Benadryl & Prednisone.


Changed on 2/14/2017

VAERS ID: 26669 Before After
VAERS Form:
Age:39.7 39.0
Sex:Male
Location:Ohio
Vaccinated:1990-11-05
Onset:1990-11-05
Submitted:1990-11-12
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chills, Face oedema, Headache, Nausea, Pyrexia

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: Librium, Tenex, Aspirin, Procardia XL
Current Illness:
Preexisting Conditions: Alcoholism, hypertension, coronary artery dis, demerol allergy causes Increased BP
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza developed nausea, headache, swelling in eyes & face, fever & chills. Treated w/Benadryl & Prednisone.


Changed on 5/14/2017

VAERS ID: 26669 Before After
VAERS Form:
Age:39.0
Sex:Male
Location:Ohio
Vaccinated:1990-11-05
Onset:1990-11-05
Submitted:1990-11-12
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chills, Face oedema, Headache, Nausea, Pyrexia

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: Librium, Tenex, Aspirin, Procardia XL
Current Illness:
Preexisting Conditions: Alcoholism, hypertension, coronary artery dis, demerol allergy causes Increased BP
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza developed nausea, headache, swelling in eyes & face, fever & chills. Treated w/Benadryl & Prednisone.


Changed on 9/14/2017

VAERS ID: 26669 Before After
VAERS Form:(blank) 1
Age:39.0
Sex:Male
Location:Ohio
Vaccinated:1990-11-05
Onset:1990-11-05
Submitted:1990-11-12
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 0 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chills, Face oedema, Headache, Nausea, Pyrexia

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: Librium, Tenex, Aspirin, Procardia XL
Current Illness:
Preexisting Conditions: Alcoholism, hypertension, coronary artery dis, demerol allergy causes Increased BP
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza developed nausea, headache, swelling in eyes & face, fever & chills. Treated w/Benadryl & Prednisone.


Changed on 2/14/2018

VAERS ID: 26669 Before After
VAERS Form:1
Age:39.0
Sex:Male
Location:Ohio
Vaccinated:1990-11-05
Onset:1990-11-05
Submitted:1990-11-12
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chills, Face oedema, Headache, Nausea, Pyrexia

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: Librium, Tenex, Aspirin, Procardia XL
Current Illness:
Preexisting Conditions: Alcoholism, hypertension, coronary artery dis, demerol allergy causes Increased BP
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza developed nausea, headache, swelling in eyes & face, fever & chills. Treated w/Benadryl & Prednisone.


Changed on 6/14/2018

VAERS ID: 26669 Before After
VAERS Form:1
Age:39.0
Sex:Male
Location:Ohio
Vaccinated:1990-11-05
Onset:1990-11-05
Submitted:1990-11-12
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chills, Face oedema, Headache, Nausea, Pyrexia

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: Librium, Tenex, Aspirin, Procardia XL
Current Illness:
Preexisting Conditions: Alcoholism, hypertension, coronary artery dis, demerol allergy causes Increased BP
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza developed nausea, headache, swelling in eyes & face, fever & chills. Treated w/Benadryl & Prednisone.


Changed on 8/14/2018

VAERS ID: 26669 Before After
VAERS Form:1
Age:39.0
Sex:Male
Location:Ohio
Vaccinated:1990-11-05
Onset:1990-11-05
Submitted:1990-11-12
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chills, Face oedema, Headache, Nausea, Pyrexia

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: Librium, Tenex, Aspirin, Procardia XL
Current Illness:
Preexisting Conditions: Alcoholism, hypertension, coronary artery dis, demerol allergy causes Increased BP
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza developed nausea, headache, swelling in eyes & face, fever & chills. Treated w/Benadryl & Prednisone.


Changed on 9/14/2018

VAERS ID: 26669 Before After
VAERS Form:1
Age:39.0
Sex:Male
Location:Ohio
Vaccinated:1990-11-05
Onset:1990-11-05
Submitted:1990-11-12
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chills, Face oedema, Headache, Nausea, Pyrexia

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: Librium, Tenex, Aspirin, Procardia XL
Current Illness:
Preexisting Conditions: Alcoholism, hypertension, coronary artery dis, demerol allergy causes Increased BP
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza developed nausea, headache, swelling in eyes & face, fever & chills. Treated w/Benadryl & Prednisone.


Changed on 10/14/2018

VAERS ID: 26669 Before After
VAERS Form:1
Age:39.0
Sex:Male
Location:Ohio
Vaccinated:1990-11-05
Onset:1990-11-05
Submitted:1990-11-12
Entered:1990-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chills, Face oedema, Headache, Nausea, Pyrexia

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: Librium, Tenex, Aspirin, Procardia XL
Current Illness:
Preexisting Conditions: Alcoholism, hypertension, coronary artery dis, demerol allergy causes Increased BP
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza developed nausea, headache, swelling in eyes & face, fever & chills. Treated w/Benadryl & Prednisone.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=26669&WAYBACKHISTORY=ON


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