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This is VAERS ID 29271

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 29271
VAERS Form:
Age:62.4
Sex:Female
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-12-26
Submitted:0000-00-00
Entered:1991-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 0F11221 / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: FEVER, CYANOSIS, DYSPNEA, COUGH INC, HYPOXIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 11DEC90- WBC 16,700 w/no diff + PHS; ABG(RA)-7.48/PO2 36/PCO2 32; LFTS- NL
CDC 'Split Type':

Write-up: Pt developed progressive cough, DOE & low grade fever about 24 hrs p/vax x 2wks; Admitted to Hosp from 11DEC to about 20DEC w/bilateral pulmonary infiltrates hypoxemia & mild leukocytosis; No bacteriologic diagnosis was made;


Changed on 12/8/2009

VAERS ID: 29271 Before After
VAERS Form:
Age:62.4
Sex:Female
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-12-26
Submitted:0000-00-00
Entered:1991-03-27 1991-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0F11221 / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Cyanosis, Dyspnoea, Hypoxia, Leukocytosis, Pyrexia, Respiratory disorder, FEVER, CYANOSIS, DYSPNEA, COUGH INC, HYPOXIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 11DEC90- WBC 16,700 w/no diff + PHS; ABG(RA)-7.48/PO2 36/PCO2 32; LFTS- NL
CDC 'Split Type':

Write-up: Pt developed progressive cough, DOE & low grade fever about 24 hrs p/vax x 2wks; Admitted to Hosp from 11DEC to about 20DEC w/bilateral pulmonary infiltrates hypoxemia & mild leukocytosis; No bacteriologic diagnosis was made;


Changed on 8/31/2010

VAERS ID: 29271 Before After
VAERS Form:
Age:62.4
Sex:Female
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-12-26
Submitted:0000-00-00
Entered:1991-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Cyanosis, Dyspnoea, Hypoxia, Leukocytosis, Pyrexia, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 11DEC90- WBC 16,700 w/no diff + PHS; ABG(RA)-7.48/PO2 36/PCO2 32; LFTS- NL
CDC 'Split Type':

Write-up: Pt developed progressive cough, DOE & low grade fever about 24 hrs p/vax x 2wks; Admitted to Hosp from 11DEC to about 20DEC w/bilateral pulmonary infiltrates hypoxemia & mild leukocytosis; No bacteriologic diagnosis was made;


Changed on 7/7/2013

VAERS ID: 29271 Before After
VAERS Form:
Age:62.4
Sex:Female
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-12-26
Submitted:0000-00-00
Entered:1991-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 0 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Cyanosis, Dyspnoea, Hypoxia, Leukocytosis, Pyrexia, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 11DEC90- WBC 16,700 w/no diff + PHS; ABG(RA)-7.48/PO2 36/PCO2 32; LFTS- NL
CDC 'Split Type':

Write-up: Pt developed progressive cough, DOE & low grade fever about 24 hrs p/vax x 2wks; Admitted to Hosp from 11DEC to about 20DEC w/bilateral pulmonary infiltrates hypoxemia & mild leukocytosis; No bacteriologic diagnosis was made;


Changed on 2/14/2017

VAERS ID: 29271 Before After
VAERS Form:
Age:62.4 62.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-12-26
Submitted:0000-00-00
Entered:1991-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Cyanosis, Dyspnoea, Hypoxia, Leukocytosis, Pyrexia, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 11DEC90- WBC 16,700 w/no diff + PHS; ABG(RA)-7.48/PO2 36/PCO2 32; LFTS- NL
CDC 'Split Type':

Write-up: Pt developed progressive cough, DOE & low grade fever about 24 hrs p/vax x 2wks; Admitted to Hosp from 11DEC to about 20DEC w/bilateral pulmonary infiltrates hypoxemia & mild leukocytosis; No bacteriologic diagnosis was made;


Changed on 5/14/2017

VAERS ID: 29271 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-12-26
Submitted:0000-00-00
Entered:1991-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Cyanosis, Dyspnoea, Hypoxia, Leukocytosis, Pyrexia, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 11DEC90- WBC 16,700 w/no diff + PHS; ABG(RA)-7.48/PO2 36/PCO2 32; LFTS- NL
CDC 'Split Type':

