National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 26941

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26941
VAERS Form:
Age:68.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-11-21
Submitted:1990-12-03
Entered:1991-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS OF11210 / 2 RA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: HEADACHE, ASTHENIA, PAIN NECK, REFLEXES DEC

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Procane, Digoxin, Tenormin
Current Illness:
Preexisting Conditions: intermittant A-Fib, CHF, NKDA
Allergies:
Diagnostic Lab Data: deceased reflexes & weakness
CDC 'Split Type':

Write-up: Pt c/o of hand/arm & neck pain, thought to be due to Procan intoxication , admitted to hosp. secondary to this Dx & developed progressive weakness once in hosp. Currently in ICU


Changed on 12/8/2009

VAERS ID: 26941 Before After
VAERS Form:
Age:68.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-11-21
Submitted:1990-12-03
Entered:1991-01-10 1990-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABS CONNAUGHT LABORATORIES OF11210 / 2 RA / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Asthenia, Headache, Hyporeflexia, Neck pain, HEADACHE, ASTHENIA, PAIN NECK, REFLEXES DEC

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Procane, Digoxin, Tenormin
Current Illness:
Preexisting Conditions: intermittant A-Fib, CHF, NKDA
Allergies:
Diagnostic Lab Data: deceased reflexes & weakness
CDC 'Split Type':

Write-up: Pt c/o of hand/arm & neck pain, thought to be due to Procan intoxication , admitted to hosp. secondary to this Dx & developed progressive weakness once in hosp. Currently in ICU


Changed on 8/31/2010

VAERS ID: 26941 Before After
VAERS Form:
Age:68.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-11-21
Submitted:1990-12-03
Entered:1990-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OF11210 / 2 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Headache, Hyporeflexia, Neck pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Procane, Digoxin, Tenormin
Current Illness:
Preexisting Conditions: intermittant A-Fib, CHF, NKDA
Allergies:
Diagnostic Lab Data: deceased reflexes & weakness
CDC 'Split Type':

Write-up: Pt c/o of hand/arm & neck pain, thought to be due to Procan intoxication , admitted to hosp. secondary to this Dx & developed progressive weakness once in hosp. Currently in ICU


Changed on 7/7/2013

VAERS ID: 26941 Before After
VAERS Form:
Age:68.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-11-21
Submitted:1990-12-03
Entered:1990-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OF11210 / 2 RA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OF11210 / 2 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Headache, Hyporeflexia, Neck pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Procane, Digoxin, Tenormin
Current Illness:
Preexisting Conditions: intermittant A-Fib, CHF, NKDA
Allergies:
Diagnostic Lab Data: deceased reflexes & weakness
CDC 'Split Type':

Write-up: Pt c/o of hand/arm & neck pain, thought to be due to Procan intoxication , admitted to hosp. secondary to this Dx & developed progressive weakness once in hosp. Currently in ICU


Changed on 5/14/2017

VAERS ID: 26941 Before After
VAERS Form:
Age:68.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-11-21
Submitted:1990-12-03
Entered:1990-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OF11210 / 2 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Headache, Hyporeflexia, Neck pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Procane, Digoxin, Tenormin
Current Illness:
Preexisting Conditions: intermittant A-Fib, CHF, NKDA
Allergies:
Diagnostic Lab Data: deceased reflexes & weakness
CDC 'Split Type':

Write-up: Pt c/o of hand/arm & neck pain, thought to be due to Procan intoxication , admitted to hosp. secondary to this Dx & developed progressive weakness once in hosp. Currently in ICU


Changed on 9/14/2017

VAERS ID: 26941 Before After
VAERS Form:(blank) 1
Age:68.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-11-21
Submitted:1990-12-03
Entered:1990-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OF11210 / 2 3 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Headache, Hyporeflexia, Neck pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Procane, Digoxin, Tenormin
Current Illness:
Preexisting Conditions: intermittant A-Fib, CHF, NKDA
Allergies:
Diagnostic Lab Data: deceased reflexes & weakness
CDC 'Split Type':

Write-up: Pt c/o of hand/arm & neck pain, thought to be due to Procan intoxication , admitted to hosp. secondary to this Dx & developed progressive weakness once in hosp. Currently in ICU


