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This is VAERS ID 26866

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26866
VAERS Form:
Age:71.3
Sex:Male
Location:Massachusetts
Vaccinated:1990-10-23
Onset:1990-10-27
Submitted:1990-10-27
Entered:1990-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 0F11226 / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: RASH, EDEMA FACE

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Given Seldane Anhydroxizine
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza four days following injection, pt stated ""I had red spots on my face"", followed by a generalized facial rash on day five & swelling of the face on day six.


Changed on 12/30/2006

VAERS ID: 26866 Before After
VAERS Form:
Age:71.3
Sex:Male
Location:Massachusetts
Vaccinated:1990-10-23
Onset:1990-10-27
Submitted:1990-10-27
Entered:1990-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 0F11226 / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: RASH, EDEMA FACE

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Given Seldane Anhydroxizine
CDC 'Split Type':

Write-up: Pt vaccinated with Influenza four days following injection, pt stated ""I /"I had red spots on my face"", face/", followed by a generalized facial rash on day five & swelling of the face on day six.


Changed on 12/8/2009

VAERS ID: 26866 Before After
VAERS Form:
Age:71.3
Sex:Male
Location:Massachusetts
Vaccinated:1990-10-23
Onset:1990-10-27
Submitted:1990-10-27
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 0F11226 / - LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Face oedema, Rash, RASH, EDEMA FACE

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Given Seldane Anhydroxizine
CDC 'Split Type': (blank) MA900005

Write-up: Pt vaccinated with Influenza four days following injection, pt stated /"I "I had red spots on my face/", face", followed by a generalized facial rash on day five & swelling of the face on day six.


Changed on 8/31/2010

VAERS ID: 26866 Before After
VAERS Form:
Age:71.3
Sex:Male
Location:Massachusetts
Vaccinated:1990-10-23
Onset:1990-10-27
Submitted:1990-10-27
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11226 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Given Seldane Anhydroxizine
CDC 'Split Type': MA900005

Write-up: Pt vaccinated with Influenza four days following injection, pt stated "I had red spots on my face", followed by a generalized facial rash on day five & swelling of the face on day six.


Changed on 7/7/2013

VAERS ID: 26866 Before After
VAERS Form:
Age:71.3
Sex:Male
Location:Massachusetts
Vaccinated:1990-10-23
Onset:1990-10-27
Submitted:1990-10-27
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11226 / - LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11226 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Given Seldane Anhydroxizine
CDC 'Split Type': MA900005

Write-up: Pt vaccinated with Influenza four days following injection, pt stated "I had red spots on my face", followed by a generalized facial rash on day five & swelling of the face on day six.


Changed on 2/14/2017

VAERS ID: 26866 Before After
VAERS Form:
Age:71.3 71.0
Sex:Male
Location:Massachusetts
Vaccinated:1990-10-23
Onset:1990-10-27
Submitted:1990-10-27
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11226 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Given Seldane Anhydroxizine
CDC 'Split Type': MA900005

Write-up: Pt vaccinated with Influenza four days following injection, pt stated "I had red spots on my face", followed by a generalized facial rash on day five & swelling of the face on day six.


Changed on 5/14/2017

VAERS ID: 26866 Before After
VAERS Form:
Age:71.0
Sex:Male
Location:Massachusetts
Vaccinated:1990-10-23
Onset:1990-10-27
Submitted:1990-10-27
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11226 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Given Seldane Anhydroxizine
CDC 'Split Type': MA900005

Write-up: Pt vaccinated with Influenza four days following injection, pt stated "I had red spots on my face", followed by a generalized facial rash on day five & swelling of the face on day six.


Changed on 9/14/2017

VAERS ID: 26866 Before After
VAERS Form:(blank) 1
Age:71.0
Sex:Male
Location:Massachusetts
Vaccinated:1990-10-23
Onset:1990-10-27
Submitted:1990-10-27
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11226 / - UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Given Seldane Anhydroxizine
CDC 'Split Type': MA900005

Write-up: Pt vaccinated with Influenza four days following injection, pt stated "I had red spots on my face", followed by a generalized facial rash on day five & swelling of the face on day six.


Changed on 2/14/2018

VAERS ID: 26866 Before After
VAERS Form:1
Age:71.0
Sex:Male
Location:Massachusetts
Vaccinated:1990-10-23
Onset:1990-10-27
Submitted:1990-10-27
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11226 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Given Seldane Anhydroxizine
CDC 'Split Type': MA900005

Write-up: Pt vaccinated with Influenza four days following injection, pt stated "I had red spots on my face", followed by a generalized facial rash on day five & swelling of the face on day six.


Changed on 6/14/2018

VAERS ID: 26866 Before After
VAERS Form:1
Age:71.0
Sex:Male
Location:Massachusetts
Vaccinated:1990-10-23
Onset:1990-10-27
Submitted:1990-10-27
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11226 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Given Seldane Anhydroxizine
CDC 'Split Type': MA900005

Write-up: Pt vaccinated with Influenza four days following injection, pt stated "I had red spots on my face", followed by a generalized facial rash on day five & swelling of the face on day six.


Changed on 8/14/2018

VAERS ID: 26866 Before After
VAERS Form:1
Age:71.0
Sex:Male
Location:Massachusetts
Vaccinated:1990-10-23
Onset:1990-10-27
Submitted:1990-10-27
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11226 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Given Seldane Anhydroxizine
CDC 'Split Type': MA900005

Write-up: Pt vaccinated with Influenza four days following injection, pt stated "I had red spots on my face", followed by a generalized facial rash on day five & swelling of the face on day six.


Changed on 9/14/2018

VAERS ID: 26866 Before After
VAERS Form:1
Age:71.0
Sex:Male
Location:Massachusetts
Vaccinated:1990-10-23
Onset:1990-10-27
Submitted:1990-10-27
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11226 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Given Seldane Anhydroxizine
CDC 'Split Type': MA900005

Write-up: Pt vaccinated with Influenza four days following injection, pt stated "I had red spots on my face", followed by a generalized facial rash on day five & swelling of the face on day six.


Changed on 10/14/2018

VAERS ID: 26866 Before After
VAERS Form:1
Age:71.0
Sex:Male
Location:Massachusetts
Vaccinated:1990-10-23
Onset:1990-10-27
Submitted:1990-10-27
Entered:1990-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11226 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Face oedema, Rash

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Given Seldane Anhydroxizine
CDC 'Split Type': MA900005

Write-up: Pt vaccinated with Influenza four days following injection, pt stated "I had red spots on my face", followed by a generalized facial rash on day five & swelling of the face on day six.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=26866&WAYBACKHISTORY=ON


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