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This is VAERS ID 40947

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 40947
VAERS Form:
Age:64.7
Sex:Female
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-31
Submitted:1992-03-11
Entered:1992-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1991-1992 / WYETH 4918151 / - LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: HYPOKINESIA, 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:
Current Illness: NONE
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data: x-ray pending;
CDC 'Split Type':

Write-up: Pt devel pain & dec ROM in arm where the vax was recvd;


Changed on 12/8/2009

VAERS ID: 40947 Before After
VAERS Form:
Age:64.7
Sex:Female
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-31
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 / - LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Hypokinesia, Pain, HYPOKINESIA, 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:
Current Illness: NONE
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data: x-ray pending;
CDC 'Split Type': (blank) MD92022

Write-up: Pt devel pain & dec ROM in arm where the vax was recvd;


Changed on 8/31/2010

VAERS ID: 40947 Before After
VAERS Form:
Age:64.7
Sex:Female
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-31
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 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Hypokinesia, 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:
Current Illness: NONE
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data: x-ray pending;
CDC 'Split Type': MD92022

Write-up: Pt devel pain & dec ROM in arm where the vax was recvd;


Changed on 7/7/2013

VAERS ID: 40947 Before After
VAERS Form:
Age:64.7
Sex:Female
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-31
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / - LA / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Hypokinesia, 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:
Current Illness: NONE
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data: x-ray pending;
CDC 'Split Type': MD92022

Write-up: Pt devel pain & dec ROM in arm where the vax was recvd;


Changed on 12/14/2016

VAERS ID: 40947 Before After
VAERS Form:
Age:64.7
Sex:Female
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-31
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / - LA / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Hypokinesia, 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:
Current Illness: NONE
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data: x-ray pending;
CDC 'Split Type': MD92022

Write-up: Pt devel pain & dec ROM in arm where the vax was recvd;


Changed on 2/14/2017

VAERS ID: 40947 Before After
VAERS Form:
Age:64.7 64.0
Sex:Female
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-31
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Hypokinesia, 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:
Current Illness: NONE
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data: x-ray pending;
CDC 'Split Type': MD92022

Write-up: Pt devel pain & dec ROM in arm where the vax was recvd;


Changed on 5/14/2017

VAERS ID: 40947 Before After
VAERS Form:
Age:64.0
Sex:Female
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-31
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / - LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Hypokinesia, 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:
Current Illness: NONE
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data: x-ray pending;
CDC 'Split Type': MD92022

Write-up: Pt devel pain & dec ROM in arm where the vax was recvd;


Changed on 9/14/2017

VAERS ID: 40947 Before After
VAERS Form:(blank) 1
Age:64.0
Sex:Female
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-31
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / - UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Hypokinesia, 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:
Current Illness: NONE
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data: x-ray pending;
CDC 'Split Type': MD92022

Write-up: Pt devel pain & dec ROM in arm where the vax was recvd;


Changed on 2/14/2018

VAERS ID: 40947 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-31
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Hypokinesia, 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:
Current Illness: NONE
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data: x-ray pending;
CDC 'Split Type': MD92022

Write-up: Pt devel pain & dec ROM in arm where the vax was recvd;


Changed on 6/14/2018

VAERS ID: 40947 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-31
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Hypokinesia, 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:
Current Illness: NONE
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data: x-ray pending;
CDC 'Split Type': MD92022

Write-up: Pt devel pain & dec ROM in arm where the vax was recvd;


Changed on 8/14/2018

VAERS ID: 40947 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-31
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Hypokinesia, 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:
Current Illness: NONE
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data: x-ray pending;
CDC 'Split Type': MD92022

Write-up: Pt devel pain & dec ROM in arm where the vax was recvd;


Changed on 9/14/2018

VAERS ID: 40947 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-31
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Hypokinesia, 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:
Current Illness: NONE
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data: x-ray pending;
CDC 'Split Type': MD92022

Write-up: Pt devel pain & dec ROM in arm where the vax was recvd;


Changed on 10/14/2018

VAERS ID: 40947 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Maryland
Vaccinated:1991-10-22
Onset:1991-10-31
Submitted:1992-03-11
Entered:1992-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918151 / UNK LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Hypokinesia, 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:
Current Illness: NONE
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data: x-ray pending;
CDC 'Split Type': MD92022

Write-up: Pt devel pain & dec ROM in arm where the vax was recvd;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=40947&WAYBACKHISTORY=ON


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