Write-up: Pt developed progressive cough, DOE & low grade fever about 24 hrs p/vax x 2wks; Admitted to Hosp from 11DEC to about 20DEC w/bilateral pulmonary infiltrates hypoxemia & mild leukocytosis; No bacteriologic diagnosis was made;


Changed on 9/14/2017

VAERS ID: 29271 Before After
VAERS Form:(blank) 1
Age:62.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-12-26
Submitted:0000-00-00
Entered:1991-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 0 1 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Cyanosis, Dyspnoea, Hypoxia, Leukocytosis, Pyrexia, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 11DEC90- WBC 16,700 w/no diff + PHS; ABG(RA)-7.48/PO2 36/PCO2 32; LFTS- NL
CDC 'Split Type':

Write-up: Pt developed progressive cough, DOE & low grade fever about 24 hrs p/vax x 2wks; Admitted to Hosp from 11DEC to about 20DEC w/bilateral pulmonary infiltrates hypoxemia & mild leukocytosis; No bacteriologic diagnosis was made;


Changed on 2/14/2018

VAERS ID: 29271 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-12-26
Submitted:0000-00-00
Entered:1991-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 1 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Cyanosis, Dyspnoea, Hypoxia, Leukocytosis, Pyrexia, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 11DEC90- WBC 16,700 w/no diff + PHS; ABG(RA)-7.48/PO2 36/PCO2 32; LFTS- NL
CDC 'Split Type':

Write-up: Pt developed progressive cough, DOE & low grade fever about 24 hrs p/vax x 2wks; Admitted to Hosp from 11DEC to about 20DEC w/bilateral pulmonary infiltrates hypoxemia & mild leukocytosis; No bacteriologic diagnosis was made;


Changed on 6/14/2018

VAERS ID: 29271 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-12-26
Submitted:0000-00-00
Entered:1991-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 1 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Cyanosis, Dyspnoea, Hypoxia, Leukocytosis, Pyrexia, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 11DEC90- WBC 16,700 w/no diff + PHS; ABG(RA)-7.48/PO2 36/PCO2 32; LFTS- NL
CDC 'Split Type':

Write-up: Pt developed progressive cough, DOE & low grade fever about 24 hrs p/vax x 2wks; Admitted to Hosp from 11DEC to about 20DEC w/bilateral pulmonary infiltrates hypoxemia & mild leukocytosis; No bacteriologic diagnosis was made;


Changed on 8/14/2018

VAERS ID: 29271 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-12-26
Submitted:0000-00-00
Entered:1991-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 1 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Cyanosis, Dyspnoea, Hypoxia, Leukocytosis, Pyrexia, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 11DEC90- WBC 16,700 w/no diff + PHS; ABG(RA)-7.48/PO2 36/PCO2 32; LFTS- NL
CDC 'Split Type':

Write-up: Pt developed progressive cough, DOE & low grade fever about 24 hrs p/vax x 2wks; Admitted to Hosp from 11DEC to about 20DEC w/bilateral pulmonary infiltrates hypoxemia & mild leukocytosis; No bacteriologic diagnosis was made;


Changed on 9/14/2018

VAERS ID: 29271 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-12-26
Submitted:0000-00-00
Entered:1991-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 1 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Cyanosis, Dyspnoea, Hypoxia, Leukocytosis, Pyrexia, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 11DEC90- WBC 16,700 w/no diff + PHS; ABG(RA)-7.48/PO2 36/PCO2 32; LFTS- NL
CDC 'Split Type':

Write-up: Pt developed progressive cough, DOE & low grade fever about 24 hrs p/vax x 2wks; Admitted to Hosp from 11DEC to about 20DEC w/bilateral pulmonary infiltrates hypoxemia & mild leukocytosis; No bacteriologic diagnosis was made;


Changed on 10/14/2018

VAERS ID: 29271 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-11-08
Onset:1990-12-26
Submitted:0000-00-00
Entered:1991-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 1 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Cyanosis, Dyspnoea, Hypoxia, Leukocytosis, Pyrexia, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 11DEC90- WBC 16,700 w/no diff + PHS; ABG(RA)-7.48/PO2 36/PCO2 32; LFTS- NL
CDC 'Split Type':

Write-up: Pt developed progressive cough, DOE & low grade fever about 24 hrs p/vax x 2wks; Admitted to Hosp from 11DEC to about 20DEC w/bilateral pulmonary infiltrates hypoxemia & mild leukocytosis; No bacteriologic diagnosis was made;

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