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This is VAERS ID 26729

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26729
VAERS Form:
Age:68.2
Sex:Male
Location:Mississippi
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-05
Entered:1990-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS / PARKE-DAVIS 01770P / 0 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: DIZZINESS, NAUSEA, VOMIT, SWEAT, ASTHENIA

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: Cardizem, Axid, Carafate
Current Illness:
Preexisting Conditions: HTN, Cardiovascular - Dr. Joseph Messina (PMD)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Fluogen approx 15 min after receiving vaccine pt c/o dizziness, weakness, excessive perspiring, nausea. vomited X 2; BP 140/80, P80 Reg, BS 150.


Changed on 12/8/2009

VAERS ID: 26729 Before After
VAERS Form:
Age:68.2
Sex:Male
Location:Mississippi
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-05
Entered:1990-11-27 1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS INFLUENZA (SEASONAL) (FLUOGEN 90-91) / PARKE-DAVIS 01770P / 0 RA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Nausea, Vomiting, DIZZINESS, NAUSEA, VOMIT, SWEAT, ASTHENIA

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: Cardizem, Axid, Carafate
Current Illness:
Preexisting Conditions: HTN, Cardiovascular - Dr. Joseph Messina (PMD)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) MS901

Write-up: Pt vaccinated with Fluogen approx 15 min after receiving vaccine pt c/o dizziness, weakness, excessive perspiring, nausea. vomited X 2; BP 140/80, P80 Reg, BS 150.


Changed on 8/31/2010

VAERS ID: 26729 Before After
VAERS Form:
Age:68.2
Sex:Male
Location:Mississippi
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-05
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 90-91) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Nausea, Vomiting

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: Cardizem, Axid, Carafate
Current Illness:
Preexisting Conditions: HTN, Cardiovascular - Dr. Joseph Messina (PMD)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS901

Write-up: Pt vaccinated with Fluogen approx 15 min after receiving vaccine pt c/o dizziness, weakness, excessive perspiring, nausea. vomited X 2; BP 140/80, P80 Reg, BS 150.


Changed on 2/13/2013

VAERS ID: 26729 Before After
VAERS Form:
Age:68.2 68.0
Sex:Male
Location:Mississippi
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-05
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / 0 RA / IM

Administered by: Public Unknown      Purchased by: Public Unknown
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Nausea, Vomiting

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: Cardizem, Axid, Carafate
Current Illness:
Preexisting Conditions: HTN, Cardiovascular - Dr. Joseph Messina (PMD)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS901

Write-up: Pt vaccinated with Fluogen approx 15 min after receiving vaccine pt c/o dizziness, weakness, excessive perspiring, nausea. vomited X 2; BP 140/80, P80 Reg, BS 150.


Changed on 7/7/2013

VAERS ID: 26729 Before After
VAERS Form:
Age:68.0
Sex:Male
Location:Mississippi
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-05
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / 0 RA / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Nausea, Vomiting

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: Cardizem, Axid, Carafate
Current Illness:
Preexisting Conditions: HTN, Cardiovascular
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS901

Write-up: Pt vaccinated with Fluogen approx 15 min after receiving vaccine pt c/o dizziness, weakness, excessive perspiring, nausea. vomited X 2; BP 140/80, P80 Reg, BS 150.


Changed on 6/14/2014

VAERS ID: 26729 Before After
VAERS Form:
Age:68.0
Sex:Male
Location:Mississippi
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-05
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Nausea, Vomiting

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: Cardizem, Axid, Carafate
Current Illness:
Preexisting Conditions: HTN, Cardiovascular
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS901

Write-up: Pt vaccinated with Fluogen approx 15 min after receiving vaccine pt c/o dizziness, weakness, excessive perspiring, nausea. vomited X 2; BP 140/80, P80 Reg, BS 150.


Changed on 3/14/2015

VAERS ID: 26729 Before After
VAERS Form:
Age:68.0
Sex:Male
Location:Mississippi
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-05
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Nausea, Vomiting

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: Cardizem, Axid, Carafate
Current Illness:
Preexisting Conditions: HTN, Cardiovascular
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS901

Write-up: Pt vaccinated with Fluogen approx 15 min after receiving vaccine pt c/o dizziness, weakness, excessive perspiring, nausea. vomited X 2; BP 140/80, P80 Reg, BS 150.


Changed on 9/14/2017

VAERS ID: 26729 Before After
VAERS Form:(blank) 1
Age:68.0
Sex:Male
Location:Mississippi
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-05
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / 0 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Nausea, Vomiting

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: Cardizem, Axid, Carafate
Current Illness:
Preexisting Conditions: HTN, Cardiovascular
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS901

Write-up: Pt vaccinated with Fluogen approx 15 min after receiving vaccine pt c/o dizziness, weakness, excessive perspiring, nausea. vomited X 2; BP 140/80, P80 Reg, BS 150.


Changed on 2/14/2018

VAERS ID: 26729 Before After
VAERS Form:1
Age:68.0
Sex:Male
Location:Mississippi
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-05
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Nausea, Vomiting

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: Cardizem, Axid, Carafate
Current Illness:
Preexisting Conditions: HTN, Cardiovascular
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS901

Write-up: Pt vaccinated with Fluogen approx 15 min after receiving vaccine pt c/o dizziness, weakness, excessive perspiring, nausea. vomited X 2; BP 140/80, P80 Reg, BS 150.


Changed on 6/14/2018

VAERS ID: 26729 Before After
VAERS Form:1
Age:68.0
Sex:Male
Location:Mississippi
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-05
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Nausea, Vomiting

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: Cardizem, Axid, Carafate
Current Illness:
Preexisting Conditions: HTN, Cardiovascular
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS901

Write-up: Pt vaccinated with Fluogen approx 15 min after receiving vaccine pt c/o dizziness, weakness, excessive perspiring, nausea. vomited X 2; BP 140/80, P80 Reg, BS 150.


Changed on 8/14/2018

VAERS ID: 26729 Before After
VAERS Form:1
Age:68.0
Sex:Male
Location:Mississippi
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-05
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Nausea, Vomiting

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: Cardizem, Axid, Carafate
Current Illness:
Preexisting Conditions: HTN, Cardiovascular
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS901

Write-up: Pt vaccinated with Fluogen approx 15 min after receiving vaccine pt c/o dizziness, weakness, excessive perspiring, nausea. vomited X 2; BP 140/80, P80 Reg, BS 150.


Changed on 9/14/2018

VAERS ID: 26729 Before After
VAERS Form:1
Age:68.0
Sex:Male
Location:Mississippi
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-05
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Nausea, Vomiting

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: Cardizem, Axid, Carafate
Current Illness:
Preexisting Conditions: HTN, Cardiovascular
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS901

Write-up: Pt vaccinated with Fluogen approx 15 min after receiving vaccine pt c/o dizziness, weakness, excessive perspiring, nausea. vomited X 2; BP 140/80, P80 Reg, BS 150.


Changed on 10/14/2018

VAERS ID: 26729 Before After
VAERS Form:1
Age:68.0
Sex:Male
Location:Mississippi
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-05
Entered:1990-11-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Nausea, Vomiting

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: Cardizem, Axid, Carafate
Current Illness:
Preexisting Conditions: HTN, Cardiovascular
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MS901

Write-up: Pt vaccinated with Fluogen approx 15 min after receiving vaccine pt c/o dizziness, weakness, excessive perspiring, nausea. vomited X 2; BP 140/80, P80 Reg, BS 150.

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