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This is VAERS ID 27388

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27388
VAERS Form:
Age:7.2
Sex:Female
Location:Georgia
Vaccinated:1990-11-28
Onset:1990-12-06
Submitted:1990-12-27
Entered:1991-01-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS / PARKE-DAVIS 02580P / 0 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: FEVER, VOMIT, RHINITIS, COUGH INC, PHARYNGITIS

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: Folic acid, Pencillin
Current Illness:
Preexisting Conditions: Sickle Cell
Allergies:
Diagnostic Lab Data: blood work, chest x-ray (MCCG)
CDC 'Split Type':

Write-up: Pt vaccinated with FLU developed fever 102, vomiting, sore throat, red, mattered eyes, runny nose, cough.


Changed on 12/8/2009

VAERS ID: 27388 Before After
VAERS Form:
Age:7.2
Sex:Female
Location:Georgia
Vaccinated:1990-11-28
Onset:1990-12-06
Submitted:1990-12-27
Entered:1991-01-16 1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS INFLUENZA (SEASONAL) (FLUOGEN 90-91) / PARKE-DAVIS 02580P / 0 RA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Cough, Pharyngitis, Pyrexia, Rhinitis, Vomiting, FEVER, VOMIT, RHINITIS, COUGH INC, PHARYNGITIS

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: Folic acid, Pencillin
Current Illness:
Preexisting Conditions: Sickle Cell
Allergies:
Diagnostic Lab Data: blood work, chest x-ray (MCCG)
CDC 'Split Type': (blank) GA9018

Write-up: Pt vaccinated with FLU developed fever 102, vomiting, sore throat, red, mattered eyes, runny nose, cough.


Changed on 8/31/2010

VAERS ID: 27388 Before After
VAERS Form:
Age:7.2
Sex:Female
Location:Georgia
Vaccinated:1990-11-28
Onset:1990-12-06
Submitted:1990-12-27
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 90-91) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Cough, Pharyngitis, Pyrexia, Rhinitis, Vomiting

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: Folic acid, Pencillin
Current Illness:
Preexisting Conditions: Sickle Cell
Allergies:
Diagnostic Lab Data: blood work, chest x-ray (MCCG)
CDC 'Split Type': GA9018

Write-up: Pt vaccinated with FLU developed fever 102, vomiting, sore throat, red, mattered eyes, runny nose, cough.


Changed on 7/7/2013

VAERS ID: 27388 Before After
VAERS Form:
Age:7.2
Sex:Female
Location:Georgia
Vaccinated:1990-11-28
Onset:1990-12-06
Submitted:1990-12-27
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 0 RA / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Cough, Pharyngitis, Pyrexia, Rhinitis, Vomiting

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: Folic acid, Pencillin
Current Illness:
Preexisting Conditions: Sickle Cell
Allergies:
Diagnostic Lab Data: blood work, chest x-ray (MCCG)
CDC 'Split Type': GA9018

Write-up: Pt vaccinated with FLU developed fever 102, vomiting, sore throat, red, mattered eyes, runny nose, cough.


Changed on 2/14/2017

VAERS ID: 27388 Before After
VAERS Form:
Age:7.2 7.0
Sex:Female
Location:Georgia
Vaccinated:1990-11-28
Onset:1990-12-06
Submitted:1990-12-27
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Cough, Pharyngitis, Pyrexia, Rhinitis, Vomiting

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: Folic acid, Pencillin
Current Illness:
Preexisting Conditions: Sickle Cell
Allergies:
Diagnostic Lab Data: blood work, chest x-ray (MCCG)
CDC 'Split Type': GA9018

Write-up: Pt vaccinated with FLU developed fever 102, vomiting, sore throat, red, mattered eyes, runny nose, cough.


Changed on 5/14/2017

VAERS ID: 27388 Before After
VAERS Form:
Age:7.0
Sex:Female
Location:Georgia
Vaccinated:1990-11-28
Onset:1990-12-06
Submitted:1990-12-27
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Cough, Pharyngitis, Pyrexia, Rhinitis, Vomiting

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: Folic acid, Pencillin
Current Illness:
Preexisting Conditions: Sickle Cell
Allergies:
Diagnostic Lab Data: blood work, chest x-ray (MCCG)
CDC 'Split Type': GA9018

Write-up: Pt vaccinated with FLU developed fever 102, vomiting, sore throat, red, mattered eyes, runny nose, cough.


