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This is VAERS ID 37808

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 37808
VAERS Form:
Age:49.9
Sex:Male
Location:Florida
Vaccinated:1991-11-21
Onset:1991-11-21
Submitted:1991-11-26
Entered:1991-12-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1991-1992 / PARKE-DAVIS - / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: FEVER, DIARRHEA, SHOCK, OLIGURIA, ALKALOSIS

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: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: AZT (Retrovin), Bactrim, Diflucan
Current Illness: Pt is HIV pos
Preexisting Conditions: Pt has had crytococcal meningitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Shock, metabolic alkalosis, high fever & diarrhea are reported p/recvd flu vax 21NOV91; pt has had cryptococcal meningitis & is HIV positive; Seen in ER t106.7F in shock & diarrhea admitted to hosp & found to be oliguric;


Changed on 12/8/2009

VAERS ID: 37808 Before After
VAERS Form:
Age:49.9
Sex:Male
Location:Florida
Vaccinated:1991-11-21
Onset:1991-11-21
Submitted:1991-11-26
Entered:1991-12-12 1991-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1991-1992 INFLUENZA (SEASONAL) (FLUOGEN 91-92) / PARKE-DAVIS - / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Alkalosis, Diarrhoea, Oliguria, Pyrexia, Shock, FEVER, DIARRHEA, SHOCK, OLIGURIA, ALKALOSIS

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: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: AZT (Retrovin), Bactrim, Diflucan
Current Illness: Pt is HIV pos
Preexisting Conditions: Pt has had crytococcal meningitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 914091068

Write-up: Shock, metabolic alkalosis, high fever & diarrhea are reported p/recvd flu vax 21NOV91; pt has had cryptococcal meningitis & is HIV positive; Seen in ER t106.7F in shock & diarrhea admitted to hosp & found to be oliguric;


Changed on 8/31/2010

VAERS ID: 37808 Before After
VAERS Form:
Age:49.9
Sex:Male
Location:Florida
Vaccinated:1991-11-21
Onset:1991-11-21
Submitted:1991-11-26
Entered:1991-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 91-92) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Alkalosis, Diarrhoea, Oliguria, Pyrexia, Shock

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: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: AZT (Retrovin), Bactrim, Diflucan
Current Illness: Pt is HIV pos
Preexisting Conditions: Pt has had crytococcal meningitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914091068

Write-up: Shock, metabolic alkalosis, high fever & diarrhea are reported p/recvd flu vax 21NOV91; pt has had cryptococcal meningitis & is HIV positive; Seen in ER t106.7F in shock & diarrhea admitted to hosp & found to be oliguric;


Changed on 7/7/2013

VAERS ID: 37808 Before After
VAERS Form:
Age:49.9
Sex:Male
Location:Florida
Vaccinated:1991-11-21
Onset:1991-11-21
Submitted:1991-11-26
Entered:1991-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 - / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Alkalosis, Diarrhoea, Oliguria, Pyrexia, Shock

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: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: AZT (Retrovin), Bactrim, Diflucan
Current Illness: Pt is HIV pos
Preexisting Conditions: Pt has had crytococcal meningitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914091068

Write-up: Shock, metabolic alkalosis, high fever & diarrhea are reported p/recvd flu vax 21NOV91; pt has had cryptococcal meningitis & is HIV positive; Seen in ER t106.7F in shock & diarrhea admitted to hosp & found to be oliguric;


Changed on 2/14/2017

VAERS ID: 37808 Before After
VAERS Form:
Age:49.9 49.0
Sex:Male
Location:Florida
Vaccinated:1991-11-21
Onset:1991-11-21
Submitted:1991-11-26
Entered:1991-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Alkalosis, Diarrhoea, Oliguria, Pyrexia, Shock

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: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications: AZT (Retrovin), Bactrim, Diflucan
Current Illness: Pt is HIV pos
Preexisting Conditions: Pt has had crytococcal meningitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914091068

Write-up: Shock, metabolic alkalosis, high fever & diarrhea are reported p/recvd flu vax 21NOV91; pt has had cryptococcal meningitis & is HIV positive; Seen in ER t106.7F in shock & diarrhea admitted to hosp & found to be oliguric;


Changed on 5/14/2017

VAERS ID: 37808 Before After
VAERS Form:
Age:49.0
Sex:Male
Location:Florida
Vaccinated:1991-11-21
Onset:1991-11-21
Submitted:1991-11-26
Entered:1991-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Alkalosis, Diarrhoea, Oliguria, Pyrexia, Shock

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: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: AZT (Retrovin), Bactrim, Diflucan
Current Illness: Pt is HIV pos
Preexisting Conditions: Pt has had crytococcal meningitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914091068

