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This is VAERS ID 40946

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 40946
VAERS Form:
Age:72.8
Sex:Male
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-25
Submitted:1992-03-11
Entered:1992-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1991-1992 / WYETH 4918151 / 0 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: PAIN INJECT SITE

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: bladder cancer
Preexisting Conditions: bladder cancer
Allergies:
Diagnostic Lab Data: x-ray of arm; no fracture 3FEB92;
CDC 'Split Type':

Write-up: Pt c/o onset of continuous pain in arm @ site of inject;


Changed on 12/8/2009

VAERS ID: 40946 Before After
VAERS Form:
Age:72.8
Sex:Male
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-25
Submitted:1992-03-11
Entered:1992-04-03 1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1991-1992 INFLUENZA (SEASONAL) (NO BRAND NAME, 91-92) / WYETH WYETH PHARMACEUTICALS, INC 4918151 / 0 LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Injection site pain, PAIN INJECT SITE

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: bladder cancer
Preexisting Conditions: bladder cancer
Allergies:
Diagnostic Lab Data: x-ray of arm; no fracture 3FEB92;
CDC 'Split Type': (blank) MD92021

Write-up: Pt c/o onset of continuous pain in arm @ site of inject;


Changed on 8/31/2010

VAERS ID: 40946 Before After
VAERS Form:
Age:72.8
Sex:Male
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-25
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 91-92) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4918151 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: bladder cancer
Preexisting Conditions: bladder cancer
Allergies:
Diagnostic Lab Data: x-ray of arm; no fracture 3FEB92;
CDC 'Split Type': MD92021

Write-up: Pt c/o onset of continuous pain in arm @ site of inject;


Changed on 7/7/2013

VAERS ID: 40946 Before After
VAERS Form:
Age:72.8
Sex:Male
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-25
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / 0 LA / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: bladder cancer
Preexisting Conditions: bladder cancer
Allergies:
Diagnostic Lab Data: x-ray of arm; no fracture 3FEB92;
CDC 'Split Type': MD92021

Write-up: Pt c/o onset of continuous pain in arm @ site of inject;


Changed on 12/14/2016

VAERS ID: 40946 Before After
VAERS Form:
Age:72.8
Sex:Male
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-25
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / 0 LA / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: bladder cancer
Preexisting Conditions: bladder cancer
Allergies:
Diagnostic Lab Data: x-ray of arm; no fracture 3FEB92;
CDC 'Split Type': MD92021

Write-up: Pt c/o onset of continuous pain in arm @ site of inject;


Changed on 2/14/2017

VAERS ID: 40946 Before After
VAERS Form:
Age:72.8 72.0
Sex:Male
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-25
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: bladder cancer
Preexisting Conditions: bladder cancer
Allergies:
Diagnostic Lab Data: x-ray of arm; no fracture 3FEB92;
CDC 'Split Type': MD92021

Write-up: Pt c/o onset of continuous pain in arm @ site of inject;


Changed on 5/14/2017

VAERS ID: 40946 Before After
VAERS Form:
Age:72.0
Sex:Male
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-25
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: bladder cancer
Preexisting Conditions: bladder cancer
Allergies:
Diagnostic Lab Data: x-ray of arm; no fracture 3FEB92;
CDC 'Split Type': MD92021

Write-up: Pt c/o onset of continuous pain in arm @ site of inject;


Changed on 9/14/2017

VAERS ID: 40946 Before After
VAERS Form:(blank) 1
Age:72.0
Sex:Male
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-25
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / 0 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: bladder cancer
Preexisting Conditions: bladder cancer
Allergies:
Diagnostic Lab Data: x-ray of arm; no fracture 3FEB92;
CDC 'Split Type': MD92021

Write-up: Pt c/o onset of continuous pain in arm @ site of inject;


Changed on 2/14/2018

VAERS ID: 40946 Before After
VAERS Form:1
Age:72.0
Sex:Male
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-25
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: bladder cancer
Preexisting Conditions: bladder cancer
Allergies:
Diagnostic Lab Data: x-ray of arm; no fracture 3FEB92;
CDC 'Split Type': MD92021

Write-up: Pt c/o onset of continuous pain in arm @ site of inject;


Changed on 6/14/2018

VAERS ID: 40946 Before After
VAERS Form:1
Age:72.0
Sex:Male
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-25
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: bladder cancer
Preexisting Conditions: bladder cancer
Allergies:
Diagnostic Lab Data: x-ray of arm; no fracture 3FEB92;
CDC 'Split Type': MD92021

Write-up: Pt c/o onset of continuous pain in arm @ site of inject;


Changed on 8/14/2018

VAERS ID: 40946 Before After
VAERS Form:1
Age:72.0
Sex:Male
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-25
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: bladder cancer
Preexisting Conditions: bladder cancer
Allergies:
Diagnostic Lab Data: x-ray of arm; no fracture 3FEB92;
CDC 'Split Type': MD92021

Write-up: Pt c/o onset of continuous pain in arm @ site of inject;


Changed on 9/14/2018

VAERS ID: 40946 Before After
VAERS Form:1
Age:72.0
Sex:Male
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-25
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: bladder cancer
Preexisting Conditions: bladder cancer
Allergies:
Diagnostic Lab Data: x-ray of arm; no fracture 3FEB92;
CDC 'Split Type': MD92021

Write-up: Pt c/o onset of continuous pain in arm @ site of inject;


Changed on 10/14/2018

VAERS ID: 40946 Before After
VAERS Form:1
Age:72.0
Sex:Male
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-25
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: bladder cancer
Preexisting Conditions: bladder cancer
Allergies:
Diagnostic Lab Data: x-ray of arm; no fracture 3FEB92;
CDC 'Split Type': MD92021

Write-up: Pt c/o onset of continuous pain in arm @ site of inject;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=40946&WAYBACKHISTORY=ON


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