Changed on 9/14/2017

VAERS ID: 27388 Before After
VAERS Form:(blank) 1
Age:7.0
Sex:Female
Location:Georgia
Vaccinated:1990-11-28
Onset:1990-12-06
Submitted:1990-12-27
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 0 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Cough, Pharyngitis, Pyrexia, Rhinitis, Vomiting

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: Folic acid, Pencillin
Current Illness:
Preexisting Conditions: Sickle Cell
Allergies:
Diagnostic Lab Data: blood work, chest x-ray (MCCG)
CDC 'Split Type': GA9018

Write-up: Pt vaccinated with FLU developed fever 102, vomiting, sore throat, red, mattered eyes, runny nose, cough.


Changed on 2/14/2018

VAERS ID: 27388 Before After
VAERS Form:1
Age:7.0
Sex:Female
Location:Georgia
Vaccinated:1990-11-28
Onset:1990-12-06
Submitted:1990-12-27
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Cough, Pharyngitis, Pyrexia, Rhinitis, Vomiting

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: Folic acid, Pencillin
Current Illness:
Preexisting Conditions: Sickle Cell
Allergies:
Diagnostic Lab Data: blood work, chest x-ray (MCCG)
CDC 'Split Type': GA9018

Write-up: Pt vaccinated with FLU developed fever 102, vomiting, sore throat, red, mattered eyes, runny nose, cough.


Changed on 6/14/2018

VAERS ID: 27388 Before After
VAERS Form:1
Age:7.0
Sex:Female
Location:Georgia
Vaccinated:1990-11-28
Onset:1990-12-06
Submitted:1990-12-27
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Cough, Pharyngitis, Pyrexia, Rhinitis, Vomiting

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: Folic acid, Pencillin
Current Illness:
Preexisting Conditions: Sickle Cell
Allergies:
Diagnostic Lab Data: blood work, chest x-ray (MCCG)
CDC 'Split Type': GA9018

Write-up: Pt vaccinated with FLU developed fever 102, vomiting, sore throat, red, mattered eyes, runny nose, cough.


Changed on 8/14/2018

VAERS ID: 27388 Before After
VAERS Form:1
Age:7.0
Sex:Female
Location:Georgia
Vaccinated:1990-11-28
Onset:1990-12-06
Submitted:1990-12-27
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Cough, Pharyngitis, Pyrexia, Rhinitis, Vomiting

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: Folic acid, Pencillin
Current Illness:
Preexisting Conditions: Sickle Cell
Allergies:
Diagnostic Lab Data: blood work, chest x-ray (MCCG)
CDC 'Split Type': GA9018

Write-up: Pt vaccinated with FLU developed fever 102, vomiting, sore throat, red, mattered eyes, runny nose, cough.


Changed on 9/14/2018

VAERS ID: 27388 Before After
VAERS Form:1
Age:7.0
Sex:Female
Location:Georgia
Vaccinated:1990-11-28
Onset:1990-12-06
Submitted:1990-12-27
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Cough, Pharyngitis, Pyrexia, Rhinitis, Vomiting

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: Folic acid, Pencillin
Current Illness:
Preexisting Conditions: Sickle Cell
Allergies:
Diagnostic Lab Data: blood work, chest x-ray (MCCG)
CDC 'Split Type': GA9018

Write-up: Pt vaccinated with FLU developed fever 102, vomiting, sore throat, red, mattered eyes, runny nose, cough.


Changed on 10/14/2018

VAERS ID: 27388 Before After
VAERS Form:1
Age:7.0
Sex:Female
Location:Georgia
Vaccinated:1990-11-28
Onset:1990-12-06
Submitted:1990-12-27
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Cough, Pharyngitis, Pyrexia, Rhinitis, Vomiting

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: Folic acid, Pencillin
Current Illness:
Preexisting Conditions: Sickle Cell
Allergies:
Diagnostic Lab Data: blood work, chest x-ray (MCCG)
CDC 'Split Type': GA9018

Write-up: Pt vaccinated with FLU developed fever 102, vomiting, sore throat, red, mattered eyes, runny nose, cough.

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