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This is VAERS ID 26888

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26888
VAERS Form:
Age:80.3
Sex:Female
Location:California
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-27
Entered:1990-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH 4908201 / - - / IM
PPV: PNU-IMUNE(R)23 / LEDERLE 287906 / - - / IM

Administered by: Military      Purchased by: Unknown
Symptoms: FEVER, RASH, SERUM SICK

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: Temezepam, Cefaclor, Furosemide, DSS KCL 10% Soln; Haldol, Nimotop
Current Illness: s/p Subarachnoid hemmorhage Parkinsons
Preexisting Conditions: Subarachnoid Hemmmorhage, Parkinsons Disease; CVA;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pnu-Imune 23/Influenza developed minor rash; MD notified dx serum sickness, temp 100.1 (R); Pt w/vascular macular erythematous eruptions over extensor surfaces large joints. Treatment: Diphenhydramine & APAP.


Changed on 12/8/2009

VAERS ID: 26888 Before After
VAERS Form:
Age:80.3
Sex:Female
Location:California
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-27
Entered:1990-12-06 1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) / WYETH WYETH PHARMACEUTICALS, INC 4908201 / - - / IM
PPV: PNU-IMUNE(R)23 PNEUMO (PNU-IMUNE) / LEDERLE LEDERLE LABORATORIES 287906 / - - / IM

Administered by: Military      Purchased by: Unknown Public
Symptoms: Pyrexia, Rash, Serum sickness, FEVER, RASH, SERUM SICK

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: Temezepam, Cefaclor, Furosemide, DSS KCL 10% Soln; Haldol, Nimotop
Current Illness: s/p Subarachnoid hemmorhage Parkinsons
Preexisting Conditions: Subarachnoid Hemmmorhage, Parkinsons Disease; CVA;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pnu-Imune 23/Influenza developed minor rash; MD notified dx serum sickness, temp 100.1 (R); Pt w/vascular macular erythematous eruptions over extensor surfaces large joints. Treatment: Diphenhydramine & APAP.


Changed on 8/31/2010

VAERS ID: 26888 Before After
VAERS Form:
Age:80.3
Sex:Female
Location:California
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-27
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4908201 / - - / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 287906 / - - / IM

Administered by: Military      Purchased by: Public
Symptoms: Pyrexia, Rash, Serum sickness

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: Temezepam, Cefaclor, Furosemide, DSS KCL 10% Soln; Haldol, Nimotop
Current Illness: s/p Subarachnoid hemmorhage Parkinsons
Preexisting Conditions: Subarachnoid Hemmmorhage, Parkinsons Disease; CVA;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pnu-Imune 23/Influenza developed minor rash; MD notified dx serum sickness, temp 100.1 (R); Pt w/vascular macular erythematous eruptions over extensor surfaces large joints. Treatment: Diphenhydramine & APAP.


Changed on 7/7/2013

VAERS ID: 26888 Before After
VAERS Form:
Age:80.3
Sex:Female
Location:California
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-27
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / - - / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / - - / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 287906 / - - / IM

Administered by: Military      Purchased by: Public
Symptoms: Pyrexia, Rash, Serum sickness

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: Temezepam, Cefaclor, Furosemide, DSS KCL 10% Soln; Haldol, Nimotop
Current Illness: s/p Subarachnoid hemmorhage Parkinsons
Preexisting Conditions: Subarachnoid Hemmmorhage, Parkinsons Disease; CVA;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pnu-Imune 23/Influenza developed minor rash; MD notified dx serum sickness, temp 100.1 (R); Pt w/vascular macular erythematous eruptions over extensor surfaces large joints. Treatment: Diphenhydramine & APAP.


Changed on 12/14/2016

VAERS ID: 26888 Before After
VAERS Form:
Age:80.3
Sex:Female
Location:California
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-27
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / - - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / - - / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 287906 / - - / IM

Administered by: Military      Purchased by: Public
Symptoms: Pyrexia, Rash, Serum sickness

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: Temezepam, Cefaclor, Furosemide, DSS KCL 10% Soln; Haldol, Nimotop
Current Illness: s/p Subarachnoid hemmorhage Parkinsons
Preexisting Conditions: Subarachnoid Hemmmorhage, Parkinsons Disease; CVA;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pnu-Imune 23/Influenza developed minor rash; MD notified dx serum sickness, temp 100.1 (R); Pt w/vascular macular erythematous eruptions over extensor surfaces large joints. Treatment: Diphenhydramine & APAP.


Changed on 2/14/2017

VAERS ID: 26888 Before After
VAERS Form:
Age:80.3 80.0
Sex:Female
Location:California
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-27
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / - - / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 287906 / - - / IM

Administered by: Military      Purchased by: Public
Symptoms: Pyrexia, Rash, Serum sickness

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: Temezepam, Cefaclor, Furosemide, DSS KCL 10% Soln; Haldol, Nimotop
Current Illness: s/p Subarachnoid hemmorhage Parkinsons
Preexisting Conditions: Subarachnoid Hemmmorhage, Parkinsons Disease; CVA;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pnu-Imune 23/Influenza developed minor rash; MD notified dx serum sickness, temp 100.1 (R); Pt w/vascular macular erythematous eruptions over extensor surfaces large joints. Treatment: Diphenhydramine & APAP.


