National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 26722

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26722
VAERS Form:
Age:37.0
Sex:Male
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-10-17
Submitted:1990-10-30
Entered:1990-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 0F11210 / 0 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: DIZZINESS, HYPOTENS, ASTHENIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza, fainting, BP 56/30, pulse weak thready 96. No redness swelling at site of injection. Given Epinephrine.


Changed on 12/8/2009

VAERS ID: 26722 Before After
VAERS Form:
Age:37.0
Sex:Male
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-10-17
Submitted:1990-10-30
Entered:1990-11-27 1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0F11210 / 0 LA / IM

Administered by: Public      Purchased by: Unknown Other
Symptoms: Asthenia, Dizziness, Hypotension, DIZZINESS, HYPOTENS, ASTHENIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza, fainting, BP 56/30, pulse weak thready 96. No redness swelling at site of injection. Given Epinephrine.


Changed on 8/31/2010

VAERS ID: 26722 Before After
VAERS Form:
Age:37.0
Sex:Male
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-10-17
Submitted:1990-10-30
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11210 / 0 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Dizziness, Hypotension

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza, fainting, BP 56/30, pulse weak thready 96. No redness swelling at site of injection. Given Epinephrine.


Changed on 7/7/2013

VAERS ID: 26722 Before After
VAERS Form:
Age:37.0
Sex:Male
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-10-17
Submitted:1990-10-30
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11210 / 0 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11210 / 0 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Dizziness, Hypotension

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza, fainting, BP 56/30, pulse weak thready 96. No redness swelling at site of injection. Given Epinephrine.


Changed on 5/14/2017

VAERS ID: 26722 Before After
VAERS Form:
Age:37.0
Sex:Male
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-10-17
Submitted:1990-10-30
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11210 / 0 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Dizziness, Hypotension

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza, fainting, BP 56/30, pulse weak thready 96. No redness swelling at site of injection. Given Epinephrine.


Changed on 9/14/2017

VAERS ID: 26722 Before After
VAERS Form:(blank) 1
Age:37.0
Sex:Male
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-10-17
Submitted:1990-10-30
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11210 / 0 1 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Dizziness, Hypotension

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza, fainting, BP 56/30, pulse weak thready 96. No redness swelling at site of injection. Given Epinephrine.


Changed on 2/14/2018

VAERS ID: 26722 Before After
VAERS Form:1
Age:37.0
Sex:Male
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-10-17
Submitted:1990-10-30
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11210 / 1 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Dizziness, Hypotension

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza, fainting, BP 56/30, pulse weak thready 96. No redness swelling at site of injection. Given Epinephrine.


Changed on 6/14/2018

VAERS ID: 26722 Before After
VAERS Form:1
Age:37.0
Sex:Male
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-10-17
Submitted:1990-10-30
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11210 / 1 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Dizziness, Hypotension

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza, fainting, BP 56/30, pulse weak thready 96. No redness swelling at site of injection. Given Epinephrine.


Changed on 8/14/2018

VAERS ID: 26722 Before After
VAERS Form:1
Age:37.0
Sex:Male
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-10-17
Submitted:1990-10-30
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11210 / 1 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Dizziness, Hypotension

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza, fainting, BP 56/30, pulse weak thready 96. No redness swelling at site of injection. Given Epinephrine.


Changed on 9/14/2018

VAERS ID: 26722 Before After
VAERS Form:1
Age:37.0
Sex:Male
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-10-17
Submitted:1990-10-30
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11210 / 1 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Dizziness, Hypotension

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza, fainting, BP 56/30, pulse weak thready 96. No redness swelling at site of injection. Given Epinephrine.


Changed on 10/14/2018

VAERS ID: 26722 Before After
VAERS Form:1
Age:37.0
Sex:Male
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-10-17
Submitted:1990-10-30
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11210 / 1 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Dizziness, Hypotension

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza, fainting, BP 56/30, pulse weak thready 96. No redness swelling at site of injection. Given Epinephrine.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=26722&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166