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This is VAERS ID 29955

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 29955
VAERS Form:
Age:39.3
Sex:Male
Location:California
Vaccinated:1990-10-31
Onset:1990-11-15
Submitted:1990-11-29
Entered:1991-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH 4908204 / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: FEVER, ARTHRALGIA, FLU SYND, ASTHENIA, COUGH INC

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cardizem 30 mg tid, Presantine 50 mg tid
Current Illness: none
Preexisting Conditions: angio-plasty
Allergies:
Diagnostic Lab Data: Neurological evaluation
CDC 'Split Type':

Write-up: Recvd injection 31Oct90- 15Nov90 numbness in lt arm-hand-went to ER-Adm for observation over night. DX virus-infection-still very tired. Had neurological evaluation.


Changed on 12/8/2009

VAERS ID: 29955 Before After
VAERS Form:
Age:39.3
Sex:Male
Location:California
Vaccinated:1990-10-31
Onset:1990-11-15
Submitted:1990-11-29
Entered:1991-04-23 1991-04-18
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 4908204 / - LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Arthralgia, Asthenia, Chest pain, Cough, Hyperhidrosis, Hypertension, Influenza, Paraesthesia, Pharyngitis, Pyrexia, FEVER, ARTHRALGIA, FLU SYND, ASTHENIA, COUGH INC

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cardizem 30 mg tid, Presantine 50 mg tid
Current Illness: none
Preexisting Conditions: angio-plasty
Allergies:
Diagnostic Lab Data: Neurological evaluation
CDC 'Split Type': (blank) CA9139

Write-up: Recvd injection 31Oct90- 15Nov90 numbness in lt arm-hand-went to ER-Adm for observation over night. DX virus-infection-still very tired. Had neurological evaluation.


Changed on 8/31/2010

VAERS ID: 29955 Before After
VAERS Form:
Age:39.3
Sex:Male
Location:California
Vaccinated:1990-10-31
Onset:1990-11-15
Submitted:1990-11-29
Entered:1991-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4908204 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Asthenia, Chest pain, Cough, Hyperhidrosis, Hypertension, Influenza, Paraesthesia, Pharyngitis, Pyrexia

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cardizem 30 mg tid, Presantine 50 mg tid
Current Illness: none
Preexisting Conditions: angio-plasty
Allergies:
Diagnostic Lab Data: Neurological evaluation
CDC 'Split Type': CA9139

Write-up: Recvd injection 31Oct90- 15Nov90 numbness in lt arm-hand-went to ER-Adm for observation over night. DX virus-infection-still very tired. Had neurological evaluation.


Changed on 7/7/2013

VAERS ID: 29955 Before After
VAERS Form:
Age:39.3
Sex:Male
Location:California
Vaccinated:1990-10-31
Onset:1990-11-15
Submitted:1990-11-29
Entered:1991-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908204 / - LA / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908204 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Asthenia, Chest pain, Cough, Hyperhidrosis, Hypertension, Influenza, Paraesthesia, Pharyngitis, Pyrexia

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cardizem 30 mg tid, Presantine 50 mg tid
Current Illness: none
Preexisting Conditions: angio-plasty
Allergies:
Diagnostic Lab Data: Neurological evaluation
CDC 'Split Type': CA9139

Write-up: Recvd injection 31Oct90- 15Nov90 numbness in lt arm-hand-went to ER-Adm for observation over night. DX virus-infection-still very tired. Had neurological evaluation.


Changed on 12/14/2016

VAERS ID: 29955 Before After
VAERS Form:
Age:39.3
Sex:Male
Location:California
Vaccinated:1990-10-31
Onset:1990-11-15
Submitted:1990-11-29
Entered:1991-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908204 / - LA / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908204 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Asthenia, Chest pain, Cough, Hyperhidrosis, Hypertension, Influenza, Paraesthesia, Pharyngitis, Pyrexia

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cardizem 30 mg tid, Presantine 50 mg tid
Current Illness: none
Preexisting Conditions: angio-plasty
Allergies:
Diagnostic Lab Data: Neurological evaluation
CDC 'Split Type': CA9139

Write-up: Recvd injection 31Oct90- 15Nov90 numbness in lt arm-hand-went to ER-Adm for observation over night. DX virus-infection-still very tired. Had neurological evaluation.


Changed on 2/14/2017

VAERS ID: 29955 Before After
VAERS Form:
Age:39.3 39.0
Sex:Male
Location:California
Vaccinated:1990-10-31
Onset:1990-11-15
Submitted:1990-11-29
Entered:1991-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908204 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Asthenia, Chest pain, Cough, Hyperhidrosis, Hypertension, Influenza, Paraesthesia, Pharyngitis, Pyrexia

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cardizem 30 mg tid, Presantine 50 mg tid
Current Illness: none
Preexisting Conditions: angio-plasty
Allergies:
Diagnostic Lab Data: Neurological evaluation
CDC 'Split Type': CA9139

Write-up: Recvd injection 31Oct90- 15Nov90 numbness in lt arm-hand-went to ER-Adm for observation over night. DX virus-infection-still very tired. Had neurological evaluation.


