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This is VAERS ID 27347

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27347
VAERS Form:
Age:69.0
Sex:Male
Location:Illinois
Vaccinated:1990-11-06
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS / PARKE-DAVIS - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: PETECHIA, STOMATITIS, THROMBOCYTOPENIA

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? No
Previous Vaccinations:
Other Medications: Mantle radiation.
Current Illness:
Preexisting Conditions: Stage I Hodgkin''s receiving mantle irradiation.
Allergies:
Diagnostic Lab Data: Platelet CT on 9NOV90 - 2000 per cubic millimeter
CDC 'Split Type':

Write-up: Pt vaccinated w/FLUOGEN developed thrombocytopenia & petechiae, sore mouth, CBC & platelet count revealed a platelet count of 2000 per cubic mm. Diffuse petechial hemorrhages. MD feel prob unrelated to the FLUOGEN to do bone marrow analysis


Changed on 12/8/2009

VAERS ID: 27347 Before After
VAERS Form:
Age:69.0
Sex:Male
Location:Illinois
Vaccinated:1990-11-06
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-10 1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS INFLUENZA (SEASONAL) (FLUOGEN 90-91) / PARKE-DAVIS - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Petechiae, Stomatitis, Thrombocytopenia, PETECHIA, STOMATITIS, THROMBOCYTOPENIA

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? No
Previous Vaccinations:
Other Medications: Mantle radiation.
Current Illness:
Preexisting Conditions: Stage I Hodgkin''s receiving mantle irradiation.
Allergies:
Diagnostic Lab Data: Platelet CT on 9NOV90 - 2000 per cubic millimeter
CDC 'Split Type': (blank) 904090010

Write-up: Pt vaccinated w/FLUOGEN developed thrombocytopenia & petechiae, sore mouth, CBC & platelet count revealed a platelet count of 2000 per cubic mm. Diffuse petechial hemorrhages. MD feel prob unrelated to the FLUOGEN to do bone marrow analysis


Changed on 8/31/2010

VAERS ID: 27347 Before After
VAERS Form:
Age:69.0
Sex:Male
Location:Illinois
Vaccinated:1990-11-06
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 90-91) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Petechiae, Stomatitis, Thrombocytopenia

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? No
Previous Vaccinations:
Other Medications: Mantle radiation.
Current Illness:
Preexisting Conditions: Stage I Hodgkin''s receiving mantle irradiation.
Allergies:
Diagnostic Lab Data: Platelet CT on 9NOV90 - 2000 per cubic millimeter
CDC 'Split Type': 904090010

Write-up: Pt vaccinated w/FLUOGEN developed thrombocytopenia & petechiae, sore mouth, CBC & platelet count revealed a platelet count of 2000 per cubic mm. Diffuse petechial hemorrhages. MD feel prob unrelated to the FLUOGEN to do bone marrow analysis


Changed on 7/7/2013

VAERS ID: 27347 Before After
VAERS Form:
Age:69.0
Sex:Male
Location:Illinois
Vaccinated:1990-11-06
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Petechiae, Stomatitis, Thrombocytopenia

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? No
Previous Vaccinations:
Other Medications: Mantle radiation.
Current Illness:
Preexisting Conditions: Stage I Hodgkin''s receiving mantle irradiation.
Allergies:
Diagnostic Lab Data: Platelet CT on 9NOV90 - 2000 per cubic millimeter
CDC 'Split Type': 904090010

Write-up: Pt vaccinated w/FLUOGEN developed thrombocytopenia & petechiae, sore mouth, CBC & platelet count revealed a platelet count of 2000 per cubic mm. Diffuse petechial hemorrhages. MD feel prob unrelated to the FLUOGEN to do bone marrow analysis


Changed on 5/14/2017

VAERS ID: 27347 Before After
VAERS Form:
Age:69.0
Sex:Male
Location:Illinois
Vaccinated:1990-11-06
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Petechiae, Stomatitis, Thrombocytopenia

