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This is VAERS ID 28558

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 28558
VAERS Form:
Age:
Sex:Male
Location:Illinois
Vaccinated:1989-12-19
Onset:1989-12-20
Submitted:0000-00-00
Entered:1991-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1989-1990 / CONNAUGHT LABS 9F01230 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: FEVER, COUGH INC, HEMOPTYSIS

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:
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC 'Split Type':

Write-up: Fever up to 103F; Coughed up thick mucus which was blood tinged; Seen in ER; 23DEC89 temp down; %JAN90 cough still present; MD did not think cough related to inject;


Changed on 12/8/2009

VAERS ID: 28558 Before After
VAERS Form:
Age:
Sex:Male
Location:Illinois
Vaccinated:1989-12-19
Onset:1989-12-20
Submitted:0000-00-00
Entered:1991-04-08 1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1989-1990 INFLUENZA (SEASONAL) (FLUZONE 89-90) / CONNAUGHT LABS CONNAUGHT LABORATORIES 9F01230 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Haemoptysis, Pyrexia, FEVER, COUGH INC, HEMOPTYSIS

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:
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC 'Split Type': (blank) CO3279

Write-up: Fever up to 103F; Coughed up thick mucus which was blood tinged; Seen in ER; 23DEC89 temp down; %JAN90 cough still present; MD did not think cough related to inject;


Changed on 8/31/2010

VAERS ID: 28558 Before After
VAERS Form:
Age:
Sex:Male
Location:Illinois
Vaccinated:1989-12-19
Onset:1989-12-20
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 89-90) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9F01230 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Haemoptysis, Pyrexia

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:
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC 'Split Type': CO3279

Write-up: Fever up to 103F; Coughed up thick mucus which was blood tinged; Seen in ER; 23DEC89 temp down; %JAN90 cough still present; MD did not think cough related to inject;


Changed on 7/7/2013

VAERS ID: 28558 Before After
VAERS Form:
Age:
Sex:Male
Location:Illinois
Vaccinated:1989-12-19
Onset:1989-12-20
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9F01230 / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9F01230 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Haemoptysis, Pyrexia

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:
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC 'Split Type': CO3279

Write-up: Fever up to 103F; Coughed up thick mucus which was blood tinged; Seen in ER; 23DEC89 temp down; %JAN90 cough still present; MD did not think cough related to inject;


Changed on 5/14/2017

VAERS ID: 28558 Before After
VAERS Form:
Age:
Sex:Male
Location:Illinois
Vaccinated:1989-12-19
Onset:1989-12-20
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9F01230 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Haemoptysis, Pyrexia

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:
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC 'Split Type': CO3279

Write-up: Fever up to 103F; Coughed up thick mucus which was blood tinged; Seen in ER; 23DEC89 temp down; %JAN90 cough still present; MD did not think cough related to inject;


Changed on 9/14/2017

VAERS ID: 28558 Before After
VAERS Form:(blank) 1
Age:
Sex:Male
Location:Illinois
Vaccinated:1989-12-19
Onset:1989-12-20
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9F01230 / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Haemoptysis, Pyrexia

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:
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC 'Split Type': CO3279

Write-up: Fever up to 103F; Coughed up thick mucus which was blood tinged; Seen in ER; 23DEC89 temp down; %JAN90 cough still present; MD did not think cough related to inject;


Changed on 2/14/2018

VAERS ID: 28558 Before After
VAERS Form:1
Age:
Sex:Male
Location:Illinois
Vaccinated:1989-12-19
Onset:1989-12-20
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9F01230 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Haemoptysis, Pyrexia

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:
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC 'Split Type': CO3279

Write-up: Fever up to 103F; Coughed up thick mucus which was blood tinged; Seen in ER; 23DEC89 temp down; %JAN90 cough still present; MD did not think cough related to inject;


