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This is VAERS ID 37802

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 37802
VAERS Form:
Age:82.9
Sex:Female
Location:Missouri
Vaccinated:1991-11-08
Onset:1991-11-21
Submitted:1991-11-27
Entered:1991-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1991-1992 / WYETH 4918146 / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: CHILLS, FEVER, 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:     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: Thyroid
Current Illness: NONE
Preexisting Conditions: mold, grasses, tres, flower, house dust; thyroid deficiency
Allergies:
Diagnostic Lab Data: Pneumonia-CXR;
CDC 'Split Type': mold, grasses, tres, flower, house dust; thyroid deficiency

Write-up: 21NOV91 coughing, fever, chills, fatigue, weakness; hospitalized 24NOV91 MD does not feel condition is assoc w/flu shot;


Changed on 12/8/2009

VAERS ID: 37802 Before After
VAERS Form:
Age:82.9
Sex:Female
Location:Missouri
Vaccinated:1991-11-08
Onset:1991-11-21
Submitted:1991-11-27
Entered:1991-12-10 1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1991-1992 INFLUENZA (SEASONAL) (NO BRAND NAME, 91-92) / WYETH WYETH PHARMACEUTICALS, INC 4918146 / - LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Asthenia, Chills, Cough, Pyrexia, CHILLS, FEVER, 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:     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: Thyroid
Current Illness: NONE
Preexisting Conditions: mold, grasses, tres, flower, house dust; thyroid deficiency
Allergies:
Diagnostic Lab Data: Pneumonia-CXR;
CDC 'Split Type': mold, grasses, tres, flower, house dust; thyroid deficiency MO9194

Write-up: 21NOV91 coughing, fever, chills, fatigue, weakness; hospitalized 24NOV91 MD does not feel condition is assoc w/flu shot;


Changed on 8/31/2010

VAERS ID: 37802 Before After
VAERS Form:
Age:82.9
Sex:Female
Location:Missouri
Vaccinated:1991-11-08
Onset:1991-11-21
Submitted:1991-11-27
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 91-92) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4918146 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Chills, Cough, 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:     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: Thyroid
Current Illness: NONE
Preexisting Conditions: mold, grasses, tres, flower, house dust; thyroid deficiency
Allergies:
Diagnostic Lab Data: Pneumonia-CXR;
CDC 'Split Type': MO9194

Write-up: 21NOV91 coughing, fever, chills, fatigue, weakness; hospitalized 24NOV91 MD does not feel condition is assoc w/flu shot;


Changed on 7/7/2013

VAERS ID: 37802 Before After
VAERS Form:
Age:82.9
Sex:Female
Location:Missouri
Vaccinated:1991-11-08
Onset:1991-11-21
Submitted:1991-11-27
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / - LA / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Chills, Cough, 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:     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: Thyroid
Current Illness: NONE
Preexisting Conditions: mold, grasses, tres, flower, house dust; thyroid deficiency
Allergies:
Diagnostic Lab Data: Pneumonia-CXR;
CDC 'Split Type': MO9194

Write-up: 21NOV91 coughing, fever, chills, fatigue, weakness; hospitalized 24NOV91 MD does not feel condition is assoc w/flu shot;


Changed on 12/14/2016

VAERS ID: 37802 Before After
VAERS Form:
Age:82.9
Sex:Female
Location:Missouri
Vaccinated:1991-11-08
Onset:1991-11-21
Submitted:1991-11-27
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / - LA / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Chills, Cough, 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:     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: Thyroid
Current Illness: NONE
Preexisting Conditions: mold, grasses, tres, flower, house dust; thyroid deficiency
Allergies:
Diagnostic Lab Data: Pneumonia-CXR;
CDC 'Split Type': MO9194

Write-up: 21NOV91 coughing, fever, chills, fatigue, weakness; hospitalized 24NOV91 MD does not feel condition is assoc w/flu shot;


Changed on 2/14/2017

VAERS ID: 37802 Before After
VAERS Form:
Age:82.9 82.0
Sex:Female
Location:Missouri
Vaccinated:1991-11-08
Onset:1991-11-21
Submitted:1991-11-27
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Chills, Cough, 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:     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: Thyroid
Current Illness: NONE
Preexisting Conditions: mold, grasses, tres, flower, house dust; thyroid deficiency
Allergies:
Diagnostic Lab Data: Pneumonia-CXR;
CDC 'Split Type': MO9194

Write-up: 21NOV91 coughing, fever, chills, fatigue, weakness; hospitalized 24NOV91 MD does not feel condition is assoc w/flu shot;


