National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 29510

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 29510
VAERS Form:
Age:60.0
Sex:Male
Location:Unknown
Vaccinated:1990-12-15
Onset:1990-12-16
Submitted:1991-03-26
Entered:1991-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS / PARKE-DAVIS - / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: CHILLS, ANOREXIA, ASTHENIA, COUGH INC, ATELECTASIS

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:     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: ASA
Current Illness: NONE
Preexisting Conditions: No egg allergy
Allergies:
Diagnostic Lab Data: CBC, Sed RAT, Cold agglutinins, chemistry profile, CT scan of head & abdomin, Legionella titer - all WNL; CXR mild basilar; atelectasis during acute phase;
CDC 'Split Type': No egg allergy

Write-up: Polymyalgia rheumatica reported in MD receiving FLUOGEN 1st shot 15DEC90; sx of URI, fevers to 101, chills w/rigors, myalgia, headache, fatigue, anorexia, non productive cough & dysesthesias of scalp; Atelectasis on CXR;


Changed on 12/8/2009

VAERS ID: 29510 Before After
VAERS Form:
Age:60.0
Sex:Male
Location:Unknown
Vaccinated:1990-12-15
Onset:1990-12-16
Submitted:1991-03-26
Entered:1991-04-05 1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS INFLUENZA (SEASONAL) (FLUOGEN 90-91) / PARKE-DAVIS - / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Anorexia, Asthenia, Atelectasis, Chills, Cough, Headache, Myalgia, Paraesthesia, Pharyngitis, Pyrexia, CHILLS, ANOREXIA, ASTHENIA, COUGH INC, ATELECTASIS

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:     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: ASA
Current Illness: NONE
Preexisting Conditions: No egg allergy
Allergies:
Diagnostic Lab Data: CBC, Sed RAT, Cold agglutinins, chemistry profile, CT scan of head & abdomin, Legionella titer - all WNL; CXR mild basilar; atelectasis during acute phase;
CDC 'Split Type': No egg allergy 914090005

Write-up: Polymyalgia rheumatica reported in MD receiving FLUOGEN 1st shot 15DEC90; sx of URI, fevers to 101, chills w/rigors, myalgia, headache, fatigue, anorexia, non productive cough & dysesthesias of scalp; Atelectasis on CXR;


Changed on 8/31/2010

VAERS ID: 29510 Before After
VAERS Form:
Age:60.0
Sex:Male
Location:Unknown
Vaccinated:1990-12-15
Onset:1990-12-16
Submitted:1991-03-26
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 90-91) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Atelectasis, Chills, Cough, Headache, Myalgia, Paraesthesia, Pharyngitis, Pyrexia

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:     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: ASA
Current Illness: NONE
Preexisting Conditions: No egg allergy
Allergies:
Diagnostic Lab Data: CBC, Sed RAT, Cold agglutinins, chemistry profile, CT scan of head & abdomin, Legionella titer - all WNL; CXR mild basilar; atelectasis during acute phase;
CDC 'Split Type': 914090005

Write-up: Polymyalgia rheumatica reported in MD receiving FLUOGEN 1st shot 15DEC90; sx of URI, fevers to 101, chills w/rigors, myalgia, headache, fatigue, anorexia, non productive cough & dysesthesias of scalp; Atelectasis on CXR;


Changed on 7/7/2013

VAERS ID: 29510 Before After
VAERS Form:
Age:60.0
Sex:Male
Location:Unknown
Vaccinated:1990-12-15
Onset:1990-12-16
Submitted:1991-03-26
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 - / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Atelectasis, Chills, Cough, Headache, Myalgia, Paraesthesia, Pharyngitis, Pyrexia

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:     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: ASA
Current Illness: NONE
Preexisting Conditions: No egg allergy
Allergies:
Diagnostic Lab Data: CBC, Sed RAT, Cold agglutinins, chemistry profile, CT scan of head & abdomin, Legionella titer - all WNL; CXR mild basilar; atelectasis during acute phase;
CDC 'Split Type': 914090005

Write-up: Polymyalgia rheumatica reported in MD receiving FLUOGEN 1st shot 15DEC90; sx of URI, fevers to 101, chills w/rigors, myalgia, headache, fatigue, anorexia, non productive cough & dysesthesias of scalp; Atelectasis on CXR;


Changed on 5/14/2017

VAERS ID: 29510 Before After
VAERS Form:
Age:60.0
Sex:Male
Location:Unknown
Vaccinated:1990-12-15
Onset:1990-12-16
Submitted:1991-03-26
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Atelectasis, Chills, Cough, Headache, Myalgia, Paraesthesia, Pharyngitis, Pyrexia

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:     Extended hospital stay? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: ASA
Current Illness: NONE
Preexisting Conditions: No egg allergy
Allergies:
Diagnostic Lab Data: CBC, Sed RAT, Cold agglutinins, chemistry profile, CT scan of head & abdomin, Legionella titer - all WNL; CXR mild basilar; atelectasis during acute phase;
CDC 'Split Type': 914090005

Write-up: Polymyalgia rheumatica reported in MD receiving FLUOGEN 1st shot 15DEC90; sx of URI, fevers to 101, chills w/rigors, myalgia, headache, fatigue, anorexia, non productive cough & dysesthesias of scalp; Atelectasis on CXR;


Changed on 9/14/2017

VAERS ID: 29510 Before After
VAERS Form:(blank) 1
Age:60.0
Sex:Male
Location:Unknown
Vaccinated:1990-12-15
Onset:1990-12-16
Submitted:1991-03-26
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Atelectasis, Chills, Cough, Headache, Myalgia, Paraesthesia, Pharyngitis, Pyrexia

