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This is VAERS ID 28567

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 28567
VAERS Form:
Age:96.0
Sex:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1991-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1989-1990 / CONNAUGHT LABS 0F11217 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: FLU SYND

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: Flu-like sx;


Changed on 12/8/2009

VAERS ID: 28567 Before After
VAERS Form:
Age:96.0
Sex:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
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 0F11217 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Influenza, FLU SYND

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) CO3694

Write-up: Flu-like sx; symptoms


Changed on 8/31/2010

VAERS ID: 28567 Before After
VAERS Form:
Age:96.0
Sex:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
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 0F11217 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Influenza

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': CO3694

Write-up: Flu-like symptoms


Changed on 7/7/2013

VAERS ID: 28567 Before After
VAERS Form:
Age:96.0
Sex:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Influenza

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': CO3694

Write-up: Flu-like symptoms


Changed on 9/14/2017

VAERS ID: 28567 Before After
VAERS Form:(blank) 1
Age:96.0
Sex:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Influenza

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': CO3694

Write-up: Flu-like symptoms


Changed on 2/14/2018

VAERS ID: 28567 Before After
VAERS Form:1
Age:96.0
Sex:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Influenza

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': CO3694

Write-up: Flu-like symptoms


Changed on 6/14/2018

VAERS ID: 28567 Before After
VAERS Form:1
Age:96.0
Sex:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Influenza

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': CO3694

Write-up: Flu-like symptoms


Changed on 8/14/2018

VAERS ID: 28567 Before After
VAERS Form:1
Age:96.0
Sex:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Influenza

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': CO3694

Write-up: Flu-like symptoms


Changed on 9/14/2018

VAERS ID: 28567 Before After
VAERS Form:1
Age:96.0
Sex:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Influenza

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': CO3694

Write-up: Flu-like symptoms


Changed on 10/14/2018

VAERS ID: 28567 Before After
VAERS Form:1
Age:96.0
Sex:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Influenza

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': CO3694

Write-up: Flu-like symptoms


Changed on 12/24/2020

VAERS ID: 28567 Before After
VAERS Form:1
Age:96.0
Sex:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Influenza

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': CO3694

Write-up: Flu-like symptoms


Changed on 12/30/2020

VAERS ID: 28567 Before After
VAERS Form:1
Age:96.0
Sex:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Influenza

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': CO3694

Write-up: Flu-like symptoms


Changed on 5/7/2021

VAERS ID: 28567 Before After
VAERS Form:1
Age:96.0
Sex:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Influenza

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': CO3694

Write-up: Flu-like symptoms


Changed on 5/14/2021

VAERS ID: 28567 Before After
VAERS Form:1
Age:96.0
Sex:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Influenza

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': CO3694

Write-up: Flu-like symptoms

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=28567&WAYBACKHISTORY=ON

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