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This is VAERS ID 27543

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27543
VAERS Form:
Age:85.0
Sex:Male
Location:Georgia
Vaccinated:1990-11-19
Onset:1990-11-19
Submitted:1990-11-21
Entered:1991-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS / PARKE-DAVIS 06580P / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: SWEAT, TREMOR, GAIT ABNORM, ASTHENIA, HYPOGLYCEM

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Procardia, Micronase, Ativan
Current Illness:
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data: Blood Sugar Test - 21
CDC 'Split Type':

Write-up: Pt vaccinated w/FLU developed difficulty walking out to the car, BP & Pulse normal. Felt clammy & blood sugar was 21. Also difficulty getting 1/2 cup coke swallowed was shaking & moaning,took to Hosp treated & observed in ER,admit for 1 day


Changed on 12/8/2009

VAERS ID: 27543 Before After
VAERS Form:
Age:85.0
Sex:Male
Location:Georgia
Vaccinated:1990-11-19
Onset:1990-11-19
Submitted:1990-11-21
Entered:1991-01-29 1991-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS INFLUENZA (SEASONAL) (FLUOGEN 90-91) / PARKE-DAVIS 06580P / - LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Asthenia, Gait disturbance, Hyperhidrosis, Hypoglycaemia, Tremor, SWEAT, TREMOR, GAIT ABNORM, ASTHENIA, HYPOGLYCEM

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Procardia, Micronase, Ativan
Current Illness:
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data: Blood Sugar Test - 21
CDC 'Split Type': (blank) GA9025

Write-up: Pt vaccinated w/FLU developed difficulty walking out to the car, BP & Pulse normal. Felt clammy & blood sugar was 21. Also difficulty getting 1/2 cup coke swallowed was shaking & moaning,took to Hosp treated & observed in ER,admit for 1 day


Changed on 8/31/2010

VAERS ID: 27543 Before After
VAERS Form:
Age:85.0
Sex:Male
Location:Georgia
Vaccinated:1990-11-19
Onset:1990-11-19
Submitted:1990-11-21
Entered:1991-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 90-91) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 06580P / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Gait disturbance, Hyperhidrosis, Hypoglycaemia, Tremor

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Procardia, Micronase, Ativan
Current Illness:
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data: Blood Sugar Test - 21
CDC 'Split Type': GA9025

Write-up: Pt vaccinated w/FLU developed difficulty walking out to the car, BP & Pulse normal. Felt clammy & blood sugar was 21. Also difficulty getting 1/2 cup coke swallowed was shaking & moaning,took to Hosp treated & observed in ER,admit for 1 day


Changed on 7/7/2013

VAERS ID: 27543 Before After
VAERS Form:
Age:85.0
Sex:Male
Location:Georgia
Vaccinated:1990-11-19
Onset:1990-11-19
Submitted:1990-11-21
Entered:1991-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 06580P / - LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 06580P / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Gait disturbance, Hyperhidrosis, Hypoglycaemia, Tremor

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Procardia, Micronase, Ativan
Current Illness:
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data: Blood Sugar Test - 21
CDC 'Split Type': GA9025

Write-up: Pt vaccinated w/FLU developed difficulty walking out to the car, BP & Pulse normal. Felt clammy & blood sugar was 21. Also difficulty getting 1/2 cup coke swallowed was shaking & moaning,took to Hosp treated & observed in ER,admit for 1 day


Changed on 5/14/2017

VAERS ID: 27543 Before After
VAERS Form:
Age:85.0
Sex:Male
Location:Georgia
Vaccinated:1990-11-19
Onset:1990-11-19
Submitted:1990-11-21
Entered:1991-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 06580P / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Gait disturbance, Hyperhidrosis, Hypoglycaemia, Tremor

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Procardia, Micronase, Ativan
Current Illness:
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data: Blood Sugar Test - 21
CDC 'Split Type': GA9025

Write-up: Pt vaccinated w/FLU developed difficulty walking out to the car, BP & Pulse normal. Felt clammy & blood sugar was 21. Also difficulty getting 1/2 cup coke swallowed was shaking & moaning,took to Hosp treated & observed in ER,admit for 1 day