Changed on 5/14/2017

VAERS ID: 26888 Before After
VAERS Form:
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-27
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / - - / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 287906 / - - / IM

Administered by: Military      Purchased by: Public
Symptoms: Pyrexia, Rash, Serum sickness

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: Temezepam, Cefaclor, Furosemide, DSS KCL 10% Soln; Haldol, Nimotop
Current Illness: s/p Subarachnoid hemmorhage Parkinsons
Preexisting Conditions: Subarachnoid Hemmmorhage, Parkinsons Disease; CVA;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pnu-Imune 23/Influenza developed minor rash; MD notified dx serum sickness, temp 100.1 (R); Pt w/vascular macular erythematous eruptions over extensor surfaces large joints. Treatment: Diphenhydramine & APAP.


Changed on 9/14/2017

VAERS ID: 26888 Before After
VAERS Form:(blank) 1
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-27
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / - UNK - / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 287906 / - UNK - / IM

Administered by: Military      Purchased by: Public
Symptoms: Pyrexia, Rash, Serum sickness

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: Temezepam, Cefaclor, Furosemide, DSS KCL 10% Soln; Haldol, Nimotop
Current Illness: s/p Subarachnoid hemmorhage Parkinsons
Preexisting Conditions: Subarachnoid Hemmmorhage, Parkinsons Disease; CVA;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pnu-Imune 23/Influenza developed minor rash; MD notified dx serum sickness, temp 100.1 (R); Pt w/vascular macular erythematous eruptions over extensor surfaces large joints. Treatment: Diphenhydramine & APAP.


Changed on 2/14/2018

VAERS ID: 26888 Before After
VAERS Form:1
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-27
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / UNK - / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 287906 / UNK - / IM

Administered by: Military      Purchased by: Public
Symptoms: Pyrexia, Rash, Serum sickness

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: Temezepam, Cefaclor, Furosemide, DSS KCL 10% Soln; Haldol, Nimotop
Current Illness: s/p Subarachnoid hemmorhage Parkinsons
Preexisting Conditions: Subarachnoid Hemmmorhage, Parkinsons Disease; CVA;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pnu-Imune 23/Influenza developed minor rash; MD notified dx serum sickness, temp 100.1 (R); Pt w/vascular macular erythematous eruptions over extensor surfaces large joints. Treatment: Diphenhydramine & APAP.


Changed on 6/14/2018

VAERS ID: 26888 Before After
VAERS Form:1
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-27
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / UNK - / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 287906 / UNK - / IM

Administered by: Military      Purchased by: Public
Symptoms: Pyrexia, Rash, Serum sickness

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: Temezepam, Cefaclor, Furosemide, DSS KCL 10% Soln; Haldol, Nimotop
Current Illness: s/p Subarachnoid hemmorhage Parkinsons
Preexisting Conditions: Subarachnoid Hemmmorhage, Parkinsons Disease; CVA;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pnu-Imune 23/Influenza developed minor rash; MD notified dx serum sickness, temp 100.1 (R); Pt w/vascular macular erythematous eruptions over extensor surfaces large joints. Treatment: Diphenhydramine & APAP.


Changed on 8/14/2018

VAERS ID: 26888 Before After
VAERS Form:1
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-27
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / UNK - / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 287906 / UNK - / IM

Administered by: Military      Purchased by: Public
Symptoms: Pyrexia, Rash, Serum sickness

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: Temezepam, Cefaclor, Furosemide, DSS KCL 10% Soln; Haldol, Nimotop
Current Illness: s/p Subarachnoid hemmorhage Parkinsons
Preexisting Conditions: Subarachnoid Hemmmorhage, Parkinsons Disease; CVA;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pnu-Imune 23/Influenza developed minor rash; MD notified dx serum sickness, temp 100.1 (R); Pt w/vascular macular erythematous eruptions over extensor surfaces large joints. Treatment: Diphenhydramine & APAP.


Changed on 9/14/2018

VAERS ID: 26888 Before After
VAERS Form:1
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-27
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / UNK - / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 287906 / UNK - / IM

Administered by: Military      Purchased by: Public
Symptoms: Pyrexia, Rash, Serum sickness

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: Temezepam, Cefaclor, Furosemide, DSS KCL 10% Soln; Haldol, Nimotop
Current Illness: s/p Subarachnoid hemmorhage Parkinsons
Preexisting Conditions: Subarachnoid Hemmmorhage, Parkinsons Disease; CVA;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pnu-Imune 23/Influenza developed minor rash; MD notified dx serum sickness, temp 100.1 (R); Pt w/vascular macular erythematous eruptions over extensor surfaces large joints. Treatment: Diphenhydramine & APAP.


Changed on 10/14/2018

VAERS ID: 26888 Before After
VAERS Form:1
Age:80.0
Sex:Female
Location:California
Vaccinated:1990-11-26
Onset:1990-11-26
Submitted:1990-11-27
Entered:1990-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908201 / UNK - / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 287906 / UNK - / IM

Administered by: Military      Purchased by: Public
Symptoms: Pyrexia, Rash, Serum sickness

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: Temezepam, Cefaclor, Furosemide, DSS KCL 10% Soln; Haldol, Nimotop
Current Illness: s/p Subarachnoid hemmorhage Parkinsons
Preexisting Conditions: Subarachnoid Hemmmorhage, Parkinsons Disease; CVA;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pnu-Imune 23/Influenza developed minor rash; MD notified dx serum sickness, temp 100.1 (R); Pt w/vascular macular erythematous eruptions over extensor surfaces large joints. Treatment: Diphenhydramine & APAP.

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