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This is VAERS ID 27168

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27168
VAERS Form:
Age:27.3
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH 4908209 / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: CHILLS, FEVER, NAUSEA, ALLERG REACT, PAIN

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.


Changed on 12/8/2009

VAERS ID: 27168 Before After
VAERS Form:
Age:27.3
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1991-01-08 1990-12-26
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 4908209 / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Hypersensitivity, Nausea, Pain, Pyrexia, Urticaria, CHILLS, FEVER, NAUSEA, ALLERG REACT, PAIN

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.


Changed on 8/31/2010

VAERS ID: 27168 Before After
VAERS Form:
Age:27.3
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4908209 / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Hypersensitivity, Nausea, Pain, Pyrexia, Urticaria

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.


Changed on 7/7/2013

VAERS ID: 27168 Before After
VAERS Form:
Age:27.3
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908209 / - LA / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908209 / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Hypersensitivity, Nausea, Pain, Pyrexia, Urticaria

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.


Changed on 12/14/2016

VAERS ID: 27168 Before After
VAERS Form:
Age:27.3
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908209 / - LA / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908209 / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Hypersensitivity, Nausea, Pain, Pyrexia, Urticaria

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.


Changed on 2/14/2017

VAERS ID: 27168 Before After
VAERS Form:
Age:27.3 27.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908209 / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Hypersensitivity, Nausea, Pain, Pyrexia, Urticaria

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.


Changed on 5/14/2017

VAERS ID: 27168 Before After
VAERS Form:
Age:27.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908209 / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Hypersensitivity, Nausea, Pain, Pyrexia, Urticaria

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.


Changed on 9/14/2017

VAERS ID: 27168 Before After
VAERS Form:(blank) 1
Age:27.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908209 / - UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Hypersensitivity, Nausea, Pain, Pyrexia, Urticaria

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.


Changed on 2/14/2018

VAERS ID: 27168 Before After
VAERS Form:1
Age:27.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908209 / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Hypersensitivity, Nausea, Pain, Pyrexia, Urticaria

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.


Changed on 6/14/2018

VAERS ID: 27168 Before After
VAERS Form:1
Age:27.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908209 / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Hypersensitivity, Nausea, Pain, Pyrexia, Urticaria

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.


Changed on 8/14/2018

VAERS ID: 27168 Before After
VAERS Form:1
Age:27.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908209 / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Hypersensitivity, Nausea, Pain, Pyrexia, Urticaria

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.


Changed on 9/14/2018

VAERS ID: 27168 Before After
VAERS Form:1
Age:27.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908209 / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Hypersensitivity, Nausea, Pain, Pyrexia, Urticaria

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.


Changed on 10/14/2018

VAERS ID: 27168 Before After
VAERS Form:1
Age:27.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908209 / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Hypersensitivity, Nausea, Pain, Pyrexia, Urticaria

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.


Changed on 12/24/2020

VAERS ID: 27168 Before After
VAERS Form:1
Age:27.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908209 / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Hypersensitivity, Nausea, Pain, Pyrexia, Urticaria

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.


Changed on 12/30/2020

VAERS ID: 27168 Before After
VAERS Form:1
Age:27.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908209 / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Hypersensitivity, Nausea, Pain, Pyrexia, Urticaria

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.


Changed on 5/7/2021

VAERS ID: 27168 Before After
VAERS Form:1
Age:27.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908209 / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Hypersensitivity, Nausea, Pain, Pyrexia, Urticaria

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.


Changed on 5/14/2021

VAERS ID: 27168 Before After
VAERS Form:1
Age:27.0
Sex:Female
Location:Illinois
Vaccinated:1990-10-24
Onset:1990-11-12
Submitted:1990-12-17
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908209 / UNK LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Hypersensitivity, Nausea, Pain, Pyrexia, Urticaria

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: Insulin 2x daily to manage diabetes
Current Illness:
Preexisting Conditions: Diabetes, type 1
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 11/7/90, developed chills, nausea, 103 fever, achiness, lasted 24-36 hrs treated w/aspirin/rest. 11/12/90 severe allergic rxn, hives on arms, neck, back, legs, face & throat. ER gave adrenaline inject. Treated hives w/Benadryl.

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