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This is VAERS ID 36164

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 36164
VAERS Form:
Age:68.1
Sex:Female
Location:Georgia
Vaccinated:1991-10-07
Onset:1991-10-08
Submitted:1991-10-08
Entered:1991-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH 498145 / 0 LA / IM
PPV: PNU-IMUNE(R)23 / LEDERLE 308911 / 0 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: ASTHENIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tegretol ?BP meds
Current Illness: NONE
Preexisting Conditions: Hx of brain tumor, szs & hypertension;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: PC from Med ctr; admitted via ER @ 11AM w/ c/o feeling weak; has past hx of brain tumor, sz & hypertension on Tegretol & BP meds; no sz activity noted toady;


Changed on 12/8/2009

VAERS ID: 36164 Before After
VAERS Form:
Age:68.1
Sex:Female
Location:Georgia
Vaccinated:1991-10-07
Onset:1991-10-08
Submitted:1991-10-08
Entered:1991-11-12 1991-11-08
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 498145 / 0 LA / IM
PPV: PNU-IMUNE(R)23 PNEUMO (PNU-IMUNE) / LEDERLE LEDERLE LABORATORIES 308911 / 0 RA / IM

Administered by: Public      Purchased by: Unknown Other
Symptoms: Asthenia, ASTHENIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tegretol ?BP meds
Current Illness: NONE
Preexisting Conditions: Hx of brain tumor, szs & hypertension;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) GA91294

Write-up: PC from Med ctr; admitted via ER @ 11AM w/ c/o feeling weak; has past hx of brain tumor, sz & hypertension on Tegretol & BP meds; no sz activity noted toady;


Changed on 8/31/2010

VAERS ID: 36164 Before After
VAERS Form:
Age:68.1
Sex:Female
Location:Georgia
Vaccinated:1991-10-07
Onset:1991-10-08
Submitted:1991-10-08
Entered:1991-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 498145 / 0 LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 308911 / 0 RA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tegretol ?BP meds
Current Illness: NONE
Preexisting Conditions: Hx of brain tumor, szs & hypertension;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GA91294

Write-up: PC from Med ctr; admitted via ER @ 11AM w/ c/o feeling weak; has past hx of brain tumor, sz & hypertension on Tegretol & BP meds; no sz activity noted toady;


Changed on 7/7/2013

VAERS ID: 36164 Before After
VAERS Form:
Age:68.1
Sex:Female
Location:Georgia
Vaccinated:1991-10-07
Onset:1991-10-08
Submitted:1991-10-08
Entered:1991-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 498145 / 0 LA / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 498145 / 0 LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 308911 / 0 RA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tegretol ?BP meds
Current Illness: NONE
Preexisting Conditions: Hx of brain tumor, szs & hypertension;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GA91294

Write-up: PC from Med ctr; admitted via ER @ 11AM w/ c/o feeling weak; has past hx of brain tumor, sz & hypertension on Tegretol & BP meds; no sz activity noted toady;


Changed on 12/14/2016

VAERS ID: 36164 Before After
VAERS Form:
Age:68.1
Sex:Female
Location:Georgia
Vaccinated:1991-10-07
Onset:1991-10-08
Submitted:1991-10-08
Entered:1991-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 498145 / 0 LA / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 498145 / 0 LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 308911 / 0 RA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tegretol ?BP meds
Current Illness: NONE
Preexisting Conditions: Hx of brain tumor, szs & hypertension;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GA91294

Write-up: PC from Med ctr; admitted via ER @ 11AM w/ c/o feeling weak; has past hx of brain tumor, sz & hypertension on Tegretol & BP meds; no sz activity noted toady;


Changed on 2/14/2017

VAERS ID: 36164 Before After
VAERS Form:
Age:68.1 68.0
Sex:Female
Location:Georgia
Vaccinated:1991-10-07
Onset:1991-10-08
Submitted:1991-10-08
Entered:1991-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 498145 / 0 LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 308911 / 0 RA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tegretol ?BP meds
Current Illness: NONE
Preexisting Conditions: Hx of brain tumor, szs & hypertension;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GA91294

Write-up: PC from Med ctr; admitted via ER @ 11AM w/ c/o feeling weak; has past hx of brain tumor, sz & hypertension on Tegretol & BP meds; no sz activity noted toady;