Write-up: Shock, metabolic alkalosis, high fever & diarrhea are reported p/recvd flu vax 21NOV91; pt has had cryptococcal meningitis & is HIV positive; Seen in ER t106.7F in shock & diarrhea admitted to hosp & found to be oliguric;


Changed on 9/14/2017

VAERS ID: 37808 Before After
VAERS Form:(blank) 1
Age:49.0
Sex:Male
Location:Florida
Vaccinated:1991-11-21
Onset:1991-11-21
Submitted:1991-11-26
Entered:1991-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 0 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Alkalosis, Diarrhoea, Oliguria, Pyrexia, Shock

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: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: AZT (Retrovin), Bactrim, Diflucan
Current Illness: Pt is HIV pos
Preexisting Conditions: Pt has had crytococcal meningitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914091068

Write-up: Shock, metabolic alkalosis, high fever & diarrhea are reported p/recvd flu vax 21NOV91; pt has had cryptococcal meningitis & is HIV positive; Seen in ER t106.7F in shock & diarrhea admitted to hosp & found to be oliguric;


Changed on 2/14/2018

VAERS ID: 37808 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:Florida
Vaccinated:1991-11-21
Onset:1991-11-21
Submitted:1991-11-26
Entered:1991-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Alkalosis, Diarrhoea, Oliguria, Pyrexia, Shock

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: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: AZT (Retrovin), Bactrim, Diflucan
Current Illness: Pt is HIV pos
Preexisting Conditions: Pt has had crytococcal meningitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914091068

Write-up: Shock, metabolic alkalosis, high fever & diarrhea are reported p/recvd flu vax 21NOV91; pt has had cryptococcal meningitis & is HIV positive; Seen in ER t106.7F in shock & diarrhea admitted to hosp & found to be oliguric;


Changed on 6/14/2018

VAERS ID: 37808 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:Florida
Vaccinated:1991-11-21
Onset:1991-11-21
Submitted:1991-11-26
Entered:1991-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Alkalosis, Diarrhoea, Oliguria, Pyrexia, Shock

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: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: AZT (Retrovin), Bactrim, Diflucan
Current Illness: Pt is HIV pos
Preexisting Conditions: Pt has had crytococcal meningitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914091068

Write-up: Shock, metabolic alkalosis, high fever & diarrhea are reported p/recvd flu vax 21NOV91; pt has had cryptococcal meningitis & is HIV positive; Seen in ER t106.7F in shock & diarrhea admitted to hosp & found to be oliguric;


Changed on 8/14/2018

VAERS ID: 37808 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:Florida
Vaccinated:1991-11-21
Onset:1991-11-21
Submitted:1991-11-26
Entered:1991-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Alkalosis, Diarrhoea, Oliguria, Pyrexia, Shock

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: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: AZT (Retrovin), Bactrim, Diflucan
Current Illness: Pt is HIV pos
Preexisting Conditions: Pt has had crytococcal meningitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914091068

Write-up: Shock, metabolic alkalosis, high fever & diarrhea are reported p/recvd flu vax 21NOV91; pt has had cryptococcal meningitis & is HIV positive; Seen in ER t106.7F in shock & diarrhea admitted to hosp & found to be oliguric;


Changed on 9/14/2018

VAERS ID: 37808 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:Florida
Vaccinated:1991-11-21
Onset:1991-11-21
Submitted:1991-11-26
Entered:1991-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Alkalosis, Diarrhoea, Oliguria, Pyrexia, Shock

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: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: AZT (Retrovin), Bactrim, Diflucan
Current Illness: Pt is HIV pos
Preexisting Conditions: Pt has had crytococcal meningitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914091068

Write-up: Shock, metabolic alkalosis, high fever & diarrhea are reported p/recvd flu vax 21NOV91; pt has had cryptococcal meningitis & is HIV positive; Seen in ER t106.7F in shock & diarrhea admitted to hosp & found to be oliguric;


Changed on 10/14/2018

VAERS ID: 37808 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:Florida
Vaccinated:1991-11-21
Onset:1991-11-21
Submitted:1991-11-26
Entered:1991-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Alkalosis, Diarrhoea, Oliguria, Pyrexia, Shock

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: 6     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: AZT (Retrovin), Bactrim, Diflucan
Current Illness: Pt is HIV pos
Preexisting Conditions: Pt has had crytococcal meningitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 914091068

Write-up: Shock, metabolic alkalosis, high fever & diarrhea are reported p/recvd flu vax 21NOV91; pt has had cryptococcal meningitis & is HIV positive; Seen in ER t106.7F in shock & diarrhea admitted to hosp & found to be oliguric;

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