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This is VAERS ID 36344

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 36344
VAERS Form:
Age:60.0
Sex:Male
Location:Texas
Vaccinated:1991-10-28
Onset:1991-10-28
Submitted:1991-10-28
Entered:1991-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1991-1992 / WYETH - / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: VOMIT, SPEECH DIS, CONFUS, HYPERTENS

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: Pt had similar rxn @ 40 w/Influenza;
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': UNK

Write-up: Pt exp mental confusion, slurring of speech, hypertension, & vomiting immediately p/vax; treated in ER w/meds; Seem to be improving but MD had pt admitted to hosp for continued observation;


Changed on 12/8/2009

VAERS ID: 36344 Before After
VAERS Form:
Age:60.0
Sex:Male
Location:Texas
Vaccinated:1991-10-28
Onset:1991-10-28
Submitted:1991-10-28
Entered:1991-11-27 1991-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1991-1992 INFLUENZA (SEASONAL) (NO BRAND NAME, 91-92) / WYETH WYETH PHARMACEUTICALS, INC - / - - / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Confusional state, Hypertension, Speech disorder, Vomiting, VOMIT, SPEECH DIS, CONFUS, HYPERTENS

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: Pt had similar rxn @ 40 w/Influenza;
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': UNK 891304014J

Write-up: Pt exp mental confusion, slurring of speech, hypertension, & vomiting immediately p/vax; treated in ER w/meds; Seem to be improving but MD had pt admitted to hosp for continued observation;


Changed on 8/31/2010

VAERS ID: 36344 Before After
VAERS Form:
Age:60.0
Sex:Male
Location:Texas
Vaccinated:1991-10-28
Onset:1991-10-28
Submitted:1991-10-28
Entered:1991-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 91-92) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - - / IM

Administered by: Private      Purchased by: Private
Symptoms: Confusional state, Hypertension, Speech disorder, Vomiting

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: Pt had similar rxn @ 40 w/Influenza;
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891304014J

Write-up: Pt exp mental confusion, slurring of speech, hypertension, & vomiting immediately p/vax; treated in ER w/meds; Seem to be improving but MD had pt admitted to hosp for continued observation;


Changed on 7/7/2013

VAERS ID: 36344 Before After
VAERS Form:
Age:60.0
Sex:Male
Location:Texas
Vaccinated:1991-10-28
Onset:1991-10-28
Submitted:1991-10-28
Entered:1991-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / IM

Administered by: Private      Purchased by: Private
Symptoms: Confusional state, Hypertension, Speech disorder, Vomiting

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: Pt had similar rxn @ 40 w/Influenza;
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891304014J

Write-up: Pt exp mental confusion, slurring of speech, hypertension, & vomiting immediately p/vax; treated in ER w/meds; Seem to be improving but MD had pt admitted to hosp for continued observation;


Changed on 12/14/2016

VAERS ID: 36344 Before After
VAERS Form:
Age:60.0
Sex:Male
Location:Texas
Vaccinated:1991-10-28
Onset:1991-10-28
Submitted:1991-10-28
Entered:1991-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / IM

Administered by: Private      Purchased by: Private
Symptoms: Confusional state, Hypertension, Speech disorder, Vomiting

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: Pt had similar rxn @ 40 w/Influenza;
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891304014J

Write-up: Pt exp mental confusion, slurring of speech, hypertension, & vomiting immediately p/vax; treated in ER w/meds; Seem to be improving but MD had pt admitted to hosp for continued observation;


Changed on 5/14/2017

VAERS ID: 36344 Before After
VAERS Form:
Age:60.0
Sex:Male
Location:Texas
Vaccinated:1991-10-28
Onset:1991-10-28
Submitted:1991-10-28
Entered:1991-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / IM

Administered by: Private      Purchased by: Private
Symptoms: Confusional state, Hypertension, Speech disorder, Vomiting

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: Pt had similar rxn @ 40 w/Influenza; w/Influenza;~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891304014J

Write-up: Pt exp mental confusion, slurring of speech, hypertension, & vomiting immediately p/vax; treated in ER w/meds; Seem to be improving but MD had pt admitted to hosp for continued observation;


Changed on 9/14/2017

VAERS ID: 36344 Before After
VAERS Form:(blank) 1
Age:60.0
Sex:Male
Location:Texas
Vaccinated:1991-10-28
Onset:1991-10-28
Submitted:1991-10-28
Entered:1991-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Confusional state, Hypertension, Speech disorder, Vomiting

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: Pt had similar rxn @ 40 w/Influenza;~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891304014J

Write-up: Pt exp mental confusion, slurring of speech, hypertension, & vomiting immediately p/vax; treated in ER w/meds; Seem to be improving but MD had pt admitted to hosp for continued observation;


Changed on 2/14/2018

VAERS ID: 36344 Before After
VAERS Form:1
Age:60.0
Sex:Male
Location:Texas
Vaccinated:1991-10-28
Onset:1991-10-28
Submitted:1991-10-28
Entered:1991-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Confusional state, Hypertension, Speech disorder, Vomiting

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: Pt had similar rxn @ 40 w/Influenza;~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891304014J

Write-up: Pt exp mental confusion, slurring of speech, hypertension, & vomiting immediately p/vax; treated in ER w/meds; Seem to be improving but MD had pt admitted to hosp for continued observation;


Changed on 6/14/2018

VAERS ID: 36344 Before After
VAERS Form:1
Age:60.0
Sex:Male
Location:Texas
Vaccinated:1991-10-28
Onset:1991-10-28
Submitted:1991-10-28
Entered:1991-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Confusional state, Hypertension, Speech disorder, Vomiting

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: Pt had similar rxn @ 40 w/Influenza;~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891304014J

Write-up: Pt exp mental confusion, slurring of speech, hypertension, & vomiting immediately p/vax; treated in ER w/meds; Seem to be improving but MD had pt admitted to hosp for continued observation;


Changed on 8/14/2018

VAERS ID: 36344 Before After
VAERS Form:1
Age:60.0
Sex:Male
Location:Texas
Vaccinated:1991-10-28
Onset:1991-10-28
Submitted:1991-10-28
Entered:1991-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Confusional state, Hypertension, Speech disorder, Vomiting

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: Pt had similar rxn @ 40 w/Influenza;~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891304014J

Write-up: Pt exp mental confusion, slurring of speech, hypertension, & vomiting immediately p/vax; treated in ER w/meds; Seem to be improving but MD had pt admitted to hosp for continued observation;


Changed on 9/14/2018

VAERS ID: 36344 Before After
VAERS Form:1
Age:60.0
Sex:Male
Location:Texas
Vaccinated:1991-10-28
Onset:1991-10-28
Submitted:1991-10-28
Entered:1991-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Confusional state, Hypertension, Speech disorder, Vomiting

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: Pt had similar rxn @ 40 w/Influenza;~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891304014J

Write-up: Pt exp mental confusion, slurring of speech, hypertension, & vomiting immediately p/vax; treated in ER w/meds; Seem to be improving but MD had pt admitted to hosp for continued observation;


Changed on 10/14/2018

VAERS ID: 36344 Before After
VAERS Form:1
Age:60.0
Sex:Male
Location:Texas
Vaccinated:1991-10-28
Onset:1991-10-28
Submitted:1991-10-28
Entered:1991-11-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Confusional state, Hypertension, Speech disorder, Vomiting

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: Pt had similar rxn @ 40 w/Influenza;~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 891304014J

Write-up: Pt exp mental confusion, slurring of speech, hypertension, & vomiting immediately p/vax; treated in ER w/meds; Seem to be improving but MD had pt admitted to hosp for continued observation;

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