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This is VAERS ID 26862

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26862
VAERS Form:
Age:69.4
Sex:Male
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-11-08
Submitted:1990-11-26
Entered:1990-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 0F11223 / 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: MALAISE, ASTHENIA, PARESTHESIA

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: Doxepin HCL, Hytrin, Dipyradimole
Current Illness:
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vac w/ flu vac developed weakness and mild numbness in torso lasting seven days. Denies difficulty breathing has not had prior reactions to Flu vaccine. 14Feb91: Neurologist comment,"" insufficient evidence to relate sx to flu shot"".


Changed on 12/30/2006

VAERS ID: 26862 Before After
VAERS Form:
Age:69.4
Sex:Male
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-11-08
Submitted:1990-11-26
Entered:1990-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 0F11223 / 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: MALAISE, ASTHENIA, PARESTHESIA

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: Doxepin HCL, Hytrin, Dipyradimole
Current Illness:
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vac w/ flu vac developed weakness and mild numbness in torso lasting seven days. Denies difficulty breathing has not had prior reactions to Flu vaccine. 14Feb91: Neurologist comment,"" comment,/" insufficient evidence to relate sx to flu shot"". shot/".


Changed on 12/8/2009

VAERS ID: 26862 Before After
VAERS Form:
Age:69.4
Sex:Male
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-11-08
Submitted:1990-11-26
Entered:1990-12-05 1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0F11223 / 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Malaise, Paraesthesia, MALAISE, ASTHENIA, PARESTHESIA

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: Doxepin HCL, Hytrin, Dipyradimole
Current Illness:
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) MA900001

Write-up: Pt vac w/ flu vac developed weakness and mild numbness in torso lasting seven days. Denies difficulty breathing has not had prior reactions to Flu vaccine. 14Feb91: Neurologist comment,/" comment," insufficient evidence to relate sx to flu shot/". shot".


Changed on 8/31/2010

VAERS ID: 26862 Before After
VAERS Form:
Age:69.4
Sex:Male
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-11-08
Submitted:1990-11-26
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11223 / 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Malaise, Paraesthesia

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: Doxepin HCL, Hytrin, Dipyradimole
Current Illness:
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MA900001

Write-up: Pt vac w/ flu vac developed weakness and mild numbness in torso lasting seven days. Denies difficulty breathing has not had prior reactions to Flu vaccine. 14Feb91: Neurologist comment," insufficient evidence to relate sx to flu shot".


Changed on 7/7/2013

VAERS ID: 26862 Before After
VAERS Form:
Age:69.4
Sex:Male
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-11-08
Submitted:1990-11-26
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11223 / 4 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11223 / 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Malaise, Paraesthesia

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: Doxepin HCL, Hytrin, Dipyradimole
Current Illness:
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MA900001

Write-up: Pt vac w/ flu vac developed weakness and mild numbness in torso lasting seven days. Denies difficulty breathing has not had prior reactions to Flu vaccine. 14Feb91: Neurologist comment," insufficient evidence to relate sx to flu shot".


Changed on 2/14/2017

VAERS ID: 26862 Before After
VAERS Form:
Age:69.4 69.0
Sex:Male
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-11-08
Submitted:1990-11-26
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11223 / 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Malaise, Paraesthesia

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: Doxepin HCL, Hytrin, Dipyradimole
Current Illness:
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MA900001

Write-up: Pt vac w/ flu vac developed weakness and mild numbness in torso lasting seven days. Denies difficulty breathing has not had prior reactions to Flu vaccine. 14Feb91: Neurologist comment," insufficient evidence to relate sx to flu shot".


Changed on 5/14/2017

VAERS ID: 26862 Before After
VAERS Form:
Age:69.0
Sex:Male
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-11-08
Submitted:1990-11-26
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11223 / 4 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Malaise, Paraesthesia

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: ~ ()~~~In patient
Other Medications: Doxepin HCL, Hytrin, Dipyradimole
Current Illness:
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MA900001

Write-up: Pt vac w/ flu vac developed weakness and mild numbness in torso lasting seven days. Denies difficulty breathing has not had prior reactions to Flu vaccine. 14Feb91: Neurologist comment," insufficient evidence to relate sx to flu shot".


Changed on 9/14/2017

VAERS ID: 26862 Before After
VAERS Form:(blank) 1
Age:69.0
Sex:Male
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-11-08
Submitted:1990-11-26
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11223 / 4 5 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Malaise, Paraesthesia

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: ~ ()~~~In patient
Other Medications: Doxepin HCL, Hytrin, Dipyradimole
Current Illness:
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MA900001

Write-up: Pt vac w/ flu vac developed weakness and mild numbness in torso lasting seven days. Denies difficulty breathing has not had prior reactions to Flu vaccine. 14Feb91: Neurologist comment," insufficient evidence to relate sx to flu shot".


Changed on 2/14/2018

VAERS ID: 26862 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-11-08
Submitted:1990-11-26
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11223 / 5 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Malaise, Paraesthesia

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: ~ ()~~~In patient
Other Medications: Doxepin HCL, Hytrin, Dipyradimole
Current Illness:
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MA900001

Write-up: Pt vac w/ flu vac developed weakness and mild numbness in torso lasting seven days. Denies difficulty breathing has not had prior reactions to Flu vaccine. 14Feb91: Neurologist comment," insufficient evidence to relate sx to flu shot".


Changed on 6/14/2018

VAERS ID: 26862 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-11-08
Submitted:1990-11-26
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11223 / 5 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Malaise, Paraesthesia

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: ~ ()~~~In patient
Other Medications: Doxepin HCL, Hytrin, Dipyradimole
Current Illness:
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MA900001

Write-up: Pt vac w/ flu vac developed weakness and mild numbness in torso lasting seven days. Denies difficulty breathing has not had prior reactions to Flu vaccine. 14Feb91: Neurologist comment," insufficient evidence to relate sx to flu shot".


Changed on 8/14/2018

VAERS ID: 26862 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-11-08
Submitted:1990-11-26
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11223 / 5 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Malaise, Paraesthesia

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: ~ ()~~~In patient
Other Medications: Doxepin HCL, Hytrin, Dipyradimole
Current Illness:
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MA900001

Write-up: Pt vac w/ flu vac developed weakness and mild numbness in torso lasting seven days. Denies difficulty breathing has not had prior reactions to Flu vaccine. 14Feb91: Neurologist comment," insufficient evidence to relate sx to flu shot".


Changed on 9/14/2018

VAERS ID: 26862 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-11-08
Submitted:1990-11-26
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11223 / 5 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Malaise, Paraesthesia

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: ~ ()~~~In patient
Other Medications: Doxepin HCL, Hytrin, Dipyradimole
Current Illness:
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MA900001

Write-up: Pt vac w/ flu vac developed weakness and mild numbness in torso lasting seven days. Denies difficulty breathing has not had prior reactions to Flu vaccine. 14Feb91: Neurologist comment," insufficient evidence to relate sx to flu shot".


Changed on 10/14/2018

VAERS ID: 26862 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-11-08
Submitted:1990-11-26
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11223 / 5 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthenia, Malaise, Paraesthesia

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: ~ ()~~~In patient
Other Medications: Doxepin HCL, Hytrin, Dipyradimole
Current Illness:
Preexisting Conditions: Hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MA900001

Write-up: Pt vac w/ flu vac developed weakness and mild numbness in torso lasting seven days. Denies difficulty breathing has not had prior reactions to Flu vaccine. 14Feb91: Neurologist comment," insufficient evidence to relate sx to flu shot".

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