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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 28380 |
VAERS Form: | |
Age: | 80.7 |
Sex: | Male |
Location: | Michigan |
Vaccinated: | 1990-10-01 |
Onset: | 1990-10-10 |
Submitted: | 1991-02-06 |
Entered: | 1991-02-26 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH | 4908209 / 0 | A / IM |
Administered by: Private Purchased by: Unknown
Symptoms: FEVER, FLU SYND, SEPSIS, PHARYNGITIS
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:
Write-up: Pt developed flu like respiratory symptoms nine days /p receiving Flu vax(1990-91 formula).Pt was admitted to acute care facility /w a respiratory infection, sepsis, & T. F/U info,
Vaccinated: | 1990-10-01 |
Onset: | 1990-10-10 |
Submitted: | 1991-02-06 |
Entered: | 1991-02-26 1991-02-18 |
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 | 4908209 / 0 | A / IM |
Administered by: Private Purchased by: Unknown Private
Symptoms: Influenza, Pharyngitis, Pyrexia, Sepsis, FEVER, FLU SYND, SEPSIS, PHARYNGITIS
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:
Write-up: Pt developed flu like respiratory symptoms nine days /p receiving Flu vax(1990-91 formula).Pt was admitted to acute care facility /w a respiratory infection, sepsis, & T. F/U info,
Vaccinated: | 1990-10-01 |
Onset: | 1990-10-10 |
Submitted: | 1991-02-06 |
Entered: | 1991-02-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH | 4908209 / 0 | A / IM |
Administered by: Private Purchased by: Private
Symptoms: Influenza, Pharyngitis, Pyrexia, Sepsis
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:
Write-up: Pt developed flu like respiratory symptoms nine days /p receiving Flu vax(1990-91 formula).Pt was admitted to acute care facility /w a respiratory infection, sepsis, & T. F/U info,
Vaccinated: | 1990-10-01 |
Onset: | 1990-10-10 |
Submitted: | 1991-02-06 |
Entered: | 1991-02-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4908209 / 0 | A / IM |
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4908209 / 0 | A / IM |
Administered by: Private Purchased by: Private
Symptoms: Influenza, Pharyngitis, Pyrexia, Sepsis
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:
Write-up: Pt developed flu like respiratory symptoms nine days /p receiving Flu vax(1990-91 formula).Pt was admitted to acute care facility /w a respiratory infection, sepsis, & T. F/U info,
Vaccinated: | 1990-10-01 |
Onset: | 1990-10-10 |
Submitted: | 1991-02-06 |
Entered: | 1991-02-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4908209 / 0 | A / IM |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4908209 / 0 | A / IM |
Administered by: Private Purchased by: Private
Symptoms: Influenza, Pharyngitis, Pyrexia, Sepsis
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:
Write-up: Pt developed flu like respiratory symptoms nine days /p receiving Flu vax(1990-91 formula).Pt was admitted to acute care facility /w a respiratory infection, sepsis, & T. F/U info,
Vaccinated: | 1990-10-01 |
Onset: | 1990-10-10 |
Submitted: | 1991-02-06 |
Entered: | 1991-02-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4908209 / 0 | A / IM |
Administered by: Private Purchased by: Private
Symptoms: Influenza, Pharyngitis, Pyrexia, Sepsis
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:
Write-up: Pt developed flu like respiratory symptoms nine days /p receiving Flu vax(1990-91 formula).Pt was admitted to acute care facility /w a respiratory infection, sepsis, & T. F/U info,
Vaccinated: | 1990-10-01 |
Onset: | 1990-10-10 |
Submitted: | 1991-02-06 |
Entered: | 1991-02-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4908209 / 0 | A - / IM IM A |
Administered by: Private Purchased by: Private
Symptoms: Influenza, Pharyngitis, Pyrexia, Sepsis
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:
Write-up: Pt developed flu like respiratory symptoms nine days /p receiving Flu vax(1990-91 formula).Pt was admitted to acute care facility /w a respiratory infection, sepsis, & T. F/U info,
Vaccinated: | 1990-10-01 |
Onset: | 1990-10-10 |
Submitted: | 1991-02-06 |
Entered: | 1991-02-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4908209 / 0 1 | - / IM A |
