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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 28835 |
VAERS Form: | |
Age: | 70.2 |
Sex: | Female |
Location: | Maryland |
Vaccinated: | 1990-10-02 |
Onset: | 1990-10-24 |
Submitted: | 1990-11-07 |
Entered: | 1991-03-13 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: FLUOGEN 1990-1991 PARKE-DAVIS / PARKE-DAVIS | 02580P / - | LA / IM |
Administered by: Public Purchased by: Unknown
Symptoms: CHILLS, ARTHRITIS, ARTHRALGIA, DEHYDRAT, COMA
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5
Write-up: local rxn lt deltoid, rash, T 103 F,
Vaccinated: | 1990-10-02 |
Onset: | 1990-10-24 |
Submitted: | 1990-11-07 |
Entered: | 1991-03-13 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 |
Administered by: Public Purchased by: Unknown Public
Symptoms: Arthralgia, Arthritis, Chills, Coma, Dehydration, Injection site reaction, Palpitations, Pyrexia, Rash, Syncope, Vomiting, CHILLS, ARTHRITIS, ARTHRALGIA, DEHYDRAT, COMA
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5
Write-up: local rxn lt deltoid, rash, T 103 F,
Vaccinated: | 1990-10-02 |
Onset: | 1990-10-24 |
Submitted: | 1990-11-07 |
Entered: | 1991-03-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (SEASONAL) (FLUOGEN 90-91) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 02580P / - | LA / IM |
Administered by: Public Purchased by: Public
Symptoms: Arthralgia, Arthritis, Chills, Coma, Dehydration, Injection site reaction, Palpitations, Pyrexia, Rash, Syncope, Vomiting
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5
Write-up: local rxn lt deltoid, rash, T 103 F,
Vaccinated: | 1990-10-02 |
Onset: | 1990-10-24 |
Submitted: | 1990-11-07 |
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 |
Administered by: Public Purchased by: Public
Symptoms: Arthralgia, Arthritis, Chills, Coma, Dehydration, Injection site reaction, Palpitations, Pyrexia, Rash, Syncope, Vomiting
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5
Write-up: local rxn lt deltoid, rash, T 103 F,
Vaccinated: | 1990-10-02 |
Onset: | 1990-10-24 |
Submitted: | 1990-11-07 |
Entered: | 1991-03-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 02580P / - | LA / IM |
Administered by: Public Purchased by: Public
Symptoms: Arthralgia, Arthritis, Chills, Coma, Dehydration, Injection site reaction, Palpitations, Pyrexia, Rash, Syncope, Vomiting
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5
Write-up: local rxn lt deltoid, rash, T 103 F,
Vaccinated: | 1990-10-02 |
Onset: | 1990-10-24 |
Submitted: | 1990-11-07 |
Entered: | 1991-03-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 02580P / - | LA / IM |
Administered by: Public Purchased by: Public
Symptoms: Arthralgia, Arthritis, Chills, Coma, Dehydration, Injection site reaction, Palpitations, Pyrexia, Rash, Syncope, Vomiting
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5
Write-up: local rxn lt deltoid, rash, T 103 F,
Vaccinated: | 1990-10-02 |
Onset: | 1990-10-24 |
Submitted: | 1990-11-07 |
Entered: | 1991-03-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 02580P / - UNK | LA / IM |
Administered by: Public Purchased by: Public
Symptoms: Arthralgia, Arthritis, Chills, Coma, Dehydration, Injection site reaction, Palpitations, Pyrexia, Rash, Syncope, Vomiting
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5
Write-up: local rxn lt deltoid, rash, T 103 F,
Vaccinated: | 1990-10-02 |
Onset: | 1990-10-24 |
Submitted: | 1990-11-07 |
Entered: | 1991-03-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 02580P / UNK | LA / IM |
Administered by: Public Purchased by: Public
Symptoms: Arthralgia, Arthritis, Chills, Coma, Dehydration, Injection site reaction, Palpitations, Pyrexia, Rash, Syncope, Vomiting
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5
Write-up: local rxn lt deltoid, rash, T 103 F,
Vaccinated: | 1990-10-02 |
Onset: | 1990-10-24 |
Submitted: | 1990-11-07 |
Entered: | 1991-03-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 02580P / UNK | LA / IM |
Administered by: Public Purchased by: Public
Symptoms: Arthralgia, Arthritis, Chills, Coma, Dehydration, Injection site reaction, Palpitations, Pyrexia, Rash, Syncope, Vomiting
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5
Write-up: local rxn lt deltoid, rash, T 103 F,
Vaccinated: | 1990-10-02 |
Onset: | 1990-10-24 |
Submitted: | 1990-11-07 |
Entered: | 1991-03-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 02580P / UNK | LA / IM |
Administered by: Public Purchased by: Public
Symptoms: Arthralgia, Arthritis, Chills, Coma, Dehydration, Injection site reaction, Palpitations, Pyrexia, Rash, Syncope, Vomiting
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5
Write-up: local rxn lt deltoid, rash, T 103 F,
Vaccinated: | 1990-10-02 |
Onset: | 1990-10-24 |
Submitted: | 1990-11-07 |
Entered: | 1991-03-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 02580P / UNK | LA / IM |
Administered by: Public Purchased by: Public
Symptoms: Arthralgia, Arthritis, Chills, Coma, Dehydration, Injection site reaction, Palpitations, Pyrexia, Rash, Syncope, Vomiting
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5
Write-up: local rxn lt deltoid, rash, T 103 F,
Vaccinated: | 1990-10-02 |
Onset: | 1990-10-24 |
Submitted: | 1990-11-07 |
Entered: | 1991-03-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 02580P / UNK | LA / IM |
Administered by: Public Purchased by: Public
Symptoms: Arthralgia, Arthritis, Chills, Coma, Dehydration, Injection site reaction, Palpitations, Pyrexia, Rash, Syncope, Vomiting
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5
Write-up: local rxn lt deltoid, rash, T 103 F,
Vaccinated: | 1990-10-02 |
Onset: | 1990-10-24 |
Submitted: | 1990-11-07 |
Entered: | 1991-03-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 02580P / UNK | LA / IM |
Administered by: Public Purchased by: Public
Symptoms: Arthralgia, Arthritis, Chills, Coma, Dehydration, Injection site reaction, Palpitations, Pyrexia, Rash, Syncope, Vomiting
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5
Write-up: local rxn lt deltoid, rash, T 103 F,
Vaccinated: | 1990-10-02 |
Onset: | 1990-10-24 |
Submitted: | 1990-11-07 |
Entered: | 1991-03-06 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 02580P / UNK | LA / IM |
Administered by: Public Purchased by: Public
Symptoms: Arthralgia, Arthritis, Chills, Coma, Dehydration, Injection site reaction, Palpitations, Pyrexia, Rash, Syncope, Vomiting
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5
Write-up: local rxn lt deltoid, rash, T 103 F,
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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=28835&WAYBACKHISTORY=ON
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