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This is VAERS ID 27220

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27220
VAERS Form:
Age:46.5
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-12
Onset:1990-12-12
Submitted:1990-12-14
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLU-IMUNE 1990-1991 LEDERLE / LEDERLE 4908201 / 0 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: INJECT SITE REACT, HEADACHE, DRY MOUTH, VASODILAT

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: Synthroid, Inderol
Current Illness:
Preexisting Conditions: Hay fever, Hypothroidism, Migraine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Inflamation @ site of injection 30 min /p inject. Headache /p 1 hr of inject. Dry mouth, flushed, warm 1 hr /p inject. 14Dec90 still has headache


Changed on 12/8/2009

VAERS ID: 27220 Before After
VAERS Form:
Age:46.5
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-12
Onset:1990-12-12
Submitted:1990-12-14
Entered:1991-01-04 1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLU-IMUNE 1990-1991 LEDERLE INFLUENZA (SEASONAL) (FLU-IMUNE 90-91) / LEDERLE LEDERLE LABORATORIES 4908201 / 0 LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Dry mouth, Headache, Injection site reaction, Vasodilatation, INJECT SITE REACT, HEADACHE, DRY MOUTH, VASODILAT

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: Synthroid, Inderol
Current Illness:
Preexisting Conditions: Hay fever, Hypothroidism, Migraine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) PA9013

Write-up: Inflamation @ site of injection 30 min /p inject. Headache /p 1 hr of inject. Dry mouth, flushed, warm 1 hr /p inject. 14Dec90 still has headache


Changed on 8/31/2010

VAERS ID: 27220 Before After
VAERS Form:
Age:46.5
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-12
Onset:1990-12-12
Submitted:1990-12-14
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLU-IMUNE 90-91) INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 4908201 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dry mouth, Headache, Injection site reaction, Vasodilatation

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: Synthroid, Inderol
Current Illness:
Preexisting Conditions: Hay fever, Hypothroidism, Migraine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PA9013

Write-up: Inflamation @ site of injection 30 min /p inject. Headache /p 1 hr of inject. Dry mouth, flushed, warm 1 hr /p inject. 14Dec90 still has headache


Changed on 7/7/2013

VAERS ID: 27220 Before After
VAERS Form:
Age:46.5
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-12
Onset:1990-12-12
Submitted:1990-12-14
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 4908201 / 0 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 4908201 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dry mouth, Headache, Injection site reaction, Vasodilatation

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: Synthroid, Inderol
Current Illness:
Preexisting Conditions: Hay fever, Hypothroidism, Migraine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PA9013

Write-up: Inflamation @ site of injection 30 min /p inject. Headache /p 1 hr of inject. Dry mouth, flushed, warm 1 hr /p inject. 14Dec90 still has headache


Changed on 2/14/2017

VAERS ID: 27220 Before After
VAERS Form:
Age:46.5 46.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-12
Onset:1990-12-12
Submitted:1990-12-14
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 4908201 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dry mouth, Headache, Injection site reaction, Vasodilatation

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: Synthroid, Inderol
Current Illness:
Preexisting Conditions: Hay fever, Hypothroidism, Migraine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PA9013

Write-up: Inflamation @ site of injection 30 min /p inject. Headache /p 1 hr of inject. Dry mouth, flushed, warm 1 hr /p inject. 14Dec90 still has headache


Changed on 5/14/2017

VAERS ID: 27220 Before After
VAERS Form:
Age:46.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-12
Onset:1990-12-12
Submitted:1990-12-14
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 4908201 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dry mouth, Headache, Injection site reaction, Vasodilatation

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid, Inderol
Current Illness:
Preexisting Conditions: Hay fever, Hypothroidism, Migraine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PA9013

Write-up: Inflamation @ site of injection 30 min /p inject. Headache /p 1 hr of inject. Dry mouth, flushed, warm 1 hr /p inject. 14Dec90 still has headache


Changed on 9/14/2017

VAERS ID: 27220 Before After
VAERS Form:(blank) 1
Age:46.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-12
Onset:1990-12-12
Submitted:1990-12-14
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 4908201 / 0 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dry mouth, Headache, Injection site reaction, Vasodilatation

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid, Inderol
Current Illness:
Preexisting Conditions: Hay fever, Hypothroidism, Migraine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PA9013

Write-up: Inflamation @ site of injection 30 min /p inject. Headache /p 1 hr of inject. Dry mouth, flushed, warm 1 hr /p inject. 14Dec90 still has headache