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Mantle radiation.
Current Illness:
Preexisting Conditions: Stage I Hodgkin''s receiving mantle irradiation.
Allergies:
Diagnostic Lab Data: Platelet CT on 9NOV90 - 2000 per cubic millimeter
CDC 'Split Type': 904090010

Write-up: Pt vaccinated w/FLUOGEN developed thrombocytopenia & petechiae, sore mouth, CBC & platelet count revealed a platelet count of 2000 per cubic mm. Diffuse petechial hemorrhages. MD feel prob unrelated to the FLUOGEN to do bone marrow analysis


Changed on 9/14/2017

VAERS ID: 27347 Before After
VAERS Form:(blank) 1
Age:69.0
Sex:Male
Location:Illinois
Vaccinated:1990-11-06
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / - UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Petechiae, Stomatitis, Thrombocytopenia

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Mantle radiation.
Current Illness:
Preexisting Conditions: Stage I Hodgkin''s receiving mantle irradiation.
Allergies:
Diagnostic Lab Data: Platelet CT on 9NOV90 - 2000 per cubic millimeter
CDC 'Split Type': 904090010

Write-up: Pt vaccinated w/FLUOGEN developed thrombocytopenia & petechiae, sore mouth, CBC & platelet count revealed a platelet count of 2000 per cubic mm. Diffuse petechial hemorrhages. MD feel prob unrelated to the FLUOGEN to do bone marrow analysis


Changed on 2/14/2018

VAERS ID: 27347 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Illinois
Vaccinated:1990-11-06
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Petechiae, Stomatitis, Thrombocytopenia

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Mantle radiation.
Current Illness:
Preexisting Conditions: Stage I Hodgkin''s receiving mantle irradiation.
Allergies:
Diagnostic Lab Data: Platelet CT on 9NOV90 - 2000 per cubic millimeter
CDC 'Split Type': 904090010

Write-up: Pt vaccinated w/FLUOGEN developed thrombocytopenia & petechiae, sore mouth, CBC & platelet count revealed a platelet count of 2000 per cubic mm. Diffuse petechial hemorrhages. MD feel prob unrelated to the FLUOGEN to do bone marrow analysis


Changed on 6/14/2018

VAERS ID: 27347 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Illinois
Vaccinated:1990-11-06
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Petechiae, Stomatitis, Thrombocytopenia

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Mantle radiation.
Current Illness:
Preexisting Conditions: Stage I Hodgkin''s receiving mantle irradiation.
Allergies:
Diagnostic Lab Data: Platelet CT on 9NOV90 - 2000 per cubic millimeter
CDC 'Split Type': 904090010

Write-up: Pt vaccinated w/FLUOGEN developed thrombocytopenia & petechiae, sore mouth, CBC & platelet count revealed a platelet count of 2000 per cubic mm. Diffuse petechial hemorrhages. MD feel prob unrelated to the FLUOGEN to do bone marrow analysis


Changed on 8/14/2018

VAERS ID: 27347 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Illinois
Vaccinated:1990-11-06
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Petechiae, Stomatitis, Thrombocytopenia

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Mantle radiation.
Current Illness:
Preexisting Conditions: Stage I Hodgkin''s receiving mantle irradiation.
Allergies:
Diagnostic Lab Data: Platelet CT on 9NOV90 - 2000 per cubic millimeter
CDC 'Split Type': 904090010

Write-up: Pt vaccinated w/FLUOGEN developed thrombocytopenia & petechiae, sore mouth, CBC & platelet count revealed a platelet count of 2000 per cubic mm. Diffuse petechial hemorrhages. MD feel prob unrelated to the FLUOGEN to do bone marrow analysis


Changed on 9/14/2018

VAERS ID: 27347 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Illinois
Vaccinated:1990-11-06
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Petechiae, Stomatitis, Thrombocytopenia

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Mantle radiation.
Current Illness:
Preexisting Conditions: Stage I Hodgkin''s receiving mantle irradiation.
Allergies:
Diagnostic Lab Data: Platelet CT on 9NOV90 - 2000 per cubic millimeter
CDC 'Split Type': 904090010

