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This is VAERS ID 27252

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27252
VAERS Form:
Age:70.3
Sex:Male
Location:West Virginia
Vaccinated:1990-11-02
Onset:1990-11-03
Submitted:1990-11-20
Entered:1991-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS / PARKE-DAVIS 02780P / - LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: MYALGIA, PHARYNGITIS

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 pt; flu-like symptoms; 69yr old; FLU; 1 dose
Other Medications: Indural, Lanoxin, Ascriptin
Current Illness:
Preexisting Conditions: hx of cardiac problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': hx of cardiac problems

Write-up: Pt vaccinated w/Influenza 1 day after immunization pt c/o throat & aching all over.


Changed on 12/8/2009

VAERS ID: 27252 Before After
VAERS Form:
Age:70.3
Sex:Male
Location:West Virginia
Vaccinated:1990-11-02
Onset:1990-11-03
Submitted:1990-11-20
Entered:1991-01-11 1990-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS INFLUENZA (SEASONAL) (FLUOGEN 90-91) / PARKE-DAVIS 02780P / - LA / -

Administered by: Public      Purchased by: Unknown Public
Symptoms: Myalgia, Pharyngitis, MYALGIA, PHARYNGITIS

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 pt; flu-like symptoms; 69yr old; FLU; 1 dose
Other Medications: Indural, Lanoxin, Ascriptin
Current Illness:
Preexisting Conditions: hx of cardiac problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': hx of cardiac problems (blank)

Write-up: Pt vaccinated w/Influenza 1 day after immunization pt c/o throat & aching all over.


Changed on 8/31/2010

VAERS ID: 27252 Before After
VAERS Form:
Age:70.3
Sex:Male
Location:West Virginia
Vaccinated:1990-11-02
Onset:1990-11-03
Submitted:1990-11-20
Entered:1990-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 90-91) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / - LA / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia, Pharyngitis

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 pt; flu-like symptoms; 69yr old; FLU; 1 dose
Other Medications: Indural, Lanoxin, Ascriptin
Current Illness:
Preexisting Conditions: hx of cardiac problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated w/Influenza 1 day after immunization pt c/o throat & aching all over.


Changed on 7/7/2013

VAERS ID: 27252 Before After
VAERS Form:
Age:70.3
Sex:Male
Location:West Virginia
Vaccinated:1990-11-02
Onset:1990-11-03
Submitted:1990-11-20
Entered:1990-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / - LA / -
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / - LA / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia, Pharyngitis

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 pt; flu-like symptoms; 69yr old; FLU; 1 dose
Other Medications: Indural, Lanoxin, Ascriptin
Current Illness:
Preexisting Conditions: hx of cardiac problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated w/Influenza 1 day after immunization pt c/o throat & aching all over.


Changed on 2/14/2017

VAERS ID: 27252 Before After
VAERS Form:
Age:70.3 70.0
Sex:Male
Location:West Virginia
Vaccinated:1990-11-02
Onset:1990-11-03
Submitted:1990-11-20
Entered:1990-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / - LA / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia, Pharyngitis

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 pt; flu-like symptoms; 69yr old; FLU; 1 dose
Other Medications: Indural, Lanoxin, Ascriptin
Current Illness:
Preexisting Conditions: hx of cardiac problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated w/Influenza 1 day after immunization pt c/o throat & aching all over.


Changed on 5/14/2017

VAERS ID: 27252 Before After
VAERS Form:
Age:70.0
Sex:Male
Location:West Virginia
Vaccinated:1990-11-02
Onset:1990-11-03
Submitted:1990-11-20
Entered:1990-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / - LA / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia, Pharyngitis

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 pt; flu-like symptoms; 69yr old; FLU; 1 dose dose~ ()~~~In patient
Other Medications: Indural, Lanoxin, Ascriptin
Current Illness:
Preexisting Conditions: hx of cardiac problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated w/Influenza 1 day after immunization pt c/o throat & aching all over.


Changed on 9/14/2017

VAERS ID: 27252 Before After
VAERS Form:(blank) 1
Age:70.0
Sex:Male
Location:West Virginia
Vaccinated:1990-11-02
Onset:1990-11-03
Submitted:1990-11-20
Entered:1990-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / - UNK LA / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia, Pharyngitis

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 pt; flu-like symptoms; 69yr old; FLU; 1 dose~ ()~~~In patient
Other Medications: Indural, Lanoxin, Ascriptin
Current Illness:
Preexisting Conditions: hx of cardiac problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated w/Influenza 1 day after immunization pt c/o throat & aching all over.


