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This is VAERS ID 28573

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 28573
VAERS Form:
Age:46.0
Sex:Female
Location:Maryland
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1991-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1989-1990 / CONNAUGHT LABS - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: RASH VESIC BULL, NECRO

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: Diffuse rash w/bullae 7 days post inject; Area around umbilicus showing early signs of necrosis;


Changed on 12/8/2009

VAERS ID: 28573 Before After
VAERS Form:
Age:46.0
Sex:Female
Location:Maryland
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1991-04-09 1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1989-1990 INFLUENZA (SEASONAL) (FLUZONE 89-90) / CONNAUGHT LABS CONNAUGHT LABORATORIES - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dermatitis bullous, Necrosis, RASH VESIC BULL, NECRO

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) CO3724

Write-up: Diffuse rash w/bullae 7 days post inject; Area around umbilicus showing early signs of necrosis;


Changed on 8/31/2010

VAERS ID: 28573 Before After
VAERS Form:
Age:46.0
Sex:Female
Location:Maryland
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 - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dermatitis bullous, Necrosis

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': CO3724

Write-up: Diffuse rash w/bullae 7 days post inject; Area around umbilicus showing early signs of necrosis;


Changed on 7/7/2013

VAERS ID: 28573 Before After
VAERS Form:
Age:46.0
Sex:Female
Location:Maryland
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 - / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dermatitis bullous, Necrosis

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': CO3724

Write-up: Diffuse rash w/bullae 7 days post inject; Area around umbilicus showing early signs of necrosis;


Changed on 5/14/2017

VAERS ID: 28573 Before After
VAERS Form:
Age:46.0
Sex:Female
Location:Maryland
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 - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dermatitis bullous, Necrosis

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': CO3724

Write-up: Diffuse rash w/bullae 7 days post inject; Area around umbilicus showing early signs of necrosis;


Changed on 9/14/2017

VAERS ID: 28573 Before After
VAERS Form:(blank) 1
Age:46.0
Sex:Female
Location:Maryland
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 - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dermatitis bullous, Necrosis

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': CO3724

Write-up: Diffuse rash w/bullae 7 days post inject; Area around umbilicus showing early signs of necrosis;


Changed on 2/14/2018

VAERS ID: 28573 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Maryland
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 - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dermatitis bullous, Necrosis

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': CO3724

Write-up: Diffuse rash w/bullae 7 days post inject; Area around umbilicus showing early signs of necrosis;


Changed on 6/14/2018

VAERS ID: 28573 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Maryland
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 - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dermatitis bullous, Necrosis

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': CO3724

Write-up: Diffuse rash w/bullae 7 days post inject; Area around umbilicus showing early signs of necrosis;


Changed on 8/14/2018

VAERS ID: 28573 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Maryland
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 - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dermatitis bullous, Necrosis

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': CO3724

Write-up: Diffuse rash w/bullae 7 days post inject; Area around umbilicus showing early signs of necrosis;


Changed on 9/14/2018

VAERS ID: 28573 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Maryland
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 - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dermatitis bullous, Necrosis

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': CO3724

Write-up: Diffuse rash w/bullae 7 days post inject; Area around umbilicus showing early signs of necrosis;


Changed on 10/14/2018

VAERS ID: 28573 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Maryland
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 - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dermatitis bullous, Necrosis

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': CO3724

Write-up: Diffuse rash w/bullae 7 days post inject; Area around umbilicus showing early signs of necrosis;


Changed on 12/24/2020

VAERS ID: 28573 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Maryland
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 - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dermatitis bullous, Necrosis

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': CO3724

Write-up: Diffuse rash w/bullae 7 days post inject; Area around umbilicus showing early signs of necrosis;


Changed on 12/30/2020

VAERS ID: 28573 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Maryland
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 - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dermatitis bullous, Necrosis

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': CO3724

Write-up: Diffuse rash w/bullae 7 days post inject; Area around umbilicus showing early signs of necrosis;


Changed on 5/7/2021

VAERS ID: 28573 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Maryland
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 - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dermatitis bullous, Necrosis

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': CO3724

Write-up: Diffuse rash w/bullae 7 days post inject; Area around umbilicus showing early signs of necrosis;


Changed on 5/14/2021

VAERS ID: 28573 Before After
VAERS Form:1
Age:46.0
Sex:Female
Location:Maryland
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 - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dermatitis bullous, Necrosis

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': CO3724

Write-up: Diffuse rash w/bullae 7 days post inject; Area around umbilicus showing early signs of necrosis;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=28573&WAYBACKHISTORY=ON

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