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:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: ASA
Current Illness: NONE
Preexisting Conditions: No egg allergy
Allergies:
Diagnostic Lab Data: CBC, Sed RAT, Cold agglutinins, chemistry profile, CT scan of head & abdomin, Legionella titer - all WNL; CXR mild basilar; atelectasis during acute phase;
CDC 'Split Type': 914090005

Write-up: Polymyalgia rheumatica reported in MD receiving FLUOGEN 1st shot 15DEC90; sx of URI, fevers to 101, chills w/rigors, myalgia, headache, fatigue, anorexia, non productive cough & dysesthesias of scalp; Atelectasis on CXR;


Changed on 2/14/2018

VAERS ID: 29510 Before After
VAERS Form:1
Age:60.0
Sex:Male
Location:Unknown
Vaccinated:1990-12-15
Onset:1990-12-16
Submitted:1991-03-26
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Atelectasis, Chills, Cough, Headache, Myalgia, Paraesthesia, Pharyngitis, Pyrexia

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:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: ASA
Current Illness: NONE
Preexisting Conditions: No egg allergy
Allergies:
Diagnostic Lab Data: CBC, Sed RAT, Cold agglutinins, chemistry profile, CT scan of head & abdomin, Legionella titer - all WNL; CXR mild basilar; atelectasis during acute phase;
CDC 'Split Type': 914090005

Write-up: Polymyalgia rheumatica reported in MD receiving FLUOGEN 1st shot 15DEC90; sx of URI, fevers to 101, chills w/rigors, myalgia, headache, fatigue, anorexia, non productive cough & dysesthesias of scalp; Atelectasis on CXR;


Changed on 6/14/2018

VAERS ID: 29510 Before After
VAERS Form:1
Age:60.0
Sex:Male
Location:Unknown
Vaccinated:1990-12-15
Onset:1990-12-16
Submitted:1991-03-26
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Atelectasis, Chills, Cough, Headache, Myalgia, Paraesthesia, Pharyngitis, Pyrexia

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:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: ASA
Current Illness: NONE
Preexisting Conditions: No egg allergy
Allergies:
Diagnostic Lab Data: CBC, Sed RAT, Cold agglutinins, chemistry profile, CT scan of head & abdomin, Legionella titer - all WNL; CXR mild basilar; atelectasis during acute phase;
CDC 'Split Type': 914090005

Write-up: Polymyalgia rheumatica reported in MD receiving FLUOGEN 1st shot 15DEC90; sx of URI, fevers to 101, chills w/rigors, myalgia, headache, fatigue, anorexia, non productive cough & dysesthesias of scalp; Atelectasis on CXR;


Changed on 8/14/2018

VAERS ID: 29510 Before After
VAERS Form:1
Age:60.0
Sex:Male
Location:Unknown
Vaccinated:1990-12-15
Onset:1990-12-16
Submitted:1991-03-26
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Atelectasis, Chills, Cough, Headache, Myalgia, Paraesthesia, Pharyngitis, Pyrexia

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:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: ASA
Current Illness: NONE
Preexisting Conditions: No egg allergy
Allergies:
Diagnostic Lab Data: CBC, Sed RAT, Cold agglutinins, chemistry profile, CT scan of head & abdomin, Legionella titer - all WNL; CXR mild basilar; atelectasis during acute phase;
CDC 'Split Type': 914090005

Write-up: Polymyalgia rheumatica reported in MD receiving FLUOGEN 1st shot 15DEC90; sx of URI, fevers to 101, chills w/rigors, myalgia, headache, fatigue, anorexia, non productive cough & dysesthesias of scalp; Atelectasis on CXR;


Changed on 9/14/2018

VAERS ID: 29510 Before After
VAERS Form:1
Age:60.0
Sex:Male
Location:Unknown
Vaccinated:1990-12-15
Onset:1990-12-16
Submitted:1991-03-26
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Atelectasis, Chills, Cough, Headache, Myalgia, Paraesthesia, Pharyngitis, Pyrexia

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:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: ASA
Current Illness: NONE
Preexisting Conditions: No egg allergy
Allergies:
Diagnostic Lab Data: CBC, Sed RAT, Cold agglutinins, chemistry profile, CT scan of head & abdomin, Legionella titer - all WNL; CXR mild basilar; atelectasis during acute phase;
CDC 'Split Type': 914090005

Write-up: Polymyalgia rheumatica reported in MD receiving FLUOGEN 1st shot 15DEC90; sx of URI, fevers to 101, chills w/rigors, myalgia, headache, fatigue, anorexia, non productive cough & dysesthesias of scalp; Atelectasis on CXR;


Changed on 10/14/2018

VAERS ID: 29510 Before After
VAERS Form:1
Age:60.0
Sex:Male
Location:Unknown
Vaccinated:1990-12-15
Onset:1990-12-16
Submitted:1991-03-26
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Anorexia, Asthenia, Atelectasis, Chills, Cough, Headache, Myalgia, Paraesthesia, Pharyngitis, Pyrexia

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:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: ASA
Current Illness: NONE
Preexisting Conditions: No egg allergy
Allergies:
Diagnostic Lab Data: CBC, Sed RAT, Cold agglutinins, chemistry profile, CT scan of head & abdomin, Legionella titer - all WNL; CXR mild basilar; atelectasis during acute phase;
CDC 'Split Type': 914090005

Write-up: Polymyalgia rheumatica reported in MD receiving FLUOGEN 1st shot 15DEC90; sx of URI, fevers to 101, chills w/rigors, myalgia, headache, fatigue, anorexia, non productive cough & dysesthesias of scalp; Atelectasis on CXR;

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=29510&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166