Changed on 5/14/2017

VAERS ID: 29955 Before After
VAERS Form:
Age:39.0
Sex:Male
Location:California
Vaccinated:1990-10-31
Onset:1990-11-15
Submitted:1990-11-29
Entered:1991-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908204 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Asthenia, Chest pain, Cough, Hyperhidrosis, Hypertension, Influenza, Paraesthesia, Pharyngitis, Pyrexia

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Cardizem 30 mg tid, Presantine 50 mg tid
Current Illness: none
Preexisting Conditions: angio-plasty
Allergies:
Diagnostic Lab Data: Neurological evaluation
CDC 'Split Type': CA9139

Write-up: Recvd injection 31Oct90- 15Nov90 numbness in lt arm-hand-went to ER-Adm for observation over night. DX virus-infection-still very tired. Had neurological evaluation.


Changed on 9/14/2017

VAERS ID: 29955 Before After
VAERS Form:(blank) 1
Age:39.0
Sex:Male
Location:California
Vaccinated:1990-10-31
Onset:1990-11-15
Submitted:1990-11-29
Entered:1991-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908204 / - UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Asthenia, Chest pain, Cough, Hyperhidrosis, Hypertension, Influenza, Paraesthesia, Pharyngitis, Pyrexia

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Cardizem 30 mg tid, Presantine 50 mg tid
Current Illness: none
Preexisting Conditions: angio-plasty
Allergies:
Diagnostic Lab Data: Neurological evaluation
CDC 'Split Type': CA9139

Write-up: Recvd injection 31Oct90- 15Nov90 numbness in lt arm-hand-went to ER-Adm for observation over night. DX virus-infection-still very tired. Had neurological evaluation.


Changed on 2/14/2018

VAERS ID: 29955 Before After
VAERS Form:1
Age:39.0
Sex:Male
Location:California
Vaccinated:1990-10-31
Onset:1990-11-15
Submitted:1990-11-29
Entered:1991-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908204 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Asthenia, Chest pain, Cough, Hyperhidrosis, Hypertension, Influenza, Paraesthesia, Pharyngitis, Pyrexia

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Cardizem 30 mg tid, Presantine 50 mg tid
Current Illness: none
Preexisting Conditions: angio-plasty
Allergies:
Diagnostic Lab Data: Neurological evaluation
CDC 'Split Type': CA9139

Write-up: Recvd injection 31Oct90- 15Nov90 numbness in lt arm-hand-went to ER-Adm for observation over night. DX virus-infection-still very tired. Had neurological evaluation.


Changed on 6/14/2018

VAERS ID: 29955 Before After
VAERS Form:1
Age:39.0
Sex:Male
Location:California
Vaccinated:1990-10-31
Onset:1990-11-15
Submitted:1990-11-29
Entered:1991-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908204 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Asthenia, Chest pain, Cough, Hyperhidrosis, Hypertension, Influenza, Paraesthesia, Pharyngitis, Pyrexia

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Cardizem 30 mg tid, Presantine 50 mg tid
Current Illness: none
Preexisting Conditions: angio-plasty
Allergies:
Diagnostic Lab Data: Neurological evaluation
CDC 'Split Type': CA9139

Write-up: Recvd injection 31Oct90- 15Nov90 numbness in lt arm-hand-went to ER-Adm for observation over night. DX virus-infection-still very tired. Had neurological evaluation.


Changed on 8/14/2018

VAERS ID: 29955 Before After
VAERS Form:1
Age:39.0
Sex:Male
Location:California
Vaccinated:1990-10-31
Onset:1990-11-15
Submitted:1990-11-29
Entered:1991-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908204 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Asthenia, Chest pain, Cough, Hyperhidrosis, Hypertension, Influenza, Paraesthesia, Pharyngitis, Pyrexia

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Cardizem 30 mg tid, Presantine 50 mg tid
Current Illness: none
Preexisting Conditions: angio-plasty
Allergies:
Diagnostic Lab Data: Neurological evaluation
CDC 'Split Type': CA9139

Write-up: Recvd injection 31Oct90- 15Nov90 numbness in lt arm-hand-went to ER-Adm for observation over night. DX virus-infection-still very tired. Had neurological evaluation.


Changed on 9/14/2018

VAERS ID: 29955 Before After
VAERS Form:1
Age:39.0
Sex:Male
Location:California
Vaccinated:1990-10-31
Onset:1990-11-15
Submitted:1990-11-29
Entered:1991-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908204 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Asthenia, Chest pain, Cough, Hyperhidrosis, Hypertension, Influenza, Paraesthesia, Pharyngitis, Pyrexia

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Cardizem 30 mg tid, Presantine 50 mg tid
Current Illness: none
Preexisting Conditions: angio-plasty
Allergies:
Diagnostic Lab Data: Neurological evaluation
CDC 'Split Type': CA9139

Write-up: Recvd injection 31Oct90- 15Nov90 numbness in lt arm-hand-went to ER-Adm for observation over night. DX virus-infection-still very tired. Had neurological evaluation.


Changed on 10/14/2018

VAERS ID: 29955 Before After
VAERS Form:1
Age:39.0
Sex:Male
Location:California
Vaccinated:1990-10-31
Onset:1990-11-15
Submitted:1990-11-29
Entered:1991-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908204 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Asthenia, Chest pain, Cough, Hyperhidrosis, Hypertension, Influenza, Paraesthesia, Pharyngitis, Pyrexia

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Cardizem 30 mg tid, Presantine 50 mg tid
Current Illness: none
Preexisting Conditions: angio-plasty
Allergies:
Diagnostic Lab Data: Neurological evaluation
CDC 'Split Type': CA9139

Write-up: Recvd injection 31Oct90- 15Nov90 numbness in lt arm-hand-went to ER-Adm for observation over night. DX virus-infection-still very tired. Had neurological evaluation.

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