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This is VAERS ID 26709

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26709
VAERS Form:
Age:79.6
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-02
Entered:1990-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 11203 / - LA / -
PPV: PNU-IMUNE(R)23 / LEDERLE 285909 / 0 RA / -

Administered by: Public      Purchased by: Unknown
Symptoms: EDEMA, PAIN

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

Write-up: Pt vaccinated Pnuemococcal/FLU rt arm now swollen, wrist to shoulder. No known allergies.


Changed on 12/8/2009

VAERS ID: 26709 Before After
VAERS Form:
Age:79.6
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-02
Entered:1990-11-27 1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABS CONNAUGHT LABORATORIES 11203 / - LA / -
PPV: PNU-IMUNE(R)23 PNEUMO (PNU-IMUNE) / LEDERLE LEDERLE LABORATORIES 285909 / 0 RA / -

Administered by: Public      Purchased by: Unknown Public
Symptoms: Oedema, Pain, EDEMA, PAIN

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) CA903

Write-up: Pt vaccinated Pnuemococcal/FLU rt arm now swollen, wrist to shoulder. No known allergies.


Changed on 8/31/2010

VAERS ID: 26709 Before After
VAERS Form:
Age:79.6
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-02
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11203 / - LA / -
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 285909 / 0 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Oedema, Pain

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA903

Write-up: Pt vaccinated Pnuemococcal/FLU rt arm now swollen, wrist to shoulder. No known allergies.


Changed on 7/7/2013

VAERS ID: 26709 Before After
VAERS Form:
Age:79.6
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-02
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11203 / - LA / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11203 / - LA / -
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 285909 / 0 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Oedema, Pain

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA903

Write-up: Pt vaccinated Pnuemococcal/FLU rt arm now swollen, wrist to shoulder. No known allergies.


Changed on 2/14/2017

VAERS ID: 26709 Before After
VAERS Form:
Age:79.6 79.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-02
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11203 / - LA / -
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 285909 / 0 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Oedema, Pain

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA903

Write-up: Pt vaccinated Pnuemococcal/FLU rt arm now swollen, wrist to shoulder. No known allergies.


Changed on 5/14/2017

VAERS ID: 26709 Before After
VAERS Form:
Age:79.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-02
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11203 / - LA / -
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 285909 / 0 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Oedema, Pain

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA903

Write-up: Pt vaccinated Pnuemococcal/FLU rt arm now swollen, wrist to shoulder. No known allergies.


Changed on 9/14/2017

VAERS ID: 26709 Before After
VAERS Form:(blank) 1
Age:79.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-02
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11203 / - UNK LA / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 0 1 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Oedema, Pain

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA903

Write-up: Pt vaccinated Pnuemococcal/FLU rt arm now swollen, wrist to shoulder. No known allergies.


Changed on 2/14/2018

VAERS ID: 26709 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-02
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11203 / UNK LA / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Oedema, Pain

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA903

Write-up: Pt vaccinated Pnuemococcal/FLU rt arm now swollen, wrist to shoulder. No known allergies.


Changed on 6/14/2018

VAERS ID: 26709 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-02
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11203 / UNK LA / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Oedema, Pain

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA903

Write-up: Pt vaccinated Pnuemococcal/FLU rt arm now swollen, wrist to shoulder. No known allergies.


Changed on 8/14/2018

VAERS ID: 26709 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-02
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11203 / UNK LA / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Oedema, Pain

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA903

Write-up: Pt vaccinated Pnuemococcal/FLU rt arm now swollen, wrist to shoulder. No known allergies.


Changed on 9/14/2018

VAERS ID: 26709 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-02
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11203 / UNK LA / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Oedema, Pain

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA903

Write-up: Pt vaccinated Pnuemococcal/FLU rt arm now swollen, wrist to shoulder. No known allergies.


Changed on 10/14/2018

VAERS ID: 26709 Before After
VAERS Form:1
Age:79.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1990-11-02
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 11203 / UNK LA / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Oedema, Pain

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA903

Write-up: Pt vaccinated Pnuemococcal/FLU rt arm now swollen, wrist to shoulder. No known allergies.

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