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This is VAERS ID 27302

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27302
VAERS Form:
Age:66.0
Sex:Female
Location:Illinois
Vaccinated:1988-10-27
Onset:1988-11-14
Submitted:1990-12-06
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH - / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: MYALGIA, PAIN, MYASTHENIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Polymyalgia Rehumatica
Preexisting Conditions: Polymyalgia Rheumatica
Allergies:
Diagnostic Lab Data: chest x-ray - Normal, no malignancy; Breast Exam: no malignancy; Sed rate: 75 (NL = 0-20 MM/1HR.) Nomocytic Anemia (MCHC):11.5 gms
CDC 'Split Type':

Write-up: Pt vaccinated w/Influenza developed aggravation reaction. This involved exacerbation of her polymyalgia rheumatica. Admitted to hosp w/severe painful weakness in her proximal muscles. Given steroidal therapy approx six months later, weaned.


Changed on 12/8/2009

VAERS ID: 27302 Before After
VAERS Form:
Age:66.0
Sex:Female
Location:Illinois
Vaccinated:1988-10-27
Onset:1988-11-14
Submitted:1990-12-06
Entered:1991-01-08 1991-01-04
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 - / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Myalgia, Myasthenic syndrome, Pain, MYALGIA, PAIN, MYASTHENIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Polymyalgia Rehumatica
Preexisting Conditions: Polymyalgia Rheumatica
Allergies:
Diagnostic Lab Data: chest x-ray - Normal, no malignancy; Breast Exam: no malignancy; Sed rate: 75 (NL = 0-20 MM/1HR.) Nomocytic Anemia (MCHC):11.5 gms
CDC 'Split Type': (blank) 890341001B

Write-up: Pt vaccinated w/Influenza developed aggravation reaction. This involved exacerbation of her polymyalgia rheumatica. Admitted to hosp w/severe painful weakness in her proximal muscles. Given steroidal therapy approx six months later, weaned.


Changed on 8/31/2010

VAERS ID: 27302 Before After
VAERS Form:
Age:66.0
Sex:Female
Location:Illinois
Vaccinated:1988-10-27
Onset:1988-11-14
Submitted:1990-12-06
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Myalgia, Myasthenic syndrome, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Polymyalgia Rehumatica
Preexisting Conditions: Polymyalgia Rheumatica
Allergies:
Diagnostic Lab Data: chest x-ray - Normal, no malignancy; Breast Exam: no malignancy; Sed rate: 75 (NL = 0-20 MM/1HR.) Nomocytic Anemia (MCHC):11.5 gms
CDC 'Split Type': 890341001B

Write-up: Pt vaccinated w/Influenza developed aggravation reaction. This involved exacerbation of her polymyalgia rheumatica. Admitted to hosp w/severe painful weakness in her proximal muscles. Given steroidal therapy approx six months later, weaned.


Changed on 7/7/2013

VAERS ID: 27302 Before After
VAERS Form:
Age:66.0
Sex:Female
Location:Illinois
Vaccinated:1988-10-27
Onset:1988-11-14
Submitted:1990-12-06
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Myalgia, Myasthenic syndrome, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Polymyalgia Rehumatica
Preexisting Conditions: Polymyalgia Rheumatica
Allergies:
Diagnostic Lab Data: chest x-ray - Normal, no malignancy; Breast Exam: no malignancy; Sed rate: 75 (NL = 0-20 MM/1HR.) Nomocytic Anemia (MCHC):11.5 gms
CDC 'Split Type': 890341001B

Write-up: Pt vaccinated w/Influenza developed aggravation reaction. This involved exacerbation of her polymyalgia rheumatica. Admitted to hosp w/severe painful weakness in her proximal muscles. Given steroidal therapy approx six months later, weaned.


Changed on 12/14/2016

VAERS ID: 27302 Before After
VAERS Form:
Age:66.0
Sex:Female
Location:Illinois
Vaccinated:1988-10-27
Onset:1988-11-14
Submitted:1990-12-06
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Myalgia, Myasthenic syndrome, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Polymyalgia Rehumatica
Preexisting Conditions: Polymyalgia Rheumatica
Allergies:
Diagnostic Lab Data: chest x-ray - Normal, no malignancy; Breast Exam: no malignancy; Sed rate: 75 (NL = 0-20 MM/1HR.) Nomocytic Anemia (MCHC):11.5 gms
CDC 'Split Type': 890341001B

Write-up: Pt vaccinated w/Influenza developed aggravation reaction. This involved exacerbation of her polymyalgia rheumatica. Admitted to hosp w/severe painful weakness in her proximal muscles. Given steroidal therapy approx six months later, weaned.


Changed on 5/14/2017

VAERS ID: 27302 Before After
VAERS Form:
Age:66.0
Sex:Female
Location:Illinois
Vaccinated:1988-10-27
Onset:1988-11-14
Submitted:1990-12-06
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Myalgia, Myasthenic syndrome, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: Polymyalgia Rehumatica
Preexisting Conditions: Polymyalgia Rheumatica
Allergies:
Diagnostic Lab Data: chest x-ray - Normal, no malignancy; Breast Exam: no malignancy; Sed rate: 75 (NL = 0-20 MM/1HR.) Nomocytic Anemia (MCHC):11.5 gms
CDC 'Split Type': 890341001B

Write-up: Pt vaccinated w/Influenza developed aggravation reaction. This involved exacerbation of her polymyalgia rheumatica. Admitted to hosp w/severe painful weakness in her proximal muscles. Given steroidal therapy approx six months later, weaned.


