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This is VAERS ID 26839

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26839
VAERS Form:
Age:55.8
Sex:Male
Location:Arizona
Vaccinated:1990-10-31
Onset:1990-11-12
Submitted:1990-11-16
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private      Purchased by: Unknown
Symptoms: EDEMA FACE, EDEMA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Nasalide, Zejtril
Current Illness: HTN
Preexisting Conditions: Duricef, Novacain, Feldene, Reglan
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated developed swelling-lips, face lt arm & lt hand. Seen in ER 13NOV90. Vsikeril injection in ER Hydroxyzine pam 50mg TID x 7 days. Seen in MD office 15NOV90 for f/u


Changed on 12/8/2009

VAERS ID: 26839 Before After
VAERS Form:
Age:55.8 55.0
Sex:Male
Location:Arizona
Vaccinated:1990-10-31 0000-00-00
Onset:1990-11-12
Submitted:1990-11-16
Entered:1990-12-04 1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Private Unknown      Purchased by: Unknown
Symptoms: Face oedema, Oedema, EDEMA FACE, EDEMA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Nasalide, Zejtril
Current Illness: HTN
Preexisting Conditions: Duricef, Novacain, Feldene, Reglan
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated developed swelling-lips, face lt arm & lt hand. Seen in ER 13NOV90. Vsikeril injection in ER Hydroxyzine pam 50mg TID x 7 days. Seen in MD office 15NOV90 for f/u


Changed on 7/7/2013

VAERS ID: 26839 Before After
VAERS Form:
Age:55.0
Sex:Male
Location:Arizona
Vaccinated:0000-00-00
Onset:1990-11-12
Submitted:1990-11-16
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Face oedema, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nasalide, Zejtril
Current Illness: HTN
Preexisting Conditions: Duricef, Novacain, Feldene, Reglan
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated developed swelling-lips, face lt arm & lt hand. Seen in ER 13NOV90. Vsikeril injection in ER Hydroxyzine pam 50mg TID x 7 days. Seen in MD office 15NOV90 for f/u


Changed on 12/14/2016

VAERS ID: 26839 Before After
VAERS Form:
Age:55.0
Sex:Male
Location:Arizona
Vaccinated:0000-00-00
Onset:1990-11-12
Submitted:1990-11-16
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Face oedema, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nasalide, Zejtril
Current Illness: HTN
Preexisting Conditions: Duricef, Novacain, Feldene, Reglan
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated developed swelling-lips, face lt arm & lt hand. Seen in ER 13NOV90. Vsikeril injection in ER Hydroxyzine pam 50mg TID x 7 days. Seen in MD office 15NOV90 for f/u


Changed on 5/14/2017

VAERS ID: 26839 Before After
VAERS Form:
Age:55.0
Sex:Male
Location:Arizona
Vaccinated:0000-00-00
Onset:1990-11-12
Submitted:1990-11-16
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Unknown Private      Purchased by: Unknown Private
Symptoms: Face oedema, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nasalide, Zejtril
Current Illness: HTN
Preexisting Conditions: Duricef, Novacain, Feldene, Reglan
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated developed swelling-lips, face lt arm & lt hand. Seen in ER 13NOV90. Vsikeril injection in ER Hydroxyzine pam 50mg TID x 7 days. Seen in MD office 15NOV90 for f/u


Changed on 9/14/2017

VAERS ID: 26839 Before After
VAERS Form:(blank) 1
Age:55.0
Sex:Male
Location:Arizona
Vaccinated:0000-00-00
Onset:1990-11-12
Submitted:1990-11-16
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nasalide, Zejtril
Current Illness: HTN
Preexisting Conditions: Duricef, Novacain, Feldene, Reglan
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated developed swelling-lips, face lt arm & lt hand. Seen in ER 13NOV90. Vsikeril injection in ER Hydroxyzine pam 50mg TID x 7 days. Seen in MD office 15NOV90 for f/u


Changed on 2/14/2018

VAERS ID: 26839 Before After
VAERS Form:1
Age:55.0
Sex:Male
Location:Arizona
Vaccinated:0000-00-00
Onset:1990-11-12
Submitted:1990-11-16
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nasalide, Zejtril
Current Illness: HTN
Preexisting Conditions: Duricef, Novacain, Feldene, Reglan
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated developed swelling-lips, face lt arm & lt hand. Seen in ER 13NOV90. Vsikeril injection in ER Hydroxyzine pam 50mg TID x 7 days. Seen in MD office 15NOV90 for f/u


Changed on 6/14/2018

VAERS ID: 26839 Before After
VAERS Form:1
Age:55.0
Sex:Male
Location:Arizona
Vaccinated:0000-00-00
Onset:1990-11-12
Submitted:1990-11-16
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nasalide, Zejtril
Current Illness: HTN
Preexisting Conditions: Duricef, Novacain, Feldene, Reglan
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated developed swelling-lips, face lt arm & lt hand. Seen in ER 13NOV90. Vsikeril injection in ER Hydroxyzine pam 50mg TID x 7 days. Seen in MD office 15NOV90 for f/u


Changed on 8/14/2018

VAERS ID: 26839 Before After
VAERS Form:1
Age:55.0
Sex:Male
Location:Arizona
Vaccinated:0000-00-00
Onset:1990-11-12
Submitted:1990-11-16
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nasalide, Zejtril
Current Illness: HTN
Preexisting Conditions: Duricef, Novacain, Feldene, Reglan
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated developed swelling-lips, face lt arm & lt hand. Seen in ER 13NOV90. Vsikeril injection in ER Hydroxyzine pam 50mg TID x 7 days. Seen in MD office 15NOV90 for f/u


Changed on 9/14/2018

VAERS ID: 26839 Before After
VAERS Form:1
Age:55.0
Sex:Male
Location:Arizona
Vaccinated:0000-00-00
Onset:1990-11-12
Submitted:1990-11-16
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nasalide, Zejtril
Current Illness: HTN
Preexisting Conditions: Duricef, Novacain, Feldene, Reglan
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated developed swelling-lips, face lt arm & lt hand. Seen in ER 13NOV90. Vsikeril injection in ER Hydroxyzine pam 50mg TID x 7 days. Seen in MD office 15NOV90 for f/u


Changed on 10/14/2018

VAERS ID: 26839 Before After
VAERS Form:1
Age:55.0
Sex:Male
Location:Arizona
Vaccinated:0000-00-00
Onset:1990-11-12
Submitted:1990-11-16
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Face oedema, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nasalide, Zejtril
Current Illness: HTN
Preexisting Conditions: Duricef, Novacain, Feldene, Reglan
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated developed swelling-lips, face lt arm & lt hand. Seen in ER 13NOV90. Vsikeril injection in ER Hydroxyzine pam 50mg TID x 7 days. Seen in MD office 15NOV90 for f/u

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=26839&WAYBACKHISTORY=ON


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