Changed on 5/14/2017

VAERS ID: 36164 Before After
VAERS Form:
Age:68.0
Sex:Female
Location:Georgia
Vaccinated:1991-10-07
Onset:1991-10-08
Submitted:1991-10-08
Entered:1991-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 498145 / 0 LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 308911 / 0 RA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Tegretol ?BP meds
Current Illness: NONE
Preexisting Conditions: Hx of brain tumor, szs & hypertension;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GA91294

Write-up: PC from Med ctr; admitted via ER @ 11AM w/ c/o feeling weak; has past hx of brain tumor, sz & hypertension on Tegretol & BP meds; no sz activity noted toady;


Changed on 9/14/2017

VAERS ID: 36164 Before After
VAERS Form:(blank) 1
Age:68.0
Sex:Female
Location:Georgia
Vaccinated:1991-10-07
Onset:1991-10-08
Submitted:1991-10-08
Entered:1991-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 498145 / 0 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 308911 / 0 1 RA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Tegretol ?BP meds
Current Illness: NONE
Preexisting Conditions: Hx of brain tumor, szs & hypertension;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GA91294

Write-up: PC from Med ctr; admitted via ER @ 11AM w/ c/o feeling weak; has past hx of brain tumor, sz & hypertension on Tegretol & BP meds; no sz activity noted toady;


Changed on 2/14/2018

VAERS ID: 36164 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Georgia
Vaccinated:1991-10-07
Onset:1991-10-08
Submitted:1991-10-08
Entered:1991-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 498145 / 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 308911 / 1 RA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Tegretol ?BP meds
Current Illness: NONE
Preexisting Conditions: Hx of brain tumor, szs & hypertension;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GA91294

Write-up: PC from Med ctr; admitted via ER @ 11AM w/ c/o feeling weak; has past hx of brain tumor, sz & hypertension on Tegretol & BP meds; no sz activity noted toady;


Changed on 6/14/2018

VAERS ID: 36164 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Georgia
Vaccinated:1991-10-07
Onset:1991-10-08
Submitted:1991-10-08
Entered:1991-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 498145 / 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 308911 / 1 RA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Tegretol ?BP meds
Current Illness: NONE
Preexisting Conditions: Hx of brain tumor, szs & hypertension;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GA91294

Write-up: PC from Med ctr; admitted via ER @ 11AM w/ c/o feeling weak; has past hx of brain tumor, sz & hypertension on Tegretol & BP meds; no sz activity noted toady;


Changed on 8/14/2018

VAERS ID: 36164 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Georgia
Vaccinated:1991-10-07
Onset:1991-10-08
Submitted:1991-10-08
Entered:1991-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 498145 / 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 308911 / 1 RA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Tegretol ?BP meds
Current Illness: NONE
Preexisting Conditions: Hx of brain tumor, szs & hypertension;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GA91294

Write-up: PC from Med ctr; admitted via ER @ 11AM w/ c/o feeling weak; has past hx of brain tumor, sz & hypertension on Tegretol & BP meds; no sz activity noted toady;


Changed on 9/14/2018

VAERS ID: 36164 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Georgia
Vaccinated:1991-10-07
Onset:1991-10-08
Submitted:1991-10-08
Entered:1991-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 498145 / 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 308911 / 1 RA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Tegretol ?BP meds
Current Illness: NONE
Preexisting Conditions: Hx of brain tumor, szs & hypertension;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GA91294

Write-up: PC from Med ctr; admitted via ER @ 11AM w/ c/o feeling weak; has past hx of brain tumor, sz & hypertension on Tegretol & BP meds; no sz activity noted toady;


Changed on 10/14/2018

VAERS ID: 36164 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Georgia
Vaccinated:1991-10-07
Onset:1991-10-08
Submitted:1991-10-08
Entered:1991-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 498145 / 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 308911 / 1 RA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Tegretol ?BP meds
Current Illness: NONE
Preexisting Conditions: Hx of brain tumor, szs & hypertension;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GA91294

Write-up: PC from Med ctr; admitted via ER @ 11AM w/ c/o feeling weak; has past hx of brain tumor, sz & hypertension on Tegretol & BP meds; no sz activity noted toady;

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