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This is VAERS ID 28832

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 28832
VAERS Form:
Age:67.7
Sex:Male
Location:Maryland
Vaccinated:1990-10-25
Onset:1990-10-27
Submitted:1990-11-08
Entered:1991-03-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS / PARKE-DAVIS 02580P / - LA / IM
PPV: PNU-IMUNE(R)23 / LEDERLE 289906 / - RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: INJECT SITE REACT, HEADACHE, PAIN BACK, ARTHRALGIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/70
CDC 'Split Type':

Write-up: Local rxn rt deltoid/lt deltoid; pain in joints - especially back; headaches.


Changed on 12/8/2009

VAERS ID: 28832 Before After
VAERS Form:
Age:67.7
Sex:Male
Location:Maryland
Vaccinated:1990-10-25
Onset:1990-10-27
Submitted:1990-11-08
Entered:1991-03-14 1991-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS INFLUENZA (SEASONAL) (FLUOGEN 90-91) / PARKE-DAVIS 02580P / - LA / IM
PPV: PNU-IMUNE(R)23 PNEUMO (PNU-IMUNE) / LEDERLE LEDERLE LABORATORIES 289906 / - RA / SC

Administered by: Public      Purchased by: Unknown Public
Symptoms: Arthralgia, Back pain, Headache, Injection site reaction, INJECT SITE REACT, HEADACHE, PAIN BACK, ARTHRALGIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/70
CDC 'Split Type': (blank) MD91003

Write-up: Local rxn rt deltoid/lt deltoid; pain in joints - especially back; headaches.


Changed on 8/31/2010

VAERS ID: 28832 Before After
VAERS Form:
Age:67.7
Sex:Male
Location:Maryland
Vaccinated:1990-10-25
Onset:1990-10-27
Submitted:1990-11-08
Entered:1991-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 90-91) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 289906 / - RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Back pain, Headache, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/70
CDC 'Split Type': MD91003

Write-up: Local rxn rt deltoid/lt deltoid; pain in joints - especially back; headaches.


Changed on 7/7/2013

VAERS ID: 28832 Before After
VAERS Form:
Age:67.7
Sex:Male
Location:Maryland
Vaccinated:1990-10-25
Onset:1990-10-27
Submitted:1990-11-08
Entered:1991-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / - LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 289906 / - RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Back pain, Headache, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/70
CDC 'Split Type': MD91003

Write-up: Local rxn rt deltoid/lt deltoid; pain in joints - especially back; headaches.


Changed on 2/14/2017

VAERS ID: 28832 Before After
VAERS Form:
Age:67.7 67.0
Sex:Male
Location:Maryland
Vaccinated:1990-10-25
Onset:1990-10-27
Submitted:1990-11-08
Entered:1991-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 289906 / - RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Back pain, Headache, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/70
CDC 'Split Type': MD91003

Write-up: Local rxn rt deltoid/lt deltoid; pain in joints - especially back; headaches.


Changed on 5/14/2017

VAERS ID: 28832 Before After
VAERS Form:
Age:67.0
Sex:Male
Location:Maryland
Vaccinated:1990-10-25
Onset:1990-10-27
Submitted:1990-11-08
Entered:1991-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 289906 / - RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Back pain, Headache, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/70
CDC 'Split Type': MD91003

Write-up: Local rxn rt deltoid/lt deltoid; pain in joints - especially back; headaches.


Changed on 9/14/2017

VAERS ID: 28832 Before After
VAERS Form:(blank) 1
Age:67.0
Sex:Male
Location:Maryland
Vaccinated:1990-10-25
Onset:1990-10-27
Submitted:1990-11-08
Entered:1991-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / - UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 289906 / - UNK RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Back pain, Headache, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/70
CDC 'Split Type': MD91003

Write-up: Local rxn rt deltoid/lt deltoid; pain in joints - especially back; headaches.


Changed on 2/14/2018

VAERS ID: 28832 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Maryland
Vaccinated:1990-10-25
Onset:1990-10-27
Submitted:1990-11-08
Entered:1991-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 289906 / UNK RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Back pain, Headache, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/70
CDC 'Split Type': MD91003

Write-up: Local rxn rt deltoid/lt deltoid; pain in joints - especially back; headaches.


Changed on 6/14/2018

VAERS ID: 28832 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Maryland
Vaccinated:1990-10-25
Onset:1990-10-27
Submitted:1990-11-08
Entered:1991-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 289906 / UNK RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Back pain, Headache, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/70
CDC 'Split Type': MD91003

Write-up: Local rxn rt deltoid/lt deltoid; pain in joints - especially back; headaches.


Changed on 8/14/2018

VAERS ID: 28832 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Maryland
Vaccinated:1990-10-25
Onset:1990-10-27
Submitted:1990-11-08
Entered:1991-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 289906 / UNK RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Back pain, Headache, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/70
CDC 'Split Type': MD91003

Write-up: Local rxn rt deltoid/lt deltoid; pain in joints - especially back; headaches.


Changed on 9/14/2018

VAERS ID: 28832 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Maryland
Vaccinated:1990-10-25
Onset:1990-10-27
Submitted:1990-11-08
Entered:1991-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 289906 / UNK RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Back pain, Headache, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/70
CDC 'Split Type': MD91003

Write-up: Local rxn rt deltoid/lt deltoid; pain in joints - especially back; headaches.


Changed on 10/14/2018

VAERS ID: 28832 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Maryland
Vaccinated:1990-10-25
Onset:1990-10-27
Submitted:1990-11-08
Entered:1991-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 289906 / UNK RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Back pain, Headache, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/70
CDC 'Split Type': MD91003

Write-up: Local rxn rt deltoid/lt deltoid; pain in joints - especially back; headaches.


Changed on 12/24/2020

VAERS ID: 28832 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Maryland
Vaccinated:1990-10-25
Onset:1990-10-27
Submitted:1990-11-08
Entered:1991-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 289906 / UNK RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Back pain, Headache, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/70
CDC 'Split Type': MD91003

Write-up: Local rxn rt deltoid/lt deltoid; pain in joints - especially back; headaches.


Changed on 12/30/2020

VAERS ID: 28832 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Maryland
Vaccinated:1990-10-25
Onset:1990-10-27
Submitted:1990-11-08
Entered:1991-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 289906 / UNK RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Back pain, Headache, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/70
CDC 'Split Type': MD91003

Write-up: Local rxn rt deltoid/lt deltoid; pain in joints - especially back; headaches.


Changed on 5/7/2021

VAERS ID: 28832 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Maryland
Vaccinated:1990-10-25
Onset:1990-10-27
Submitted:1990-11-08
Entered:1991-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 289906 / UNK RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Back pain, Headache, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/70
CDC 'Split Type': MD91003

Write-up: Local rxn rt deltoid/lt deltoid; pain in joints - especially back; headaches.


Changed on 5/14/2021

VAERS ID: 28832 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Maryland
Vaccinated:1990-10-25
Onset:1990-10-27
Submitted:1990-11-08
Entered:1991-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02580P / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 289906 / UNK RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Back pain, Headache, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: BP 130/70
CDC 'Split Type': MD91003

Write-up: Local rxn rt deltoid/lt deltoid; pain in joints - especially back; headaches.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=28832&WAYBACKHISTORY=ON

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