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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 36629 |
VAERS Form: | |
Age: | 71.3 |
Sex: | Female |
Location: | Michigan |
Vaccinated: | 1991-09-27 |
Onset: | 1991-09-28 |
Submitted: | 1991-10-01 |
Entered: | 1991-12-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA VACCINE 1991-1992 / WYETH | 4918202 / - | A / IM |
Administered by: Public Purchased by: Unknown
Symptoms: FEVER, ASTHENIA, MYASTHENIA, HYPERTENS, CEREBROVASC ACCID
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: 8
Write-up: C/o lt sided weakness became weak, lost strength; BP 190/100, t103.5 treated & released @ ER 28SEP; hospitalized 4 days later w/pneumonia ? sl stroke;
Vaccinated: | 1991-09-27 |
Onset: | 1991-09-28 |
Submitted: | 1991-10-01 |
Entered: | 1991-12-03 1991-11-25 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA VACCINE 1991-1992 INFLUENZA (SEASONAL) (NO BRAND NAME, 91-92) / WYETH WYETH PHARMACEUTICALS, INC | 4918202 / - | A / IM |
Administered by: Public Purchased by: Unknown Public
Symptoms: Asthenia, Cerebrovascular accident, Hypertension, Myasthenic syndrome, Pneumonia, Pyrexia, FEVER, ASTHENIA, MYASTHENIA, HYPERTENS, CEREBROVASC ACCID
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: 8
Write-up: C/o lt sided weakness became weak, lost strength; BP 190/100, t103.5 treated & released @ ER 28SEP; hospitalized 4 days later w/pneumonia ? sl stroke;
Vaccinated: | 1991-09-27 |
Onset: | 1991-09-28 |
Submitted: | 1991-10-01 |
Entered: | 1991-11-25 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 91-92) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH | 4918202 / - | A / IM |
Administered by: Public Purchased by: Public
Symptoms: Asthenia, Cerebrovascular accident, Hypertension, Myasthenic syndrome, Pneumonia, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8
Write-up: C/o lt sided weakness became weak, lost strength; BP 190/100, t103.5 treated & released @ ER 28SEP; hospitalized 4 days later w/pneumonia ? sl stroke;
Vaccinated: | 1991-09-27 |
Onset: | 1991-09-28 |
Submitted: | 1991-10-01 |
Entered: | 1991-11-25 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4918202 / - | A / IM |
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4918202 / - | A / IM |
Administered by: Public Purchased by: Public
Symptoms: Asthenia, Cerebrovascular accident, Hypertension, Myasthenic syndrome, Pneumonia, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8
Write-up: C/o lt sided weakness became weak, lost strength; BP 190/100, t103.5 treated & released @ ER 28SEP; hospitalized 4 days later w/pneumonia ? sl stroke;
Vaccinated: | 1991-09-27 |
Onset: | 1991-09-28 |
Submitted: | 1991-10-01 |
Entered: | 1991-11-25 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4918202 / - | A / IM |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4918202 / - | A / IM |
Administered by: Public Purchased by: Public
Symptoms: Asthenia, Cerebrovascular accident, Hypertension, Myasthenic syndrome, Pneumonia, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8
Write-up: C/o lt sided weakness became weak, lost strength; BP 190/100, t103.5 treated & released @ ER 28SEP; hospitalized 4 days later w/pneumonia ? sl stroke;
Vaccinated: | 1991-09-27 |
Onset: | 1991-09-28 |
Submitted: | 1991-10-01 |
Entered: | 1991-11-25 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4918202 / - | A / IM |
Administered by: Public Purchased by: Public
Symptoms: Asthenia, Cerebrovascular accident, Hypertension, Myasthenic syndrome, Pneumonia, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8
Write-up: C/o lt sided weakness became weak, lost strength; BP 190/100, t103.5 treated & released @ ER 28SEP; hospitalized 4 days later w/pneumonia ? sl stroke;
Vaccinated: | 1991-09-27 |
Onset: | 1991-09-28 |
Submitted: | 1991-10-01 |
Entered: | 1991-11-25 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4918202 / - | A - / IM IM A |
Administered by: Public Purchased by: Public
Symptoms: Asthenia, Cerebrovascular accident, Hypertension, Myasthenic syndrome, Pneumonia, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8
Write-up: C/o lt sided weakness became weak, lost strength; BP 190/100, t103.5 treated & released @ ER 28SEP; hospitalized 4 days later w/pneumonia ? sl stroke;
