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This is VAERS ID 26711

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26711
VAERS Form:
Age:63.6
Sex:Male
Location:California
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-11-09
Entered:1990-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 0F11203 / 1 - / -

Administered by: Public      Purchased by: Unknown
Symptoms: 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Fluzone developed facial swelling seen on 19OCT90 face was red with periorbital swelling. Benadryl 25 mg 1 or 2 caps every 8 hours.


Changed on 12/8/2009

VAERS ID: 26711 Before After
VAERS Form:
Age:63.6
Sex:Male
Location:California
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-11-09
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 0F11203 / 1 - / -

Administered by: Public      Purchased by: Unknown Public
Symptoms: Face oedema, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) CA901

Write-up: Pt vaccinated with Fluzone developed facial swelling seen on 19OCT90 face was red with periorbital swelling. Benadryl 25 mg 1 or 2 caps every 8 hours.


Changed on 8/31/2010

VAERS ID: 26711 Before After
VAERS Form:
Age:63.6
Sex:Male
Location:California
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-11-09
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / 1 - / -

Administered by: Public      Purchased by: Public
Symptoms: Face oedema

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': CA901

Write-up: Pt vaccinated with Fluzone developed facial swelling seen on 19OCT90 face was red with periorbital swelling. Benadryl 25 mg 1 or 2 caps every 8 hours.


Changed on 7/7/2013

VAERS ID: 26711 Before After
VAERS Form:
Age:63.6
Sex:Male
Location:California
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-11-09
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / 1 - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / 1 - / -

Administered by: Public      Purchased by: Public
Symptoms: Face oedema

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': CA901

Write-up: Pt vaccinated with Fluzone developed facial swelling seen on 19OCT90 face was red with periorbital swelling. Benadryl 25 mg 1 or 2 caps every 8 hours.


Changed on 2/14/2017

VAERS ID: 26711 Before After
VAERS Form:
Age:63.6 63.0
Sex:Male
Location:California
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-11-09
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / 1 - / -

Administered by: Public      Purchased by: Public
Symptoms: Face oedema

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': CA901

Write-up: Pt vaccinated with Fluzone developed facial swelling seen on 19OCT90 face was red with periorbital swelling. Benadryl 25 mg 1 or 2 caps every 8 hours.


Changed on 5/14/2017

VAERS ID: 26711 Before After
VAERS Form:
Age:63.0
Sex:Male
Location:California
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-11-09
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / 1 - / -

Administered by: Public      Purchased by: Public
Symptoms: Face oedema

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': CA901

Write-up: Pt vaccinated with Fluzone developed facial swelling seen on 19OCT90 face was red with periorbital swelling. Benadryl 25 mg 1 or 2 caps every 8 hours.


Changed on 9/14/2017

VAERS ID: 26711 Before After
VAERS Form:(blank) 1
Age:63.0
Sex:Male
Location:California
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-11-09
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / 1 2 - / -

Administered by: Public      Purchased by: Public
Symptoms: Face oedema

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': CA901

Write-up: Pt vaccinated with Fluzone developed facial swelling seen on 19OCT90 face was red with periorbital swelling. Benadryl 25 mg 1 or 2 caps every 8 hours.


Changed on 2/14/2018

VAERS ID: 26711 Before After
VAERS Form:1
Age:63.0
Sex:Male
Location:California
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-11-09
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / 2 - / -

Administered by: Public      Purchased by: Public
Symptoms: Face oedema

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': CA901

Write-up: Pt vaccinated with Fluzone developed facial swelling seen on 19OCT90 face was red with periorbital swelling. Benadryl 25 mg 1 or 2 caps every 8 hours.


Changed on 6/14/2018

VAERS ID: 26711 Before After
VAERS Form:1
Age:63.0
Sex:Male
Location:California
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-11-09
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / 2 - / -

Administered by: Public      Purchased by: Public
Symptoms: Face oedema

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': CA901

Write-up: Pt vaccinated with Fluzone developed facial swelling seen on 19OCT90 face was red with periorbital swelling. Benadryl 25 mg 1 or 2 caps every 8 hours.


Changed on 8/14/2018

VAERS ID: 26711 Before After
VAERS Form:1
Age:63.0
Sex:Male
Location:California
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-11-09
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / 2 - / -

Administered by: Public      Purchased by: Public
Symptoms: Face oedema

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': CA901

Write-up: Pt vaccinated with Fluzone developed facial swelling seen on 19OCT90 face was red with periorbital swelling. Benadryl 25 mg 1 or 2 caps every 8 hours.


Changed on 9/14/2018

VAERS ID: 26711 Before After
VAERS Form:1
Age:63.0
Sex:Male
Location:California
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-11-09
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / 2 - / -

Administered by: Public      Purchased by: Public
Symptoms: Face oedema

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': CA901

Write-up: Pt vaccinated with Fluzone developed facial swelling seen on 19OCT90 face was red with periorbital swelling. Benadryl 25 mg 1 or 2 caps every 8 hours.


Changed on 10/14/2018

VAERS ID: 26711 Before After
VAERS Form:1
Age:63.0
Sex:Male
Location:California
Vaccinated:1990-10-18
Onset:1990-10-18
Submitted:1990-11-09
Entered:1990-11-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / 2 - / -

Administered by: Public      Purchased by: Public
Symptoms: Face oedema

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': CA901

Write-up: Pt vaccinated with Fluzone developed facial swelling seen on 19OCT90 face was red with periorbital swelling. Benadryl 25 mg 1 or 2 caps every 8 hours.

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