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This is VAERS ID 27196

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27196
VAERS Form:
Age:62.0
Sex:Female
Location:California
Vaccinated:1990-11-29
Onset:1990-11-30
Submitted:1990-12-04
Entered:1991-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH OF11203 / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: NAUSEA, HEADACHE, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.


Changed on 12/8/2009

VAERS ID: 27196 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:California
Vaccinated:1990-11-29
Onset:1990-11-30
Submitted:1990-12-04
Entered:1991-01-11 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 OF11203 / - LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Headache, Nausea, Pain, NAUSEA, HEADACHE, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) CA9020

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.


Changed on 8/31/2010

VAERS ID: 27196 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:California
Vaccinated:1990-11-29
Onset:1990-11-30
Submitted:1990-12-04
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 OF11203 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Headache, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9020

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.


Changed on 7/7/2013

VAERS ID: 27196 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:California
Vaccinated:1990-11-29
Onset:1990-11-30
Submitted:1990-12-04
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH OF11203 / - LA / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH OF11203 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Headache, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9020

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.


Changed on 12/14/2016

VAERS ID: 27196 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:California
Vaccinated:1990-11-29
Onset:1990-11-30
Submitted:1990-12-04
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH OF11203 / - LA / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH OF11203 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Headache, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9020

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.


Changed on 5/14/2017

VAERS ID: 27196 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:California
Vaccinated:1990-11-29
Onset:1990-11-30
Submitted:1990-12-04
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH OF11203 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Headache, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9020

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.


Changed on 9/14/2017

VAERS ID: 27196 Before After
VAERS Form:(blank) 1
Age:62.0
Sex:Female
Location:California
Vaccinated:1990-11-29
Onset:1990-11-30
Submitted:1990-12-04
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH OF11203 / - UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Headache, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9020

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.


Changed on 2/14/2018

VAERS ID: 27196 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:1990-11-29
Onset:1990-11-30
Submitted:1990-12-04
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH OF11203 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Headache, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9020

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.


Changed on 6/14/2018

VAERS ID: 27196 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:1990-11-29
Onset:1990-11-30
Submitted:1990-12-04
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH OF11203 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Headache, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9020

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.


Changed on 8/14/2018

VAERS ID: 27196 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:1990-11-29
Onset:1990-11-30
Submitted:1990-12-04
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH OF11203 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Headache, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9020

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.


Changed on 9/14/2018

VAERS ID: 27196 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:1990-11-29
Onset:1990-11-30
Submitted:1990-12-04
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH OF11203 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Headache, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9020

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.


Changed on 10/14/2018

VAERS ID: 27196 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:1990-11-29
Onset:1990-11-30
Submitted:1990-12-04
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH OF11203 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Headache, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9020

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.


Changed on 12/24/2020

VAERS ID: 27196 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:1990-11-29
Onset:1990-11-30
Submitted:1990-12-04
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH OF11203 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Headache, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9020

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.


Changed on 12/30/2020

VAERS ID: 27196 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:1990-11-29
Onset:1990-11-30
Submitted:1990-12-04
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH OF11203 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Headache, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9020

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.


Changed on 5/7/2021

VAERS ID: 27196 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:1990-11-29
Onset:1990-11-30
Submitted:1990-12-04
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH OF11203 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Headache, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9020

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.


Changed on 5/14/2021

VAERS ID: 27196 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:1990-11-29
Onset:1990-11-30
Submitted:1990-12-04
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH OF11203 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Headache, Nausea, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Premarin, Thyroid, Septra, Micro-K, hydorchlorothiazide
Current Illness:
Preexisting Conditions: Sensitivity to anti-inflamatories, hayfever, variable hypertension
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9020

Write-up: Pt vaccinated with FLU: developed lft sore arm 2 days following immun.; had nausea for 2 days follwing flu shot; intermittent sharp pains in lft temple began 11/30 kept patient awake and lasted until 12/3/90. Consulted w/ PMD by telephone.

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