Changed on 9/14/2017

VAERS ID: 27302 Before After
VAERS Form:(blank) 1
Age:66.0
Sex:Female
Location:Illinois
Vaccinated:1988-10-27
Onset:1988-11-14
Submitted:1990-12-06
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Myalgia, Myasthenic syndrome, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: Polymyalgia Rehumatica
Preexisting Conditions: Polymyalgia Rheumatica
Allergies:
Diagnostic Lab Data: chest x-ray - Normal, no malignancy; Breast Exam: no malignancy; Sed rate: 75 (NL = 0-20 MM/1HR.) Nomocytic Anemia (MCHC):11.5 gms
CDC 'Split Type': 890341001B

Write-up: Pt vaccinated w/Influenza developed aggravation reaction. This involved exacerbation of her polymyalgia rheumatica. Admitted to hosp w/severe painful weakness in her proximal muscles. Given steroidal therapy approx six months later, weaned.


Changed on 2/14/2018

VAERS ID: 27302 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Illinois
Vaccinated:1988-10-27
Onset:1988-11-14
Submitted:1990-12-06
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Myalgia, Myasthenic syndrome, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: Polymyalgia Rehumatica
Preexisting Conditions: Polymyalgia Rheumatica
Allergies:
Diagnostic Lab Data: chest x-ray - Normal, no malignancy; Breast Exam: no malignancy; Sed rate: 75 (NL = 0-20 MM/1HR.) Nomocytic Anemia (MCHC):11.5 gms
CDC 'Split Type': 890341001B

Write-up: Pt vaccinated w/Influenza developed aggravation reaction. This involved exacerbation of her polymyalgia rheumatica. Admitted to hosp w/severe painful weakness in her proximal muscles. Given steroidal therapy approx six months later, weaned.


Changed on 6/14/2018

VAERS ID: 27302 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Illinois
Vaccinated:1988-10-27
Onset:1988-11-14
Submitted:1990-12-06
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Myalgia, Myasthenic syndrome, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: Polymyalgia Rehumatica
Preexisting Conditions: Polymyalgia Rheumatica
Allergies:
Diagnostic Lab Data: chest x-ray - Normal, no malignancy; Breast Exam: no malignancy; Sed rate: 75 (NL = 0-20 MM/1HR.) Nomocytic Anemia (MCHC):11.5 gms
CDC 'Split Type': 890341001B

Write-up: Pt vaccinated w/Influenza developed aggravation reaction. This involved exacerbation of her polymyalgia rheumatica. Admitted to hosp w/severe painful weakness in her proximal muscles. Given steroidal therapy approx six months later, weaned.


Changed on 8/14/2018

VAERS ID: 27302 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Illinois
Vaccinated:1988-10-27
Onset:1988-11-14
Submitted:1990-12-06
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Myalgia, Myasthenic syndrome, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: Polymyalgia Rehumatica
Preexisting Conditions: Polymyalgia Rheumatica
Allergies:
Diagnostic Lab Data: chest x-ray - Normal, no malignancy; Breast Exam: no malignancy; Sed rate: 75 (NL = 0-20 MM/1HR.) Nomocytic Anemia (MCHC):11.5 gms
CDC 'Split Type': 890341001B

Write-up: Pt vaccinated w/Influenza developed aggravation reaction. This involved exacerbation of her polymyalgia rheumatica. Admitted to hosp w/severe painful weakness in her proximal muscles. Given steroidal therapy approx six months later, weaned.


Changed on 9/14/2018

VAERS ID: 27302 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Illinois
Vaccinated:1988-10-27
Onset:1988-11-14
Submitted:1990-12-06
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Myalgia, Myasthenic syndrome, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: Polymyalgia Rehumatica
Preexisting Conditions: Polymyalgia Rheumatica
Allergies:
Diagnostic Lab Data: chest x-ray - Normal, no malignancy; Breast Exam: no malignancy; Sed rate: 75 (NL = 0-20 MM/1HR.) Nomocytic Anemia (MCHC):11.5 gms
CDC 'Split Type': 890341001B

Write-up: Pt vaccinated w/Influenza developed aggravation reaction. This involved exacerbation of her polymyalgia rheumatica. Admitted to hosp w/severe painful weakness in her proximal muscles. Given steroidal therapy approx six months later, weaned.


Changed on 10/14/2018

VAERS ID: 27302 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Illinois
Vaccinated:1988-10-27
Onset:1988-11-14
Submitted:1990-12-06
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Public      Purchased by: Unknown
Symptoms: Myalgia, Myasthenic syndrome, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: Polymyalgia Rehumatica
Preexisting Conditions: Polymyalgia Rheumatica
Allergies:
Diagnostic Lab Data: chest x-ray - Normal, no malignancy; Breast Exam: no malignancy; Sed rate: 75 (NL = 0-20 MM/1HR.) Nomocytic Anemia (MCHC):11.5 gms
CDC 'Split Type': 890341001B

Write-up: Pt vaccinated w/Influenza developed aggravation reaction. This involved exacerbation of her polymyalgia rheumatica. Admitted to hosp w/severe painful weakness in her proximal muscles. Given steroidal therapy approx six months later, weaned.

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