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This is VAERS ID 27226

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27226
VAERS Form:
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-04
Submitted:1990-12-07
Entered:1991-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS / PARKE-DAVIS - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: CONVULS, FEVER

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: Albuterol
Current Illness:
Preexisting Conditions: Macrocephaly, developmental delay, asthma
Allergies:
Diagnostic Lab Data: Clear panel tox-screen - EEG - negative
CDC 'Split Type':

Write-up: Pt vaccinated with Fluogen developed seizure occured 82 hrs after vaccine given, had fever 101(R).


Changed on 12/8/2009

VAERS ID: 27226 Before After
VAERS Form:
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-04
Submitted:1990-12-07
Entered:1991-01-10 1990-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS INFLUENZA (SEASONAL) (FLUOGEN 90-91) / PARKE-DAVIS - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia, CONVULS, FEVER

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: Albuterol
Current Illness:
Preexisting Conditions: Macrocephaly, developmental delay, asthma
Allergies:
Diagnostic Lab Data: Clear panel tox-screen - EEG - negative
CDC 'Split Type': (blank) 904090015

Write-up: Pt vaccinated with Fluogen developed seizure occured 82 hrs after vaccine given, had fever 101(R).


Changed on 8/31/2010

VAERS ID: 27226 Before After
VAERS Form:
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-04
Submitted:1990-12-07
Entered:1990-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 90-91) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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: Albuterol
Current Illness:
Preexisting Conditions: Macrocephaly, developmental delay, asthma
Allergies:
Diagnostic Lab Data: Clear panel tox-screen - EEG - negative
CDC 'Split Type': 904090015

Write-up: Pt vaccinated with Fluogen developed seizure occured 82 hrs after vaccine given, had fever 101(R).


Changed on 7/7/2013

VAERS ID: 27226 Before After
VAERS Form:
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-04
Submitted:1990-12-07
Entered:1990-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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: Albuterol
Current Illness:
Preexisting Conditions: Macrocephaly, developmental delay, asthma
Allergies:
Diagnostic Lab Data: Clear panel tox-screen - EEG - negative
CDC 'Split Type': 904090015

Write-up: Pt vaccinated with Fluogen developed seizure occured 82 hrs after vaccine given, had fever 101(R).


Changed on 5/14/2017

VAERS ID: 27226 Before After
VAERS Form:
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-04
Submitted:1990-12-07
Entered:1990-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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: Albuterol
Current Illness:
Preexisting Conditions: Macrocephaly, developmental delay, asthma bronchial asthma, neurological problems
Allergies:
Diagnostic Lab Data: Clear panel tox-screen - EEG - negative
CDC 'Split Type': 904090015

Write-up: Pt vaccinated with seizure reported in pt receiving Fluogen developed seizure occured necessary due to bronchial asthma & neurological problems & 82 hrs after vaccine given, later had fever 101(R). seizure, taken to ER, T 101, more seizures,


Changed on 9/14/2017

VAERS ID: 27226 Before After
VAERS Form:(blank) 1
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-04
Submitted:1990-12-07
Entered:1990-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions: bronchial asthma, neurological problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 904090015

Write-up: seizure reported in pt receiving Fluogen necessary due to bronchial asthma & neurological problems & 82 hrs later had seizure, taken to ER, T 101, more seizures,


Changed on 2/14/2018

VAERS ID: 27226 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-04
Submitted:1990-12-07
Entered:1990-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions: bronchial asthma, neurological problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 904090015

Write-up: seizure reported in pt receiving Fluogen necessary due to bronchial asthma & neurological problems & 82 hrs later had seizure, taken to ER, T 101, more seizures,


Changed on 6/14/2018

VAERS ID: 27226 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-04
Submitted:1990-12-07
Entered:1990-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions: bronchial asthma, neurological problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 904090015

Write-up: seizure reported in pt receiving Fluogen necessary due to bronchial asthma & neurological problems & 82 hrs later had seizure, taken to ER, T 101, more seizures,


Changed on 8/14/2018

VAERS ID: 27226 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-04
Submitted:1990-12-07
Entered:1990-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions: bronchial asthma, neurological problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 904090015

Write-up: seizure reported in pt receiving Fluogen necessary due to bronchial asthma & neurological problems & 82 hrs later had seizure, taken to ER, T 101, more seizures,


Changed on 9/14/2018

VAERS ID: 27226 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-04
Submitted:1990-12-07
Entered:1990-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions: bronchial asthma, neurological problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 904090015

Write-up: seizure reported in pt receiving Fluogen necessary due to bronchial asthma & neurological problems & 82 hrs later had seizure, taken to ER, T 101, more seizures,


Changed on 10/14/2018

VAERS ID: 27226 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-04
Submitted:1990-12-07
Entered:1990-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions: bronchial asthma, neurological problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 904090015

Write-up: seizure reported in pt receiving Fluogen necessary due to bronchial asthma & neurological problems & 82 hrs later had seizure, taken to ER, T 101, more seizures,


Changed on 12/24/2020

VAERS ID: 27226 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-04
Submitted:1990-12-07
Entered:1990-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions: bronchial asthma, neurological problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 904090015

Write-up: seizure reported in pt receiving Fluogen necessary due to bronchial asthma & neurological problems & 82 hrs later had seizure, taken to ER, T 101, more seizures,


Changed on 12/30/2020

VAERS ID: 27226 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-04
Submitted:1990-12-07
Entered:1990-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions: bronchial asthma, neurological problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 904090015

Write-up: seizure reported in pt receiving Fluogen necessary due to bronchial asthma & neurological problems & 82 hrs later had seizure, taken to ER, T 101, more seizures,


Changed on 5/7/2021

VAERS ID: 27226 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-04
Submitted:1990-12-07
Entered:1990-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions: bronchial asthma, neurological problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 904090015

Write-up: seizure reported in pt receiving Fluogen necessary due to bronchial asthma & neurological problems & 82 hrs later had seizure, taken to ER, T 101, more seizures,


Changed on 5/14/2021

VAERS ID: 27226 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:California
Vaccinated:1990-11-30
Onset:1990-12-04
Submitted:1990-12-07
Entered:1990-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions: bronchial asthma, neurological problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 904090015

Write-up: seizure reported in pt receiving Fluogen necessary due to bronchial asthma & neurological problems & 82 hrs later had seizure, taken to ER, T 101, more seizures,

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=27226&WAYBACKHISTORY=ON


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