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This is VAERS ID 46114

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 46114
VAERS Form:
Age:67.8
Sex:Female
Location:Louisiana
Vaccinated:1991-11-01
Onset:1991-11-16
Submitted:0000-00-00
Entered:1992-10-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1991-1992 / CONNAUGHT LABS 1F21219 / 0 RA / -

Administered by: Public      Purchased by: Unknown
Symptoms: ANEMIA HYPOCHROM, HYPERESTHESIA, LAB TEST ABNORM, LEUKOPENIA, HYPERGLYCEM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: HGB-11.5; HCT 35.4, RDW 16.1;
CDC 'Split Type':

Write-up: about 2 wks p/shot woke up 2AM w/severe pain lower back & rt leg to knee 16NOV91; pt went to ER & adm to hosp seen by bone & joint specialist; nerve problem, glucose of 136; meralgia paresthetica; pneumonia, Hgb 11.5, WBC 4,500;


Changed on 12/8/2009

VAERS ID: 46114 Before After
VAERS Form:
Age:67.8
Sex:Female
Location:Louisiana
Vaccinated:1991-11-01
Onset:1991-11-16
Submitted:0000-00-00
Entered:1992-10-16 1992-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1991-1992 INFLUENZA (SEASONAL) (FLUZONE 91-92) / CONNAUGHT LABS CONNAUGHT LABORATORIES 1F21219 / 0 RA / -

Administered by: Public      Purchased by: Unknown Public
Symptoms: Back pain, Hyperaesthesia, Hyperglycaemia, Hypochromic anaemia, Laboratory test abnormal, Leukopenia, Neuropathy, Pneumonia, ANEMIA HYPOCHROM, HYPERESTHESIA, LAB TEST ABNORM, LEUKOPENIA, HYPERGLYCEM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: HGB-11.5; HCT 35.4, RDW 16.1;
CDC 'Split Type': (blank) LA921004

Write-up: about 2 wks p/shot woke up 2AM w/severe pain lower back & rt leg to knee 16NOV91; pt went to ER & adm to hosp seen by bone & joint specialist; nerve problem, glucose of 136; meralgia paresthetica; pneumonia, Hgb 11.5, WBC 4,500;


Changed on 8/31/2010

VAERS ID: 46114 Before After
VAERS Form:
Age:67.8
Sex:Female
Location:Louisiana
Vaccinated:1991-11-01
Onset:1991-11-16
Submitted:0000-00-00
Entered:1992-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 91-92) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21219 / 0 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Back pain, Hyperaesthesia, Hyperglycaemia, Hypochromic anaemia, Laboratory test abnormal, Leukopenia, Neuropathy, Pneumonia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: HGB-11.5; HCT 35.4, RDW 16.1;
CDC 'Split Type': LA921004

Write-up: about 2 wks p/shot woke up 2AM w/severe pain lower back & rt leg to knee 16NOV91; pt went to ER & adm to hosp seen by bone & joint specialist; nerve problem, glucose of 136; meralgia paresthetica; pneumonia, Hgb 11.5, WBC 4,500;


Changed on 7/7/2013

VAERS ID: 46114 Before After
VAERS Form:
Age:67.8
Sex:Female
Location:Louisiana
Vaccinated:1991-11-01
Onset:1991-11-16
Submitted:0000-00-00
Entered:1992-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21219 / 0 RA / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21219 / 0 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Back pain, Hyperaesthesia, Hyperglycaemia, Hypochromic anaemia, Laboratory test abnormal, Leukopenia, Neuropathy, Pneumonia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: HGB-11.5; HCT 35.4, RDW 16.1;
CDC 'Split Type': LA921004

Write-up: about 2 wks p/shot woke up 2AM w/severe pain lower back & rt leg to knee 16NOV91; pt went to ER & adm to hosp seen by bone & joint specialist; nerve problem, glucose of 136; meralgia paresthetica; pneumonia, Hgb 11.5, WBC 4,500;


Changed on 2/14/2017

VAERS ID: 46114 Before After
VAERS Form:
Age:67.8 67.0
Sex:Female
Location:Louisiana
Vaccinated:1991-11-01
Onset:1991-11-16
Submitted:0000-00-00
Entered:1992-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21219 / 0 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Back pain, Hyperaesthesia, Hyperglycaemia, Hypochromic anaemia, Laboratory test abnormal, Leukopenia, Neuropathy, Pneumonia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: HGB-11.5; HCT 35.4, RDW 16.1;
CDC 'Split Type': LA921004

Write-up: about 2 wks p/shot woke up 2AM w/severe pain lower back & rt leg to knee 16NOV91; pt went to ER & adm to hosp seen by bone & joint specialist; nerve problem, glucose of 136; meralgia paresthetica; pneumonia, Hgb 11.5, WBC 4,500;


Changed on 5/14/2017

VAERS ID: 46114 Before After
VAERS Form:
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1991-11-01
Onset:1991-11-16
Submitted:0000-00-00
Entered:1992-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21219 / 0 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Back pain, Hyperaesthesia, Hyperglycaemia, Hypochromic anaemia, Laboratory test abnormal, Leukopenia, Neuropathy, Pneumonia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: HGB-11.5; HCT 35.4, RDW 16.1;
CDC 'Split Type': LA921004