Write-up: Pt vaccinated w/FLUOGEN developed thrombocytopenia & petechiae, sore mouth, CBC & platelet count revealed a platelet count of 2000 per cubic mm. Diffuse petechial hemorrhages. MD feel prob unrelated to the FLUOGEN to do bone marrow analysis


Changed on 10/14/2018

VAERS ID: 27347 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Illinois
Vaccinated:1990-11-06
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Petechiae, Stomatitis, Thrombocytopenia

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Mantle radiation.
Current Illness:
Preexisting Conditions: Stage I Hodgkin''s receiving mantle irradiation.
Allergies:
Diagnostic Lab Data: Platelet CT on 9NOV90 - 2000 per cubic millimeter
CDC 'Split Type': 904090010

Write-up: Pt vaccinated w/FLUOGEN developed thrombocytopenia & petechiae, sore mouth, CBC & platelet count revealed a platelet count of 2000 per cubic mm. Diffuse petechial hemorrhages. MD feel prob unrelated to the FLUOGEN to do bone marrow analysis


Changed on 12/24/2020

VAERS ID: 27347 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Illinois
Vaccinated:1990-11-06
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Petechiae, Stomatitis, Thrombocytopenia

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Mantle radiation.
Current Illness:
Preexisting Conditions: Stage I Hodgkin''s receiving mantle irradiation.
Allergies:
Diagnostic Lab Data: Platelet CT on 9NOV90 - 2000 per cubic millimeter
CDC 'Split Type': 904090010

Write-up: Pt vaccinated w/FLUOGEN developed thrombocytopenia & petechiae, sore mouth, CBC & platelet count revealed a platelet count of 2000 per cubic mm. Diffuse petechial hemorrhages. MD feel prob unrelated to the FLUOGEN to do bone marrow analysis


Changed on 12/30/2020

VAERS ID: 27347 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Illinois
Vaccinated:1990-11-06
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Petechiae, Stomatitis, Thrombocytopenia

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Mantle radiation.
Current Illness:
Preexisting Conditions: Stage I Hodgkin''s receiving mantle irradiation.
Allergies:
Diagnostic Lab Data: Platelet CT on 9NOV90 - 2000 per cubic millimeter
CDC 'Split Type': 904090010

Write-up: Pt vaccinated w/FLUOGEN developed thrombocytopenia & petechiae, sore mouth, CBC & platelet count revealed a platelet count of 2000 per cubic mm. Diffuse petechial hemorrhages. MD feel prob unrelated to the FLUOGEN to do bone marrow analysis


Changed on 5/7/2021

VAERS ID: 27347 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Illinois
Vaccinated:1990-11-06
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Petechiae, Stomatitis, Thrombocytopenia

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Mantle radiation.
Current Illness:
Preexisting Conditions: Stage I Hodgkin''s receiving mantle irradiation.
Allergies:
Diagnostic Lab Data: Platelet CT on 9NOV90 - 2000 per cubic millimeter
CDC 'Split Type': 904090010

Write-up: Pt vaccinated w/FLUOGEN developed thrombocytopenia & petechiae, sore mouth, CBC & platelet count revealed a platelet count of 2000 per cubic mm. Diffuse petechial hemorrhages. MD feel prob unrelated to the FLUOGEN to do bone marrow analysis


Changed on 5/14/2021

VAERS ID: 27347 Before After
VAERS Form:1
Age:69.0
Sex:Male
Location:Illinois
Vaccinated:1990-11-06
Onset:1990-11-09
Submitted:0000-00-00
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Petechiae, Stomatitis, Thrombocytopenia

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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Mantle radiation.
Current Illness:
Preexisting Conditions: Stage I Hodgkin''s receiving mantle irradiation.
Allergies:
Diagnostic Lab Data: Platelet CT on 9NOV90 - 2000 per cubic millimeter
CDC 'Split Type': 904090010

Write-up: Pt vaccinated w/FLUOGEN developed thrombocytopenia & petechiae, sore mouth, CBC & platelet count revealed a platelet count of 2000 per cubic mm. Diffuse petechial hemorrhages. MD feel prob unrelated to the FLUOGEN to do bone marrow analysis

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