Changed on 2/14/2018

VAERS ID: 27220 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-12
Onset:1990-12-12
Submitted:1990-12-14
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 4908201 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dry mouth, Headache, Injection site reaction, Vasodilatation

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid, Inderol
Current Illness:
Preexisting Conditions: Hay fever, Hypothroidism, Migraine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PA9013

Write-up: Inflamation @ site of injection 30 min /p inject. Headache /p 1 hr of inject. Dry mouth, flushed, warm 1 hr /p inject. 14Dec90 still has headache


Changed on 6/14/2018

VAERS ID: 27220 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-12
Onset:1990-12-12
Submitted:1990-12-14
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 4908201 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dry mouth, Headache, Injection site reaction, Vasodilatation

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid, Inderol
Current Illness:
Preexisting Conditions: Hay fever, Hypothroidism, Migraine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PA9013

Write-up: Inflamation @ site of injection 30 min /p inject. Headache /p 1 hr of inject. Dry mouth, flushed, warm 1 hr /p inject. 14Dec90 still has headache


Changed on 8/14/2018

VAERS ID: 27220 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-12
Onset:1990-12-12
Submitted:1990-12-14
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 4908201 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dry mouth, Headache, Injection site reaction, Vasodilatation

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid, Inderol
Current Illness:
Preexisting Conditions: Hay fever, Hypothroidism, Migraine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PA9013

Write-up: Inflamation @ site of injection 30 min /p inject. Headache /p 1 hr of inject. Dry mouth, flushed, warm 1 hr /p inject. 14Dec90 still has headache


Changed on 9/14/2018

VAERS ID: 27220 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-12
Onset:1990-12-12
Submitted:1990-12-14
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 4908201 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dry mouth, Headache, Injection site reaction, Vasodilatation

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid, Inderol
Current Illness:
Preexisting Conditions: Hay fever, Hypothroidism, Migraine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PA9013

Write-up: Inflamation @ site of injection 30 min /p inject. Headache /p 1 hr of inject. Dry mouth, flushed, warm 1 hr /p inject. 14Dec90 still has headache


Changed on 10/14/2018

VAERS ID: 27220 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-12
Onset:1990-12-12
Submitted:1990-12-14
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 4908201 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dry mouth, Headache, Injection site reaction, Vasodilatation

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid, Inderol
Current Illness:
Preexisting Conditions: Hay fever, Hypothroidism, Migraine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PA9013

Write-up: Inflamation @ site of injection 30 min /p inject. Headache /p 1 hr of inject. Dry mouth, flushed, warm 1 hr /p inject. 14Dec90 still has headache


Changed on 12/24/2020

VAERS ID: 27220 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-12
Onset:1990-12-12
Submitted:1990-12-14
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 4908201 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dry mouth, Headache, Injection site reaction, Vasodilatation

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid, Inderol
Current Illness:
Preexisting Conditions: Hay fever, Hypothroidism, Migraine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PA9013

Write-up: Inflamation @ site of injection 30 min /p inject. Headache /p 1 hr of inject. Dry mouth, flushed, warm 1 hr /p inject. 14Dec90 still has headache


Changed on 12/30/2020

VAERS ID: 27220 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-12
Onset:1990-12-12
Submitted:1990-12-14
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 4908201 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dry mouth, Headache, Injection site reaction, Vasodilatation

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid, Inderol
Current Illness:
Preexisting Conditions: Hay fever, Hypothroidism, Migraine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PA9013

Write-up: Inflamation @ site of injection 30 min /p inject. Headache /p 1 hr of inject. Dry mouth, flushed, warm 1 hr /p inject. 14Dec90 still has headache


Changed on 5/7/2021

VAERS ID: 27220 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-12
Onset:1990-12-12
Submitted:1990-12-14
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 4908201 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dry mouth, Headache, Injection site reaction, Vasodilatation

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid, Inderol
Current Illness:
Preexisting Conditions: Hay fever, Hypothroidism, Migraine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PA9013

Write-up: Inflamation @ site of injection 30 min /p inject. Headache /p 1 hr of inject. Dry mouth, flushed, warm 1 hr /p inject. 14Dec90 still has headache


Changed on 5/14/2021

VAERS ID: 27220 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-12
Onset:1990-12-12
Submitted:1990-12-14
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 4908201 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dry mouth, Headache, Injection site reaction, Vasodilatation

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Synthroid, Inderol
Current Illness:
Preexisting Conditions: Hay fever, Hypothroidism, Migraine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PA9013

Write-up: Inflamation @ site of injection 30 min /p inject. Headache /p 1 hr of inject. Dry mouth, flushed, warm 1 hr /p inject. 14Dec90 still has headache

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