Write-up: about 2 wks p/shot woke up 2AM w/severe pain lower back & rt leg to knee 16NOV91; pt went to ER & adm to hosp seen by bone & joint specialist; nerve problem, glucose of 136; meralgia paresthetica; pneumonia, Hgb 11.5, WBC 4,500;


Changed on 9/14/2017

VAERS ID: 46114 Before After
VAERS Form:(blank) 1
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1991-11-01
Onset:1991-11-16
Submitted:0000-00-00
Entered:1992-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21219 / 0 1 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Back pain, Hyperaesthesia, Hyperglycaemia, Hypochromic anaemia, Laboratory test abnormal, Leukopenia, Neuropathy, Pneumonia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: HGB-11.5; HCT 35.4, RDW 16.1;
CDC 'Split Type': LA921004

Write-up: about 2 wks p/shot woke up 2AM w/severe pain lower back & rt leg to knee 16NOV91; pt went to ER & adm to hosp seen by bone & joint specialist; nerve problem, glucose of 136; meralgia paresthetica; pneumonia, Hgb 11.5, WBC 4,500;


Changed on 2/14/2018

VAERS ID: 46114 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1991-11-01
Onset:1991-11-16
Submitted:0000-00-00
Entered:1992-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21219 / 1 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Back pain, Hyperaesthesia, Hyperglycaemia, Hypochromic anaemia, Laboratory test abnormal, Leukopenia, Neuropathy, Pneumonia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: HGB-11.5; HCT 35.4, RDW 16.1;
CDC 'Split Type': LA921004

Write-up: about 2 wks p/shot woke up 2AM w/severe pain lower back & rt leg to knee 16NOV91; pt went to ER & adm to hosp seen by bone & joint specialist; nerve problem, glucose of 136; meralgia paresthetica; pneumonia, Hgb 11.5, WBC 4,500;


Changed on 6/14/2018

VAERS ID: 46114 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1991-11-01
Onset:1991-11-16
Submitted:0000-00-00
Entered:1992-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21219 / 1 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Back pain, Hyperaesthesia, Hyperglycaemia, Hypochromic anaemia, Laboratory test abnormal, Leukopenia, Neuropathy, Pneumonia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: HGB-11.5; HCT 35.4, RDW 16.1;
CDC 'Split Type': LA921004

Write-up: about 2 wks p/shot woke up 2AM w/severe pain lower back & rt leg to knee 16NOV91; pt went to ER & adm to hosp seen by bone & joint specialist; nerve problem, glucose of 136; meralgia paresthetica; pneumonia, Hgb 11.5, WBC 4,500;


Changed on 8/14/2018

VAERS ID: 46114 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1991-11-01
Onset:1991-11-16
Submitted:0000-00-00
Entered:1992-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21219 / 1 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Back pain, Hyperaesthesia, Hyperglycaemia, Hypochromic anaemia, Laboratory test abnormal, Leukopenia, Neuropathy, Pneumonia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: HGB-11.5; HCT 35.4, RDW 16.1;
CDC 'Split Type': LA921004

Write-up: about 2 wks p/shot woke up 2AM w/severe pain lower back & rt leg to knee 16NOV91; pt went to ER & adm to hosp seen by bone & joint specialist; nerve problem, glucose of 136; meralgia paresthetica; pneumonia, Hgb 11.5, WBC 4,500;


Changed on 9/14/2018

VAERS ID: 46114 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1991-11-01
Onset:1991-11-16
Submitted:0000-00-00
Entered:1992-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21219 / 1 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Back pain, Hyperaesthesia, Hyperglycaemia, Hypochromic anaemia, Laboratory test abnormal, Leukopenia, Neuropathy, Pneumonia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: HGB-11.5; HCT 35.4, RDW 16.1;
CDC 'Split Type': LA921004

Write-up: about 2 wks p/shot woke up 2AM w/severe pain lower back & rt leg to knee 16NOV91; pt went to ER & adm to hosp seen by bone & joint specialist; nerve problem, glucose of 136; meralgia paresthetica; pneumonia, Hgb 11.5, WBC 4,500;


Changed on 10/14/2018

VAERS ID: 46114 Before After
VAERS Form:1
Age:67.0
Sex:Female
Location:Louisiana
Vaccinated:1991-11-01
Onset:1991-11-16
Submitted:0000-00-00
Entered:1992-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21219 / 1 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Back pain, Hyperaesthesia, Hyperglycaemia, Hypochromic anaemia, Laboratory test abnormal, Leukopenia, Neuropathy, Pneumonia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: HGB-11.5; HCT 35.4, RDW 16.1;
CDC 'Split Type': LA921004

Write-up: about 2 wks p/shot woke up 2AM w/severe pain lower back & rt leg to knee 16NOV91; pt went to ER & adm to hosp seen by bone & joint specialist; nerve problem, glucose of 136; meralgia paresthetica; pneumonia, Hgb 11.5, WBC 4,500;

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