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This is VAERS ID 29121

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 29121
VAERS Form:
Age:75.5
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH - / 0 A / -

Administered by: Private      Purchased by: Unknown
Symptoms: TASTE LOSS, PAROSMIA

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.


Changed on 12/8/2009

VAERS ID: 29121 Before After
VAERS Form:
Age:75.5
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-18 1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) / WYETH WYETH PHARMACEUTICALS, INC - / 0 A / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Ageusia, Parosmia, TASTE LOSS, PAROSMIA

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.


Changed on 8/31/2010

VAERS ID: 29121 Before After
VAERS Form:
Age:75.5
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / 0 A / -

Administered by: Private      Purchased by: Private
Symptoms: Ageusia, Parosmia

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.


Changed on 7/7/2013

VAERS ID: 29121 Before After
VAERS Form:
Age:75.5
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 A / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 A / -

Administered by: Private      Purchased by: Private
Symptoms: Ageusia, Parosmia

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.


Changed on 12/14/2016

VAERS ID: 29121 Before After
VAERS Form:
Age:75.5
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 A / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 A / -

Administered by: Private      Purchased by: Private
Symptoms: Ageusia, Parosmia

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.


Changed on 2/14/2017

VAERS ID: 29121 Before After
VAERS Form:
Age:75.5 75.0
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 A / -

Administered by: Private      Purchased by: Private
Symptoms: Ageusia, Parosmia

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.


Changed on 5/14/2017

VAERS ID: 29121 Before After
VAERS Form:
Age:75.0
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 A - / - A

Administered by: Private      Purchased by: Private
Symptoms: Ageusia, Parosmia

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.


Changed on 9/14/2017

VAERS ID: 29121 Before After
VAERS Form:(blank) 1
Age:75.0
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 0 1 - / A

Administered by: Private      Purchased by: Private
Symptoms: Ageusia, Parosmia

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.


Changed on 2/14/2018

VAERS ID: 29121 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / A

Administered by: Private      Purchased by: Private
Symptoms: Ageusia, Parosmia

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.


Changed on 6/14/2018

VAERS ID: 29121 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / A

Administered by: Private      Purchased by: Private
Symptoms: Ageusia, Parosmia

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.


Changed on 8/14/2018

VAERS ID: 29121 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / A

Administered by: Private      Purchased by: Private
Symptoms: Ageusia, Parosmia

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.


Changed on 9/14/2018

VAERS ID: 29121 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / A

Administered by: Private      Purchased by: Private
Symptoms: Ageusia, Parosmia

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.


Changed on 10/14/2018

VAERS ID: 29121 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / A

Administered by: Private      Purchased by: Private
Symptoms: Ageusia, Parosmia

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.


Changed on 12/24/2020

VAERS ID: 29121 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / A

Administered by: Private      Purchased by: Private
Symptoms: Ageusia, Parosmia

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.


Changed on 12/30/2020

VAERS ID: 29121 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / A

Administered by: Private      Purchased by: Private
Symptoms: Ageusia, Parosmia

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.


Changed on 5/7/2021

VAERS ID: 29121 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / A

Administered by: Private      Purchased by: Private
Symptoms: Ageusia, Parosmia

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.


Changed on 5/14/2021

VAERS ID: 29121 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Oregon
Vaccinated:1990-10-01
Onset:0000-00-00
Submitted:1991-03-04
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / 1 - / A

Administered by: Private      Purchased by: Private
Symptoms: Ageusia, Parosmia

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: Amoxicillin; Phenergan w/cod
Current Illness: NONE
Preexisting Conditions: Hx of allergic rhinitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Loss of sense of taste & smell.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=29121&WAYBACKHISTORY=ON


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