Vaccinated: | 1991-09-27 |
Onset: | 1991-09-28 |
Submitted: | 1991-10-01 |
Entered: | 1991-11-25 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4918202 / - UNK | - / IM A |
Administered by: Public Purchased by: Public
Symptoms: Asthenia, Cerebrovascular accident, Hypertension, Myasthenic syndrome, Pneumonia, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8
Write-up: C/o lt sided weakness became weak, lost strength; BP 190/100, t103.5 treated & released @ ER 28SEP; hospitalized 4 days later w/pneumonia ? sl stroke;
Vaccinated: | 1991-09-27 |
Onset: | 1991-09-28 |
Submitted: | 1991-10-01 |
Entered: | 1991-11-25 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4918202 / UNK | - / IM A |
Administered by: Public Purchased by: Public
Symptoms: Asthenia, Cerebrovascular accident, Hypertension, Myasthenic syndrome, Pneumonia, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8
Write-up: C/o lt sided weakness became weak, lost strength; BP 190/100, t103.5 treated & released @ ER 28SEP; hospitalized 4 days later w/pneumonia ? sl stroke;
Vaccinated: | 1991-09-27 |
Onset: | 1991-09-28 |
Submitted: | 1991-10-01 |
Entered: | 1991-11-25 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4918202 / UNK | - / IM A |
Administered by: Public Purchased by: Public
Symptoms: Asthenia, Cerebrovascular accident, Hypertension, Myasthenic syndrome, Pneumonia, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8
Write-up: C/o lt sided weakness became weak, lost strength; BP 190/100, t103.5 treated & released @ ER 28SEP; hospitalized 4 days later w/pneumonia ? sl stroke;
Vaccinated: | 1991-09-27 |
Onset: | 1991-09-28 |
Submitted: | 1991-10-01 |
Entered: | 1991-11-25 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4918202 / UNK | - / IM A |
Administered by: Public Purchased by: Public
Symptoms: Asthenia, Cerebrovascular accident, Hypertension, Myasthenic syndrome, Pneumonia, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8
Write-up: C/o lt sided weakness became weak, lost strength; BP 190/100, t103.5 treated & released @ ER 28SEP; hospitalized 4 days later w/pneumonia ? sl stroke;
Vaccinated: | 1991-09-27 |
Onset: | 1991-09-28 |
Submitted: | 1991-10-01 |
Entered: | 1991-11-25 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4918202 / UNK | - / IM A |
Administered by: Public Purchased by: Public
Symptoms: Asthenia, Cerebrovascular accident, Hypertension, Myasthenic syndrome, Pneumonia, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8
Write-up: C/o lt sided weakness became weak, lost strength; BP 190/100, t103.5 treated & released @ ER 28SEP; hospitalized 4 days later w/pneumonia ? sl stroke;
Vaccinated: | 1991-09-27 |
Onset: | 1991-09-28 |
Submitted: | 1991-10-01 |
Entered: | 1991-11-25 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4918202 / UNK | - / IM A |
Administered by: Public Purchased by: Public
Symptoms: Asthenia, Cerebrovascular accident, Hypertension, Myasthenic syndrome, Pneumonia, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8
Write-up: C/o lt sided weakness became weak, lost strength; BP 190/100, t103.5 treated & released @ ER 28SEP; hospitalized 4 days later w/pneumonia ? sl stroke;
Vaccinated: | 1991-09-27 |
Onset: | 1991-09-28 |
Submitted: | 1991-10-01 |
Entered: | 1991-11-25 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4918202 / UNK | - / IM A |
Administered by: Public Purchased by: Public
Symptoms: Asthenia, Cerebrovascular accident, Hypertension, Myasthenic syndrome, Pneumonia, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8
Write-up: C/o lt sided weakness became weak, lost strength; BP 190/100, t103.5 treated & released @ ER 28SEP; hospitalized 4 days later w/pneumonia ? sl stroke;
Vaccinated: | 1991-09-27 |
Onset: | 1991-09-28 |
Submitted: | 1991-10-01 |
Entered: | 1991-11-25 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH | 4918202 / UNK | - / IM A |
Administered by: Public Purchased by: Public
Symptoms: Asthenia, Cerebrovascular accident, Hypertension, Myasthenic syndrome, Pneumonia, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 8
Write-up: C/o lt sided weakness became weak, lost strength; BP 190/100, t103.5 treated & released @ ER 28SEP; hospitalized 4 days later w/pneumonia ? sl stroke;
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