Changed on 2/14/2018

VAERS ID: 26941 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-11-21
Submitted:1990-12-03
Entered:1990-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OF11210 / 3 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Headache, Hyporeflexia, Neck pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Procane, Digoxin, Tenormin
Current Illness:
Preexisting Conditions: intermittant A-Fib, CHF, NKDA
Allergies:
Diagnostic Lab Data: deceased reflexes & weakness
CDC 'Split Type':

Write-up: Pt c/o of hand/arm & neck pain, thought to be due to Procan intoxication , admitted to hosp. secondary to this Dx & developed progressive weakness once in hosp. Currently in ICU


Changed on 6/14/2018

VAERS ID: 26941 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-11-21
Submitted:1990-12-03
Entered:1990-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OF11210 / 3 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Headache, Hyporeflexia, Neck pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Procane, Digoxin, Tenormin
Current Illness:
Preexisting Conditions: intermittant A-Fib, CHF, NKDA
Allergies:
Diagnostic Lab Data: deceased reflexes & weakness
CDC 'Split Type':

Write-up: Pt c/o of hand/arm & neck pain, thought to be due to Procan intoxication , admitted to hosp. secondary to this Dx & developed progressive weakness once in hosp. Currently in ICU


Changed on 8/14/2018

VAERS ID: 26941 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-11-21
Submitted:1990-12-03
Entered:1990-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OF11210 / 3 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Headache, Hyporeflexia, Neck pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Procane, Digoxin, Tenormin
Current Illness:
Preexisting Conditions: intermittant A-Fib, CHF, NKDA
Allergies:
Diagnostic Lab Data: deceased reflexes & weakness
CDC 'Split Type':

Write-up: Pt c/o of hand/arm & neck pain, thought to be due to Procan intoxication , admitted to hosp. secondary to this Dx & developed progressive weakness once in hosp. Currently in ICU


Changed on 9/14/2018

VAERS ID: 26941 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-11-21
Submitted:1990-12-03
Entered:1990-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OF11210 / 3 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Headache, Hyporeflexia, Neck pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Procane, Digoxin, Tenormin
Current Illness:
Preexisting Conditions: intermittant A-Fib, CHF, NKDA
Allergies:
Diagnostic Lab Data: deceased reflexes & weakness
CDC 'Split Type':

Write-up: Pt c/o of hand/arm & neck pain, thought to be due to Procan intoxication , admitted to hosp. secondary to this Dx & developed progressive weakness once in hosp. Currently in ICU


Changed on 10/14/2018

VAERS ID: 26941 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-11-21
Submitted:1990-12-03
Entered:1990-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OF11210 / 3 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Headache, Hyporeflexia, Neck pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Procane, Digoxin, Tenormin
Current Illness:
Preexisting Conditions: intermittant A-Fib, CHF, NKDA
Allergies:
Diagnostic Lab Data: deceased reflexes & weakness
CDC 'Split Type':

Write-up: Pt c/o of hand/arm & neck pain, thought to be due to Procan intoxication , admitted to hosp. secondary to this Dx & developed progressive weakness once in hosp. Currently in ICU


Changed on 12/24/2020

VAERS ID: 26941 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-11-21
Submitted:1990-12-03
Entered:1990-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OF11210 / 3 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Headache, Hyporeflexia, Neck pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Procane, Digoxin, Tenormin
Current Illness:
Preexisting Conditions: intermittant A-Fib, CHF, NKDA
Allergies:
Diagnostic Lab Data: deceased reflexes & weakness
CDC 'Split Type':

Write-up: Pt c/o of hand/arm & neck pain, thought to be due to Procan intoxication , admitted to hosp. secondary to this Dx & developed progressive weakness once in hosp. Currently in ICU


Changed on 12/30/2020

VAERS ID: 26941 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Colorado
Vaccinated:1990-10-17
Onset:1990-11-21
Submitted:1990-12-03
Entered:1990-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OF11210 / 3 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Headache, Hyporeflexia, Neck pain

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Procane, Digoxin, Tenormin
Current Illness:
Preexisting Conditions: intermittant A-Fib, CHF, NKDA
Allergies:
Diagnostic Lab Data: deceased reflexes & weakness
CDC 'Split Type':

Write-up: Pt c/o of hand/arm & neck pain, thought to be due to Procan intoxication , admitted to hosp. secondary to this Dx & developed progressive weakness once in hosp. Currently in ICU

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=26941&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166