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This is VAERS ID 26844

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26844
VAERS Form:
Age:
Sex:Female
Location:Washington
Vaccinated:1990-09-01
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS / PARKE-DAVIS - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: STEVENS JOHNSON SYND

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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 FLUOGEN developed Stevens-Johnson Synd. No other details known.


Changed on 12/8/2009

VAERS ID: 26844 Before After
VAERS Form:
Age:
Sex:Female
Location:Washington
Vaccinated:1990-09-01
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-12-04 1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS INFLUENZA (SEASONAL) (FLUOGEN 90-91) / PARKE-DAVIS - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Stevens-Johnson syndrome, STEVENS JOHNSON SYND

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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) 904090004

Write-up: Pt vaccinated with FLUOGEN developed Stevens-Johnson Synd. No other details known.


Changed on 8/31/2010

VAERS ID: 26844 Before After
VAERS Form:
Age:
Sex:Female
Location:Washington
Vaccinated:1990-09-01
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 90-91) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Stevens-Johnson syndrome

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': 904090004

Write-up: Pt vaccinated with FLUOGEN developed Stevens-Johnson Synd. No other details known.


Changed on 7/7/2013

VAERS ID: 26844 Before After
VAERS Form:
Age:
Sex:Female
Location:Washington
Vaccinated:1990-09-01
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Stevens-Johnson syndrome

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': 904090004

Write-up: Pt vaccinated with FLUOGEN developed Stevens-Johnson Synd. No other details known.


Changed on 5/14/2017

VAERS ID: 26844 Before After
VAERS Form:
Age:
Sex:Female
Location:Washington
Vaccinated:1990-09-01
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Stevens-Johnson syndrome

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': 904090004

Write-up: Pt vaccinated with FLUOGEN developed Stevens-Johnson Synd. No other details known.


Changed on 9/14/2017

VAERS ID: 26844 Before After
VAERS Form:(blank) 1
Age:
Sex:Female
Location:Washington
Vaccinated:1990-09-01
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Stevens-Johnson syndrome

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': 904090004

Write-up: Pt vaccinated with FLUOGEN developed Stevens-Johnson Synd. No other details known.


Changed on 2/14/2018

VAERS ID: 26844 Before After
VAERS Form:1
Age:
Sex:Female
Location:Washington
Vaccinated:1990-09-01
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Stevens-Johnson syndrome

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': 904090004

Write-up: Pt vaccinated with FLUOGEN developed Stevens-Johnson Synd. No other details known.


Changed on 6/14/2018

VAERS ID: 26844 Before After
VAERS Form:1
Age:
Sex:Female
Location:Washington
Vaccinated:1990-09-01
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Stevens-Johnson syndrome

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': 904090004

Write-up: Pt vaccinated with FLUOGEN developed Stevens-Johnson Synd. No other details known.


Changed on 8/14/2018

VAERS ID: 26844 Before After
VAERS Form:1
Age:
Sex:Female
Location:Washington
Vaccinated:1990-09-01
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Stevens-Johnson syndrome

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': 904090004

Write-up: Pt vaccinated with FLUOGEN developed Stevens-Johnson Synd. No other details known.


Changed on 9/14/2018

VAERS ID: 26844 Before After
VAERS Form:1
Age:
Sex:Female
Location:Washington
Vaccinated:1990-09-01
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Stevens-Johnson syndrome

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': 904090004

Write-up: Pt vaccinated with FLUOGEN developed Stevens-Johnson Synd. No other details known.


Changed on 10/14/2018

VAERS ID: 26844 Before After
VAERS Form:1
Age:
Sex:Female
Location:Washington
Vaccinated:1990-09-01
Onset:1990-09-01
Submitted:0000-00-00
Entered:1990-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Stevens-Johnson syndrome

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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': 904090004

Write-up: Pt vaccinated with FLUOGEN developed Stevens-Johnson Synd. No other details known.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=26844&WAYBACKHISTORY=ON


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