Changed on 6/14/2018

VAERS ID: 28558 Before After
VAERS Form:1
Age:
Sex:Male
Location:Illinois
Vaccinated:1989-12-19
Onset:1989-12-20
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9F01230 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Haemoptysis, Pyrexia

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:
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC 'Split Type': CO3279

Write-up: Fever up to 103F; Coughed up thick mucus which was blood tinged; Seen in ER; 23DEC89 temp down; %JAN90 cough still present; MD did not think cough related to inject;


Changed on 8/14/2018

VAERS ID: 28558 Before After
VAERS Form:1
Age:
Sex:Male
Location:Illinois
Vaccinated:1989-12-19
Onset:1989-12-20
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9F01230 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Haemoptysis, Pyrexia

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:
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC 'Split Type': CO3279

Write-up: Fever up to 103F; Coughed up thick mucus which was blood tinged; Seen in ER; 23DEC89 temp down; %JAN90 cough still present; MD did not think cough related to inject;


Changed on 9/14/2018

VAERS ID: 28558 Before After
VAERS Form:1
Age:
Sex:Male
Location:Illinois
Vaccinated:1989-12-19
Onset:1989-12-20
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9F01230 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Haemoptysis, Pyrexia

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:
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC 'Split Type': CO3279

Write-up: Fever up to 103F; Coughed up thick mucus which was blood tinged; Seen in ER; 23DEC89 temp down; %JAN90 cough still present; MD did not think cough related to inject;


Changed on 10/14/2018

VAERS ID: 28558 Before After
VAERS Form:1
Age:
Sex:Male
Location:Illinois
Vaccinated:1989-12-19
Onset:1989-12-20
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9F01230 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Haemoptysis, Pyrexia

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:
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC 'Split Type': CO3279

Write-up: Fever up to 103F; Coughed up thick mucus which was blood tinged; Seen in ER; 23DEC89 temp down; %JAN90 cough still present; MD did not think cough related to inject;


Changed on 12/24/2020

VAERS ID: 28558 Before After
VAERS Form:1
Age:
Sex:Male
Location:Illinois
Vaccinated:1989-12-19
Onset:1989-12-20
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9F01230 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Haemoptysis, Pyrexia

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:
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC 'Split Type': CO3279

Write-up: Fever up to 103F; Coughed up thick mucus which was blood tinged; Seen in ER; 23DEC89 temp down; %JAN90 cough still present; MD did not think cough related to inject;


Changed on 12/30/2020

VAERS ID: 28558 Before After
VAERS Form:1
Age:
Sex:Male
Location:Illinois
Vaccinated:1989-12-19
Onset:1989-12-20
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9F01230 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Haemoptysis, Pyrexia

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:
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC 'Split Type': CO3279

Write-up: Fever up to 103F; Coughed up thick mucus which was blood tinged; Seen in ER; 23DEC89 temp down; %JAN90 cough still present; MD did not think cough related to inject;


Changed on 5/7/2021

VAERS ID: 28558 Before After
VAERS Form:1
Age:
Sex:Male
Location:Illinois
Vaccinated:1989-12-19
Onset:1989-12-20
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9F01230 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Haemoptysis, Pyrexia

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:
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC 'Split Type': CO3279

Write-up: Fever up to 103F; Coughed up thick mucus which was blood tinged; Seen in ER; 23DEC89 temp down; %JAN90 cough still present; MD did not think cough related to inject;


Changed on 5/14/2021

VAERS ID: 28558 Before After
VAERS Form:1
Age:
Sex:Male
Location:Illinois
Vaccinated:1989-12-19
Onset:1989-12-20
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9F01230 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Haemoptysis, Pyrexia

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:
Current Illness:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC 'Split Type': CO3279

Write-up: Fever up to 103F; Coughed up thick mucus which was blood tinged; Seen in ER; 23DEC89 temp down; %JAN90 cough still present; MD did not think cough related to inject;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=28558&WAYBACKHISTORY=ON

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