Administered by: Private Purchased by: Private
Symptoms: Influenza, Pharyngitis, Pyrexia, Sepsis
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:
Write-up: Pt developed flu like respiratory symptoms nine days /p receiving Flu vax(1990-91 formula).Pt was admitted to acute care facility /w a respiratory infection, sepsis, & T. F/U info,
Vaccinated: | 1990-10-01 |
Onset: | 1990-10-10 |
Submitted: | 1991-02-06 |
Entered: | 1991-02-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4908209 / 1 | - / IM A |
Administered by: Private Purchased by: Private
Symptoms: Influenza, Pharyngitis, Pyrexia, Sepsis
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:
Write-up: Pt developed flu like respiratory symptoms nine days /p receiving Flu vax(1990-91 formula).Pt was admitted to acute care facility /w a respiratory infection, sepsis, & T. F/U info,
Vaccinated: | 1990-10-01 |
Onset: | 1990-10-10 |
Submitted: | 1991-02-06 |
Entered: | 1991-02-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4908209 / 1 | - / IM A |
Administered by: Private Purchased by: Private
Symptoms: Influenza, Pharyngitis, Pyrexia, Sepsis
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:
Write-up: Pt developed flu like respiratory symptoms nine days /p receiving Flu vax(1990-91 formula).Pt was admitted to acute care facility /w a respiratory infection, sepsis, & T. F/U info,
Vaccinated: | 1990-10-01 |
Onset: | 1990-10-10 |
Submitted: | 1991-02-06 |
Entered: | 1991-02-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4908209 / 1 | - / IM A |
Administered by: Private Purchased by: Private
Symptoms: Influenza, Pharyngitis, Pyrexia, Sepsis
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:
Write-up: Pt developed flu like respiratory symptoms nine days /p receiving Flu vax(1990-91 formula).Pt was admitted to acute care facility /w a respiratory infection, sepsis, & T. F/U info,
Vaccinated: | 1990-10-01 |
Onset: | 1990-10-10 |
Submitted: | 1991-02-06 |
Entered: | 1991-02-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4908209 / 1 | - / IM A |
Administered by: Private Purchased by: Private
Symptoms: Influenza, Pharyngitis, Pyrexia, Sepsis
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:
Write-up: Pt developed flu like respiratory symptoms nine days /p receiving Flu vax(1990-91 formula).Pt was admitted to acute care facility /w a respiratory infection, sepsis, & T. F/U info,
Vaccinated: | 1990-10-01 |
Onset: | 1990-10-10 |
Submitted: | 1991-02-06 |
Entered: | 1991-02-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4908209 / 1 | - / IM A |
Administered by: Private Purchased by: Private
Symptoms: Influenza, Pharyngitis, Pyrexia, Sepsis
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:
Write-up: Pt developed flu like respiratory symptoms nine days /p receiving Flu vax(1990-91 formula).Pt was admitted to acute care facility /w a respiratory infection, sepsis, & T. F/U info,
Vaccinated: | 1990-10-01 |
Onset: | 1990-10-10 |
Submitted: | 1991-02-06 |
Entered: | 1991-02-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4908209 / 1 | - / IM A |
Administered by: Private Purchased by: Private
Symptoms: Influenza, Pharyngitis, Pyrexia, Sepsis
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:
Write-up: Pt developed flu like respiratory symptoms nine days /p receiving Flu vax(1990-91 formula).Pt was admitted to acute care facility /w a respiratory infection, sepsis, & T. F/U info,
Vaccinated: | 1990-10-01 |
Onset: | 1990-10-10 |
Submitted: | 1991-02-06 |
Entered: | 1991-02-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4908209 / 1 | - / IM A |
Administered by: Private Purchased by: Private
Symptoms: Influenza, Pharyngitis, Pyrexia, Sepsis
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:
Write-up: Pt developed flu like respiratory symptoms nine days /p receiving Flu vax(1990-91 formula).Pt was admitted to acute care facility /w a respiratory infection, sepsis, & T. F/U info,
Link To This Search Result:
https://medalerts.org/vaersdb/findfield.php?IDNUMBER=28380&WAYBACKHISTORY=ON
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