Changed on 9/14/2017

VAERS ID: 27543 Before After
VAERS Form:(blank) 1
Age:85.0
Sex:Male
Location:Georgia
Vaccinated:1990-11-19
Onset:1990-11-19
Submitted:1990-11-21
Entered:1991-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 06580P / - UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Gait disturbance, Hyperhidrosis, Hypoglycaemia, Tremor

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Procardia, Micronase, Ativan
Current Illness:
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data: Blood Sugar Test - 21
CDC 'Split Type': GA9025

Write-up: Pt vaccinated w/FLU developed difficulty walking out to the car, BP & Pulse normal. Felt clammy & blood sugar was 21. Also difficulty getting 1/2 cup coke swallowed was shaking & moaning,took to Hosp treated & observed in ER,admit for 1 day


Changed on 2/14/2018

VAERS ID: 27543 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Georgia
Vaccinated:1990-11-19
Onset:1990-11-19
Submitted:1990-11-21
Entered:1991-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 06580P / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Gait disturbance, Hyperhidrosis, Hypoglycaemia, Tremor

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Procardia, Micronase, Ativan
Current Illness:
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data: Blood Sugar Test - 21
CDC 'Split Type': GA9025

Write-up: Pt vaccinated w/FLU developed difficulty walking out to the car, BP & Pulse normal. Felt clammy & blood sugar was 21. Also difficulty getting 1/2 cup coke swallowed was shaking & moaning,took to Hosp treated & observed in ER,admit for 1 day


Changed on 6/14/2018

VAERS ID: 27543 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Georgia
Vaccinated:1990-11-19
Onset:1990-11-19
Submitted:1990-11-21
Entered:1991-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 06580P / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Gait disturbance, Hyperhidrosis, Hypoglycaemia, Tremor

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Procardia, Micronase, Ativan
Current Illness:
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data: Blood Sugar Test - 21
CDC 'Split Type': GA9025

Write-up: Pt vaccinated w/FLU developed difficulty walking out to the car, BP & Pulse normal. Felt clammy & blood sugar was 21. Also difficulty getting 1/2 cup coke swallowed was shaking & moaning,took to Hosp treated & observed in ER,admit for 1 day


Changed on 8/14/2018

VAERS ID: 27543 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Georgia
Vaccinated:1990-11-19
Onset:1990-11-19
Submitted:1990-11-21
Entered:1991-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 06580P / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Gait disturbance, Hyperhidrosis, Hypoglycaemia, Tremor

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Procardia, Micronase, Ativan
Current Illness:
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data: Blood Sugar Test - 21
CDC 'Split Type': GA9025

Write-up: Pt vaccinated w/FLU developed difficulty walking out to the car, BP & Pulse normal. Felt clammy & blood sugar was 21. Also difficulty getting 1/2 cup coke swallowed was shaking & moaning,took to Hosp treated & observed in ER,admit for 1 day


Changed on 9/14/2018

VAERS ID: 27543 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Georgia
Vaccinated:1990-11-19
Onset:1990-11-19
Submitted:1990-11-21
Entered:1991-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 06580P / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Gait disturbance, Hyperhidrosis, Hypoglycaemia, Tremor

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Procardia, Micronase, Ativan
Current Illness:
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data: Blood Sugar Test - 21
CDC 'Split Type': GA9025

Write-up: Pt vaccinated w/FLU developed difficulty walking out to the car, BP & Pulse normal. Felt clammy & blood sugar was 21. Also difficulty getting 1/2 cup coke swallowed was shaking & moaning,took to Hosp treated & observed in ER,admit for 1 day


Changed on 10/14/2018

VAERS ID: 27543 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Georgia
Vaccinated:1990-11-19
Onset:1990-11-19
Submitted:1990-11-21
Entered:1991-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 06580P / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Gait disturbance, Hyperhidrosis, Hypoglycaemia, Tremor

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Procardia, Micronase, Ativan
Current Illness:
Preexisting Conditions: Diabetes
Allergies:
Diagnostic Lab Data: Blood Sugar Test - 21
CDC 'Split Type': GA9025

Write-up: Pt vaccinated w/FLU developed difficulty walking out to the car, BP & Pulse normal. Felt clammy & blood sugar was 21. Also difficulty getting 1/2 cup coke swallowed was shaking & moaning,took to Hosp treated & observed in ER,admit for 1 day

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=27543&WAYBACKHISTORY=ON


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