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This is VAERS ID 29152

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 29152
VAERS Form:
Age:66.3
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH 4908188 / 0 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: HYSN INJECT SITE, PRURITUS, PAIN, VASODILAT

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: NONE KNOWN
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': Radioisptope treatments to neck in 60''s

Write-up: c/o elbow to shoulder area tender, warm, red but ""underneath, not where shot given"" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.


Changed on 12/8/2009

VAERS ID: 29152 Before After
VAERS Form:
Age:66.3
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-19 1991-03-15
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 4908188 / 0 LA / -

Administered by: Public      Purchased by: Unknown Public
Symptoms: Injection site hypersensitivity, Pain, Pruritus, Vasodilatation, HYSN INJECT SITE, PRURITUS, PAIN, VASODILAT

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: NONE KNOWN
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': Radioisptope treatments to neck in 60''s MN90004

Write-up: c/o elbow to shoulder area tender, warm, red but ""underneath, "underneath, not where shot given"" given" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.


Changed on 8/31/2010

VAERS ID: 29152 Before After
VAERS Form:
Age:66.3
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4908188 / 0 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Injection site hypersensitivity, Pain, Pruritus, Vasodilatation

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: NONE KNOWN
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MN90004

Write-up: c/o elbow to shoulder area tender, warm, red but "underneath, not where shot given" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.


Changed on 7/7/2013

VAERS ID: 29152 Before After
VAERS Form:
Age:66.3
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908188 / 0 LA / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908188 / 0 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Injection site hypersensitivity, Pain, Pruritus, Vasodilatation

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: NONE KNOWN
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MN90004

Write-up: c/o elbow to shoulder area tender, warm, red but "underneath, not where shot given" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.


Changed on 12/14/2016

VAERS ID: 29152 Before After
VAERS Form:
Age:66.3
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908188 / 0 LA / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908188 / 0 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Injection site hypersensitivity, Pain, Pruritus, Vasodilatation

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: NONE KNOWN
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MN90004

Write-up: c/o elbow to shoulder area tender, warm, red but "underneath, not where shot given" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.


Changed on 2/14/2017

VAERS ID: 29152 Before After
VAERS Form:
Age:66.3 66.0
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908188 / 0 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Injection site hypersensitivity, Pain, Pruritus, Vasodilatation

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: NONE KNOWN
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MN90004

Write-up: c/o elbow to shoulder area tender, warm, red but "underneath, not where shot given" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.


Changed on 5/14/2017

VAERS ID: 29152 Before After
VAERS Form:
Age:66.0
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908188 / 0 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Injection site hypersensitivity, Pain, Pruritus, Vasodilatation

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: NONE KNOWN KNOWN~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MN90004

Write-up: c/o elbow to shoulder area tender, warm, red but "underneath, not where shot given" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.


Changed on 9/14/2017

VAERS ID: 29152 Before After
VAERS Form:(blank) 1
Age:66.0
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908188 / 0 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Injection site hypersensitivity, Pain, Pruritus, Vasodilatation

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: NONE KNOWN~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MN90004

Write-up: c/o elbow to shoulder area tender, warm, red but "underneath, not where shot given" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.


Changed on 2/14/2018

VAERS ID: 29152 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908188 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Injection site hypersensitivity, Pain, Pruritus, Vasodilatation

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: NONE KNOWN~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MN90004

Write-up: c/o elbow to shoulder area tender, warm, red but "underneath, not where shot given" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.


Changed on 6/14/2018

VAERS ID: 29152 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908188 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Injection site hypersensitivity, Pain, Pruritus, Vasodilatation

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: NONE KNOWN~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MN90004

Write-up: c/o elbow to shoulder area tender, warm, red but "underneath, not where shot given" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.


Changed on 8/14/2018

VAERS ID: 29152 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908188 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Injection site hypersensitivity, Pain, Pruritus, Vasodilatation

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: NONE KNOWN~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MN90004

Write-up: c/o elbow to shoulder area tender, warm, red but "underneath, not where shot given" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.


Changed on 9/14/2018

VAERS ID: 29152 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908188 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Injection site hypersensitivity, Pain, Pruritus, Vasodilatation

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: NONE KNOWN~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MN90004

Write-up: c/o elbow to shoulder area tender, warm, red but "underneath, not where shot given" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.


Changed on 10/14/2018

VAERS ID: 29152 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908188 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Injection site hypersensitivity, Pain, Pruritus, Vasodilatation

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: NONE KNOWN~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MN90004

Write-up: c/o elbow to shoulder area tender, warm, red but "underneath, not where shot given" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.


Changed on 12/24/2020

VAERS ID: 29152 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908188 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Injection site hypersensitivity, Pain, Pruritus, Vasodilatation

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: NONE KNOWN~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MN90004

Write-up: c/o elbow to shoulder area tender, warm, red but "underneath, not where shot given" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.


Changed on 12/30/2020

VAERS ID: 29152 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908188 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Injection site hypersensitivity, Pain, Pruritus, Vasodilatation

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: NONE KNOWN~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MN90004

Write-up: c/o elbow to shoulder area tender, warm, red but "underneath, not where shot given" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.


Changed on 5/7/2021

VAERS ID: 29152 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908188 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Injection site hypersensitivity, Pain, Pruritus, Vasodilatation

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: NONE KNOWN~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MN90004

Write-up: c/o elbow to shoulder area tender, warm, red but "underneath, not where shot given" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.


Changed on 5/14/2021

VAERS ID: 29152 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Minnesota
Vaccinated:1990-11-15
Onset:1990-11-16
Submitted:0000-00-00
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908188 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Injection site hypersensitivity, Pain, Pruritus, Vasodilatation

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: NONE KNOWN~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE - "felt fine"
Preexisting Conditions: Radioisptope treatments to neck in 60''s
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': MN90004

Write-up: c/o elbow to shoulder area tender, warm, red but "underneath, not where shot given" discomfort noted w/movement. Neck & face red, warm, painful, itchy. Took Benadryl which offered relief. Neck, chin to ears still itchy & red.

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