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This is VAERS ID 41862

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 41862
VAERS Form:
Age:68.0
Sex:Male
Location:Nebraska
Vaccinated:1991-12-12
Onset:1991-12-22
Submitted:1992-04-30
Entered:1992-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1991-1992 / CONNAUGHT LABS 1F21216 / 6 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: MALAISE, ASTHENIA, EDEMA PERIPH, ANEMIA, MYELOFIBROSIS

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 10 days p/flu vax felt poorly-tired; MD tests done found to be very anemic; dx rare acute myleofibrosis of the bone; gets blood transfusions every 2 wks; has also had ear infects & now swelling of the feet is very weak;


Changed on 12/8/2009

VAERS ID: 41862 Before After
VAERS Form:
Age:68.0
Sex:Male
Location:Nebraska
Vaccinated:1991-12-12
Onset:1991-12-22
Submitted:1992-04-30
Entered:1992-05-14 1992-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1991-1992 INFLUENZA (SEASONAL) (FLUZONE 91-92) / CONNAUGHT LABS CONNAUGHT LABORATORIES 1F21216 / 6 LA / IM

Administered by: Public      Purchased by: Unknown Private
Symptoms: Anaemia, Asthenia, Malaise, Myelofibrosis, Oedema peripheral, Otitis media, MALAISE, ASTHENIA, EDEMA PERIPH, ANEMIA, MYELOFIBROSIS

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) NE9212

Write-up: 10 days p/flu vax felt poorly-tired; MD tests done found to be very anemic; dx rare acute myleofibrosis of the bone; gets blood transfusions every 2 wks; has also had ear infects & now swelling of the feet is very weak;


Changed on 8/31/2010

VAERS ID: 41862 Before After
VAERS Form:
Age:68.0
Sex:Male
Location:Nebraska
Vaccinated:1991-12-12
Onset:1991-12-22
Submitted:1992-04-30
Entered:1992-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 91-92) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21216 / 6 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Anaemia, Asthenia, Malaise, Myelofibrosis, Oedema peripheral, Otitis media

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NE9212

Write-up: 10 days p/flu vax felt poorly-tired; MD tests done found to be very anemic; dx rare acute myleofibrosis of the bone; gets blood transfusions every 2 wks; has also had ear infects & now swelling of the feet is very weak;


Changed on 4/13/2011

VAERS ID: 41862 Before After
VAERS Form:
Age:68.0
Sex:Male
Location:Nebraska
Vaccinated:1991-12-12
Onset:1991-12-22
Submitted:1992-04-30
Entered:1992-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21216 / 6 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Anaemia, Asthenia, Malaise, Myelofibrosis, Oedema peripheral, Otitis media

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NE9212

Write-up: 10 days p/flu vax felt poorly-tired; MD tests done found to be very anemic; dx rare acute myleofibrosis of the bone; gets blood transfusions every 2 wks; has also had ear infects & now swelling of the feet is very weak;


Changed on 5/13/2011

VAERS ID: 41862 Before After
VAERS Form:
Age:68.0
Sex:Male
Location:Nebraska
Vaccinated:1991-12-12
Onset:1991-12-22
Submitted:1992-04-30
Entered:1992-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21216 / 6 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Anaemia, Asthenia, Malaise, Myelofibrosis, Oedema peripheral, Otitis media

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NE9212

Write-up: 10 days p/flu vax felt poorly-tired; MD tests done found to be very anemic; dx rare acute myleofibrosis of the bone; gets blood transfusions every 2 wks; has also had ear infects & now swelling of the feet is very weak;


Changed on 6/11/2011

VAERS ID: 41862 Before After
VAERS Form:
Age:68.0
Sex:Male
Location:Nebraska
Vaccinated:1991-12-12
Onset:1991-12-22
Submitted:1992-04-30
Entered:1992-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21216 / 6 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Anaemia, Asthenia, Malaise, Myelofibrosis, Oedema peripheral, Otitis media

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NE9212

Write-up: 10 days p/flu vax felt poorly-tired; MD tests done found to be very anemic; dx rare acute myleofibrosis of the bone; gets blood transfusions every 2 wks; has also had ear infects & now swelling of the feet is very weak;


Changed on 7/7/2013

VAERS ID: 41862 Before After
VAERS Form:
Age:68.0
Sex:Male
Location:Nebraska
Vaccinated:1991-12-12
Onset:1991-12-22
Submitted:1992-04-30
Entered:1992-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21216 / 6 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21216 / 6 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Anaemia, Asthenia, Malaise, Myelofibrosis, Oedema peripheral, Otitis media