Changed on 5/14/2017

VAERS ID: 37802 Before After
VAERS Form:
Age:82.0
Sex:Female
Location:Missouri
Vaccinated:1991-11-08
Onset:1991-11-21
Submitted:1991-11-27
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Chills, Cough, 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:     Extended hospital stay? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: Thyroid
Current Illness: NONE
Preexisting Conditions: mold, grasses, tres, flower, house dust; thyroid deficiency
Allergies:
Diagnostic Lab Data: Pneumonia-CXR;
CDC 'Split Type': MO9194

Write-up: 21NOV91 coughing, fever, chills, fatigue, weakness; hospitalized 24NOV91 MD does not feel condition is assoc w/flu shot;


Changed on 9/14/2017

VAERS ID: 37802 Before After
VAERS Form:(blank) 1
Age:82.0
Sex:Female
Location:Missouri
Vaccinated:1991-11-08
Onset:1991-11-21
Submitted:1991-11-27
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / - UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Chills, Cough, 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:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Thyroid
Current Illness: NONE
Preexisting Conditions: mold, grasses, tres, flower, house dust; thyroid deficiency
Allergies:
Diagnostic Lab Data: Pneumonia-CXR;
CDC 'Split Type': MO9194

Write-up: 21NOV91 coughing, fever, chills, fatigue, weakness; hospitalized 24NOV91 MD does not feel condition is assoc w/flu shot;


Changed on 2/14/2018

VAERS ID: 37802 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Missouri
Vaccinated:1991-11-08
Onset:1991-11-21
Submitted:1991-11-27
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Chills, Cough, 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:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Thyroid
Current Illness: NONE
Preexisting Conditions: mold, grasses, tres, flower, house dust; thyroid deficiency
Allergies:
Diagnostic Lab Data: Pneumonia-CXR;
CDC 'Split Type': MO9194

Write-up: 21NOV91 coughing, fever, chills, fatigue, weakness; hospitalized 24NOV91 MD does not feel condition is assoc w/flu shot;


Changed on 6/14/2018

VAERS ID: 37802 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Missouri
Vaccinated:1991-11-08
Onset:1991-11-21
Submitted:1991-11-27
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Chills, Cough, 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:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Thyroid
Current Illness: NONE
Preexisting Conditions: mold, grasses, tres, flower, house dust; thyroid deficiency
Allergies:
Diagnostic Lab Data: Pneumonia-CXR;
CDC 'Split Type': MO9194

Write-up: 21NOV91 coughing, fever, chills, fatigue, weakness; hospitalized 24NOV91 MD does not feel condition is assoc w/flu shot;


Changed on 8/14/2018

VAERS ID: 37802 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Missouri
Vaccinated:1991-11-08
Onset:1991-11-21
Submitted:1991-11-27
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Chills, Cough, 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:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Thyroid
Current Illness: NONE
Preexisting Conditions: mold, grasses, tres, flower, house dust; thyroid deficiency
Allergies:
Diagnostic Lab Data: Pneumonia-CXR;
CDC 'Split Type': MO9194

Write-up: 21NOV91 coughing, fever, chills, fatigue, weakness; hospitalized 24NOV91 MD does not feel condition is assoc w/flu shot;


Changed on 9/14/2018

VAERS ID: 37802 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Missouri
Vaccinated:1991-11-08
Onset:1991-11-21
Submitted:1991-11-27
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Chills, Cough, 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:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Thyroid
Current Illness: NONE
Preexisting Conditions: mold, grasses, tres, flower, house dust; thyroid deficiency
Allergies:
Diagnostic Lab Data: Pneumonia-CXR;
CDC 'Split Type': MO9194

Write-up: 21NOV91 coughing, fever, chills, fatigue, weakness; hospitalized 24NOV91 MD does not feel condition is assoc w/flu shot;


Changed on 10/14/2018

VAERS ID: 37802 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Missouri
Vaccinated:1991-11-08
Onset:1991-11-21
Submitted:1991-11-27
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918146 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Chills, Cough, 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:     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Thyroid
Current Illness: NONE
Preexisting Conditions: mold, grasses, tres, flower, house dust; thyroid deficiency
Allergies:
Diagnostic Lab Data: Pneumonia-CXR;
CDC 'Split Type': MO9194

Write-up: 21NOV91 coughing, fever, chills, fatigue, weakness; hospitalized 24NOV91 MD does not feel condition is assoc w/flu shot;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=37802&WAYBACKHISTORY=ON


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