Changed on 2/14/2018

VAERS ID: 27252 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:West Virginia
Vaccinated:1990-11-02
Onset:1990-11-03
Submitted:1990-11-20
Entered:1990-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / UNK LA / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia, Pharyngitis

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 pt; flu-like symptoms; 69yr old; FLU; 1 dose~ ()~~~In patient
Other Medications: Indural, Lanoxin, Ascriptin
Current Illness:
Preexisting Conditions: hx of cardiac problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated w/Influenza 1 day after immunization pt c/o throat & aching all over.


Changed on 6/14/2018

VAERS ID: 27252 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:West Virginia
Vaccinated:1990-11-02
Onset:1990-11-03
Submitted:1990-11-20
Entered:1990-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / UNK LA / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia, Pharyngitis

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 pt; flu-like symptoms; 69yr old; FLU; 1 dose~ ()~~~In patient
Other Medications: Indural, Lanoxin, Ascriptin
Current Illness:
Preexisting Conditions: hx of cardiac problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated w/Influenza 1 day after immunization pt c/o throat & aching all over.


Changed on 8/14/2018

VAERS ID: 27252 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:West Virginia
Vaccinated:1990-11-02
Onset:1990-11-03
Submitted:1990-11-20
Entered:1990-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / UNK LA / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia, Pharyngitis

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 pt; flu-like symptoms; 69yr old; FLU; 1 dose~ ()~~~In patient
Other Medications: Indural, Lanoxin, Ascriptin
Current Illness:
Preexisting Conditions: hx of cardiac problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated w/Influenza 1 day after immunization pt c/o throat & aching all over.


Changed on 9/14/2018

VAERS ID: 27252 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:West Virginia
Vaccinated:1990-11-02
Onset:1990-11-03
Submitted:1990-11-20
Entered:1990-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / UNK LA / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia, Pharyngitis

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 pt; flu-like symptoms; 69yr old; FLU; 1 dose~ ()~~~In patient
Other Medications: Indural, Lanoxin, Ascriptin
Current Illness:
Preexisting Conditions: hx of cardiac problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated w/Influenza 1 day after immunization pt c/o throat & aching all over.


Changed on 10/14/2018

VAERS ID: 27252 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:West Virginia
Vaccinated:1990-11-02
Onset:1990-11-03
Submitted:1990-11-20
Entered:1990-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / UNK LA / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia, Pharyngitis

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 pt; flu-like symptoms; 69yr old; FLU; 1 dose~ ()~~~In patient
Other Medications: Indural, Lanoxin, Ascriptin
Current Illness:
Preexisting Conditions: hx of cardiac problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated w/Influenza 1 day after immunization pt c/o throat & aching all over.


Changed on 12/24/2020

VAERS ID: 27252 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:West Virginia
Vaccinated:1990-11-02
Onset:1990-11-03
Submitted:1990-11-20
Entered:1990-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / UNK LA / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia, Pharyngitis

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 pt; flu-like symptoms; 69yr old; FLU; 1 dose~ ()~~~In patient
Other Medications: Indural, Lanoxin, Ascriptin
Current Illness:
Preexisting Conditions: hx of cardiac problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated w/Influenza 1 day after immunization pt c/o throat & aching all over.


Changed on 12/30/2020

VAERS ID: 27252 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:West Virginia
Vaccinated:1990-11-02
Onset:1990-11-03
Submitted:1990-11-20
Entered:1990-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / UNK LA / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia, Pharyngitis

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 pt; flu-like symptoms; 69yr old; FLU; 1 dose~ ()~~~In patient
Other Medications: Indural, Lanoxin, Ascriptin
Current Illness:
Preexisting Conditions: hx of cardiac problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated w/Influenza 1 day after immunization pt c/o throat & aching all over.


Changed on 5/7/2021

VAERS ID: 27252 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:West Virginia
Vaccinated:1990-11-02
Onset:1990-11-03
Submitted:1990-11-20
Entered:1990-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / UNK LA / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia, Pharyngitis

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 pt; flu-like symptoms; 69yr old; FLU; 1 dose~ ()~~~In patient
Other Medications: Indural, Lanoxin, Ascriptin
Current Illness:
Preexisting Conditions: hx of cardiac problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated w/Influenza 1 day after immunization pt c/o throat & aching all over.


Changed on 5/14/2021

VAERS ID: 27252 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:West Virginia
Vaccinated:1990-11-02
Onset:1990-11-03
Submitted:1990-11-20
Entered:1990-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02780P / UNK LA / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia, Pharyngitis

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 pt; flu-like symptoms; 69yr old; FLU; 1 dose~ ()~~~In patient
Other Medications: Indural, Lanoxin, Ascriptin
Current Illness:
Preexisting Conditions: hx of cardiac problems
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated w/Influenza 1 day after immunization pt c/o throat & aching all over.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=27252&WAYBACKHISTORY=ON


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