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NE9212

Write-up: 10 days p/flu vax felt poorly-tired; MD tests done found to be very anemic; dx rare acute myleofibrosis of the bone; gets blood transfusions every 2 wks; has also had ear infects & now swelling of the feet is very weak;


Changed on 5/14/2017

VAERS ID: 41862 Before After
VAERS Form:
Age:68.0
Sex:Male
Location:Nebraska
Vaccinated:1991-12-12
Onset:1991-12-22
Submitted:1992-04-30
Entered:1992-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21216 / 6 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Anaemia, Asthenia, Malaise, Myelofibrosis, Oedema peripheral, Otitis media

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NE9212

Write-up: 10 days p/flu vax felt poorly-tired; MD tests done found to be very anemic; dx rare acute myleofibrosis of the bone; gets blood transfusions every 2 wks; has also had ear infects & now swelling of the feet is very weak;


Changed on 9/14/2017

VAERS ID: 41862 Before After
VAERS Form:(blank) 1
Age:68.0
Sex:Male
Location:Nebraska
Vaccinated:1991-12-12
Onset:1991-12-22
Submitted:1992-04-30
Entered:1992-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21216 / 6 7+ LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Anaemia, Asthenia, Malaise, Myelofibrosis, Oedema peripheral, Otitis media

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NE9212

Write-up: 10 days p/flu vax felt poorly-tired; MD tests done found to be very anemic; dx rare acute myleofibrosis of the bone; gets blood transfusions every 2 wks; has also had ear infects & now swelling of the feet is very weak;


Changed on 2/14/2018

VAERS ID: 41862 Before After
VAERS Form:1
Age:68.0
Sex:Male
Location:Nebraska
Vaccinated:1991-12-12
Onset:1991-12-22
Submitted:1992-04-30
Entered:1992-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21216 / 7+ LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Anaemia, Asthenia, Malaise, Myelofibrosis, Oedema peripheral, Otitis media

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NE9212

Write-up: 10 days p/flu vax felt poorly-tired; MD tests done found to be very anemic; dx rare acute myleofibrosis of the bone; gets blood transfusions every 2 wks; has also had ear infects & now swelling of the feet is very weak;


Changed on 6/14/2018

VAERS ID: 41862 Before After
VAERS Form:1
Age:68.0
Sex:Male
Location:Nebraska
Vaccinated:1991-12-12
Onset:1991-12-22
Submitted:1992-04-30
Entered:1992-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21216 / 7+ LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Anaemia, Asthenia, Malaise, Myelofibrosis, Oedema peripheral, Otitis media

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NE9212

Write-up: 10 days p/flu vax felt poorly-tired; MD tests done found to be very anemic; dx rare acute myleofibrosis of the bone; gets blood transfusions every 2 wks; has also had ear infects & now swelling of the feet is very weak;


Changed on 8/14/2018

VAERS ID: 41862 Before After
VAERS Form:1
Age:68.0
Sex:Male
Location:Nebraska
Vaccinated:1991-12-12
Onset:1991-12-22
Submitted:1992-04-30
Entered:1992-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21216 / 7+ LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Anaemia, Asthenia, Malaise, Myelofibrosis, Oedema peripheral, Otitis media

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NE9212

Write-up: 10 days p/flu vax felt poorly-tired; MD tests done found to be very anemic; dx rare acute myleofibrosis of the bone; gets blood transfusions every 2 wks; has also had ear infects & now swelling of the feet is very weak;


Changed on 9/14/2018

VAERS ID: 41862 Before After
VAERS Form:1
Age:68.0
Sex:Male
Location:Nebraska
Vaccinated:1991-12-12
Onset:1991-12-22
Submitted:1992-04-30
Entered:1992-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21216 / 7+ LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Anaemia, Asthenia, Malaise, Myelofibrosis, Oedema peripheral, Otitis media

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NE9212

Write-up: 10 days p/flu vax felt poorly-tired; MD tests done found to be very anemic; dx rare acute myleofibrosis of the bone; gets blood transfusions every 2 wks; has also had ear infects & now swelling of the feet is very weak;


Changed on 10/14/2018

VAERS ID: 41862 Before After
VAERS Form:1
Age:68.0
Sex:Male
Location:Nebraska
Vaccinated:1991-12-12
Onset:1991-12-22
Submitted:1992-04-30
Entered:1992-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21216 / 7+ LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Anaemia, Asthenia, Malaise, Myelofibrosis, Oedema peripheral, Otitis media

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NE9212

Write-up: 10 days p/flu vax felt poorly-tired; MD tests done found to be very anemic; dx rare acute myleofibrosis of the bone; gets blood transfusions every 2 wks; has also had ear infects & now swelling of the feet is very weak;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=41862&WAYBACKHISTORY=ON


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