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This is VAERS ID 27402

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27402
VAERS Form:
Age:59.8
Sex:Female
Location:Oklahoma
Vaccinated:1990-11-14
Onset:1990-11-14
Submitted:1991-01-10
Entered:1991-01-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 0F11227 / - RA / IM
PPV: PNU-IMUNE(R)23 / LEDERLE 291954 / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: INJECT SITE REACT, VASODILAT

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Local reactions, felt hot.


Changed on 12/8/2009

VAERS ID: 27402 Before After
VAERS Form:
Age:59.8
Sex:Female
Location:Oklahoma
Vaccinated:1990-11-14
Onset:1990-11-14
Submitted:1991-01-10
Entered:1991-01-16 1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0F11227 / - RA / IM
PPV: PNU-IMUNE(R)23 PNEUMO (PNU-IMUNE) / LEDERLE LEDERLE LABORATORIES 291954 / - LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Injection site reaction, Vasodilatation, INJECT SITE REACT, VASODILAT

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) OK909

Write-up: Local reactions, felt hot.


Changed on 8/31/2010

VAERS ID: 27402 Before After
VAERS Form:
Age:59.8
Sex:Female
Location:Oklahoma
Vaccinated:1990-11-14
Onset:1990-11-14
Submitted:1991-01-10
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11227 / - RA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 291954 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site reaction, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK909

Write-up: Local reactions, felt hot.


Changed on 7/7/2013

VAERS ID: 27402 Before After
VAERS Form:
Age:59.8
Sex:Female
Location:Oklahoma
Vaccinated:1990-11-14
Onset:1990-11-14
Submitted:1991-01-10
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11227 / - RA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11227 / - RA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 291954 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site reaction, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK909

Write-up: Local reactions, felt hot.


Changed on 2/14/2017

VAERS ID: 27402 Before After
VAERS Form:
Age:59.8 59.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-11-14
Onset:1990-11-14
Submitted:1991-01-10
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11227 / - RA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 291954 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site reaction, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK909

Write-up: Local reactions, felt hot.


Changed on 5/14/2017

VAERS ID: 27402 Before After
VAERS Form:
Age:59.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-11-14
Onset:1990-11-14
Submitted:1991-01-10
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11227 / - RA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 291954 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site reaction, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK909

Write-up: Local reactions, felt hot.


Changed on 9/14/2017

VAERS ID: 27402 Before After
VAERS Form:(blank) 1
Age:59.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-11-14
Onset:1990-11-14
Submitted:1991-01-10
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11227 / - UNK RA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 291954 / - UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site reaction, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK909

Write-up: Local reactions, felt hot.


Changed on 2/14/2018

VAERS ID: 27402 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-11-14
Onset:1990-11-14
Submitted:1991-01-10
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11227 / UNK RA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 291954 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site reaction, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK909

Write-up: Local reactions, felt hot.


Changed on 6/14/2018

VAERS ID: 27402 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-11-14
Onset:1990-11-14
Submitted:1991-01-10
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11227 / UNK RA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 291954 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site reaction, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK909

Write-up: Local reactions, felt hot.


Changed on 8/14/2018

VAERS ID: 27402 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-11-14
Onset:1990-11-14
Submitted:1991-01-10
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11227 / UNK RA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 291954 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site reaction, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK909

Write-up: Local reactions, felt hot.


Changed on 9/14/2018

VAERS ID: 27402 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-11-14
Onset:1990-11-14
Submitted:1991-01-10
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11227 / UNK RA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 291954 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site reaction, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK909

Write-up: Local reactions, felt hot.


Changed on 10/14/2018

VAERS ID: 27402 Before After
VAERS Form:1
Age:59.0
Sex:Female
Location:Oklahoma
Vaccinated:1990-11-14
Onset:1990-11-14
Submitted:1991-01-10
Entered:1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11227 / UNK RA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 291954 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site reaction, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK909

Write-up: Local reactions, felt hot.

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