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This is VAERS ID 29349

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 29349
VAERS Form:
Age:30.1
Sex:Female
Location:North Carolina
Vaccinated:1990-10-13
Onset:1990-12-12
Submitted:0000-00-00
Entered:1991-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 0J11164 / - A / IM

Administered by: Military      Purchased by: Unknown
Symptoms: PUPIL DIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: 0.12% Pilocarpine to affected eye to diagnose adies pupil
CDC 'Split Type': NA

Write-up: Aides pupil diagnosed 13DEC90;


Changed on 12/8/2009

VAERS ID: 29349 Before After
VAERS Form:
Age:30.1
Sex:Female
Location:North Carolina
Vaccinated:1990-10-13
Onset:1990-12-12
Submitted:0000-00-00
Entered:1991-03-29 1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0J11164 / - A / IM

Administered by: Military      Purchased by: Unknown Military
Symptoms: Pupillary disorder, PUPIL DIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: 0.12% Pilocarpine to affected eye to diagnose adies pupil
CDC 'Split Type': NA (blank)

Write-up: Aides pupil diagnosed 13DEC90;


Changed on 8/31/2010

VAERS ID: 29349 Before After
VAERS Form:
Age:30.1
Sex:Female
Location:North Carolina
Vaccinated:1990-10-13
Onset:1990-12-12
Submitted:0000-00-00
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0J11164 / - A / IM

Administered by: Military      Purchased by: Military
Symptoms: Pupillary disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: 0.12% Pilocarpine to affected eye to diagnose adies pupil
CDC 'Split Type':

Write-up: Aides pupil diagnosed 13DEC90;


Changed on 7/7/2013

VAERS ID: 29349 Before After
VAERS Form:
Age:30.1
Sex:Female
Location:North Carolina
Vaccinated:1990-10-13
Onset:1990-12-12
Submitted:0000-00-00
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0J11164 / - A / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0J11164 / - A / IM

Administered by: Military      Purchased by: Military
Symptoms: Pupillary disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: 0.12% Pilocarpine to affected eye to diagnose adies pupil
CDC 'Split Type':

Write-up: Aides pupil diagnosed 13DEC90;


Changed on 2/14/2017

VAERS ID: 29349 Before After
VAERS Form:
Age:30.1 30.0
Sex:Female
Location:North Carolina
Vaccinated:1990-10-13
Onset:1990-12-12
Submitted:0000-00-00
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0J11164 / - A / IM

Administered by: Military      Purchased by: Military
Symptoms: Pupillary disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: 0.12% Pilocarpine to affected eye to diagnose adies pupil
CDC 'Split Type':

Write-up: Aides pupil diagnosed 13DEC90;


Changed on 5/14/2017

VAERS ID: 29349 Before After
VAERS Form:
Age:30.0
Sex:Female
Location:North Carolina
Vaccinated:1990-10-13
Onset:1990-12-12
Submitted:0000-00-00
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0J11164 / - A - / IM IM A

Administered by: Military      Purchased by: Military
Symptoms: Pupillary disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: 0.12% Pilocarpine to affected eye to diagnose adies pupil
CDC 'Split Type':

Write-up: Aides pupil diagnosed 13DEC90;


Changed on 9/14/2017

VAERS ID: 29349 Before After
VAERS Form:(blank) 1
Age:30.0
Sex:Female
Location:North Carolina
Vaccinated:1990-10-13
Onset:1990-12-12
Submitted:0000-00-00
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0J11164 / - UNK - / IM A

Administered by: Military      Purchased by: Military
Symptoms: Pupillary disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: 0.12% Pilocarpine to affected eye to diagnose adies pupil
CDC 'Split Type':

Write-up: Aides pupil diagnosed 13DEC90;


Changed on 2/14/2018

VAERS ID: 29349 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:North Carolina
Vaccinated:1990-10-13
Onset:1990-12-12
Submitted:0000-00-00
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0J11164 / UNK - / IM A

Administered by: Military      Purchased by: Military
Symptoms: Pupillary disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: 0.12% Pilocarpine to affected eye to diagnose adies pupil
CDC 'Split Type':

Write-up: Aides pupil diagnosed 13DEC90;


Changed on 6/14/2018

VAERS ID: 29349 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:North Carolina
Vaccinated:1990-10-13
Onset:1990-12-12
Submitted:0000-00-00
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0J11164 / UNK - / IM A

Administered by: Military      Purchased by: Military
Symptoms: Pupillary disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: 0.12% Pilocarpine to affected eye to diagnose adies pupil
CDC 'Split Type':

Write-up: Aides pupil diagnosed 13DEC90;


Changed on 8/14/2018

VAERS ID: 29349 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:North Carolina
Vaccinated:1990-10-13
Onset:1990-12-12
Submitted:0000-00-00
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0J11164 / UNK - / IM A

Administered by: Military      Purchased by: Military
Symptoms: Pupillary disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: 0.12% Pilocarpine to affected eye to diagnose adies pupil
CDC 'Split Type':

Write-up: Aides pupil diagnosed 13DEC90;


Changed on 9/14/2018

VAERS ID: 29349 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:North Carolina
Vaccinated:1990-10-13
Onset:1990-12-12
Submitted:0000-00-00
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0J11164 / UNK - / IM A

Administered by: Military      Purchased by: Military
Symptoms: Pupillary disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: 0.12% Pilocarpine to affected eye to diagnose adies pupil
CDC 'Split Type':

Write-up: Aides pupil diagnosed 13DEC90;


Changed on 10/14/2018

VAERS ID: 29349 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:North Carolina
Vaccinated:1990-10-13
Onset:1990-12-12
Submitted:0000-00-00
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0J11164 / UNK - / IM A

Administered by: Military      Purchased by: Military
Symptoms: Pupillary disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: 0.12% Pilocarpine to affected eye to diagnose adies pupil
CDC 'Split Type':

Write-up: Aides pupil diagnosed 13DEC90;

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