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This is VAERS ID 46528

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 46528
VAERS Form:
Age:94.0
Sex:Female
Location:Michigan
Vaccinated:1992-10-06
Onset:1992-10-07
Submitted:1992-10-13
Entered:1992-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1992-1993 / WYETH - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: FEVER, HERPES ZOSTER, HYPERTENS, HALLUCIN, FIBRILLAT ATR

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt recvd flu vax the next evening devel a rash & some blisters on breasts & back; dx w/herpes zoster; tx Zovirax & DPH; also exp inc BP & hallucinations; adm to hosp 12OCT92;


Changed on 12/8/2009

VAERS ID: 46528 Before After
VAERS Form:
Age:94.0
Sex:Female
Location:Michigan
Vaccinated:1992-10-06
Onset:1992-10-07
Submitted:1992-10-13
Entered:1992-10-30 1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1992-1993 INFLUENZA (SEASONAL) (NO BRAND NAME, 92-93) / WYETH WYETH PHARMACEUTICALS, INC - / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Atrial fibrillation, Dermatitis bullous, Hallucination, Herpes zoster, Hypertension, Pyrexia, Rash, FEVER, HERPES ZOSTER, HYPERTENS, HALLUCIN, FIBRILLAT ATR

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 892289001E

Write-up: Pt recvd flu vax the next evening devel a rash & some blisters on breasts & back; dx w/herpes zoster; tx Zovirax & DPH; also exp inc BP & hallucinations; adm to hosp 12OCT92;


Changed on 8/31/2010

VAERS ID: 46528 Before After
VAERS Form:
Age:94.0
Sex:Female
Location:Michigan
Vaccinated:1992-10-06
Onset:1992-10-07
Submitted:1992-10-13
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 92-93) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Atrial fibrillation, Dermatitis bullous, Hallucination, Herpes zoster, Hypertension, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892289001E

Write-up: Pt recvd flu vax the next evening devel a rash & some blisters on breasts & back; dx w/herpes zoster; tx Zovirax & DPH; also exp inc BP & hallucinations; adm to hosp 12OCT92;


Changed on 7/7/2013

VAERS ID: 46528 Before After
VAERS Form:
Age:94.0
Sex:Female
Location:Michigan
Vaccinated:1992-10-06
Onset:1992-10-07
Submitted:1992-10-13
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Atrial fibrillation, Dermatitis bullous, Hallucination, Herpes zoster, Hypertension, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892289001E

Write-up: Pt recvd flu vax the next evening devel a rash & some blisters on breasts & back; dx w/herpes zoster; tx Zovirax & DPH; also exp inc BP & hallucinations; adm to hosp 12OCT92;


Changed on 12/14/2016

VAERS ID: 46528 Before After
VAERS Form:
Age:94.0
Sex:Female
Location:Michigan
Vaccinated:1992-10-06
Onset:1992-10-07
Submitted:1992-10-13
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Atrial fibrillation, Dermatitis bullous, Hallucination, Herpes zoster, Hypertension, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892289001E

Write-up: Pt recvd flu vax the next evening devel a rash & some blisters on breasts & back; dx w/herpes zoster; tx Zovirax & DPH; also exp inc BP & hallucinations; adm to hosp 12OCT92;


Changed on 5/14/2017

VAERS ID: 46528 Before After
VAERS Form:
Age:94.0
Sex:Female
Location:Michigan
Vaccinated:1992-10-06
Onset:1992-10-07
Submitted:1992-10-13
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Atrial fibrillation, Dermatitis bullous, Hallucination, Herpes zoster, Hypertension, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892289001E

Write-up: Pt recvd flu vax the next evening devel a rash & some blisters on breasts & back; dx w/herpes zoster; tx Zovirax & DPH; also exp inc BP & hallucinations; adm to hosp 12OCT92;


Changed on 9/14/2017

VAERS ID: 46528 Before After
VAERS Form:(blank) 1
Age:94.0
Sex:Female
Location:Michigan
Vaccinated:1992-10-06
Onset:1992-10-07
Submitted:1992-10-13
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Atrial fibrillation, Dermatitis bullous, Hallucination, Herpes zoster, Hypertension, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892289001E

Write-up: Pt recvd flu vax the next evening devel a rash & some blisters on breasts & back; dx w/herpes zoster; tx Zovirax & DPH; also exp inc BP & hallucinations; adm to hosp 12OCT92;


Changed on 2/14/2018

VAERS ID: 46528 Before After
VAERS Form:1
Age:94.0
Sex:Female
Location:Michigan
Vaccinated:1992-10-06
Onset:1992-10-07
Submitted:1992-10-13
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Atrial fibrillation, Dermatitis bullous, Hallucination, Herpes zoster, Hypertension, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892289001E

Write-up: Pt recvd flu vax the next evening devel a rash & some blisters on breasts & back; dx w/herpes zoster; tx Zovirax & DPH; also exp inc BP & hallucinations; adm to hosp 12OCT92;


Changed on 6/14/2018

VAERS ID: 46528 Before After
VAERS Form:1
Age:94.0
Sex:Female
Location:Michigan
Vaccinated:1992-10-06
Onset:1992-10-07
Submitted:1992-10-13
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Atrial fibrillation, Dermatitis bullous, Hallucination, Herpes zoster, Hypertension, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892289001E

Write-up: Pt recvd flu vax the next evening devel a rash & some blisters on breasts & back; dx w/herpes zoster; tx Zovirax & DPH; also exp inc BP & hallucinations; adm to hosp 12OCT92;


Changed on 8/14/2018

VAERS ID: 46528 Before After
VAERS Form:1
Age:94.0
Sex:Female
Location:Michigan
Vaccinated:1992-10-06
Onset:1992-10-07
Submitted:1992-10-13
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Atrial fibrillation, Dermatitis bullous, Hallucination, Herpes zoster, Hypertension, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892289001E

Write-up: Pt recvd flu vax the next evening devel a rash & some blisters on breasts & back; dx w/herpes zoster; tx Zovirax & DPH; also exp inc BP & hallucinations; adm to hosp 12OCT92;


Changed on 9/14/2018

VAERS ID: 46528 Before After
VAERS Form:1
Age:94.0
Sex:Female
Location:Michigan
Vaccinated:1992-10-06
Onset:1992-10-07
Submitted:1992-10-13
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Atrial fibrillation, Dermatitis bullous, Hallucination, Herpes zoster, Hypertension, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892289001E

Write-up: Pt recvd flu vax the next evening devel a rash & some blisters on breasts & back; dx w/herpes zoster; tx Zovirax & DPH; also exp inc BP & hallucinations; adm to hosp 12OCT92;


Changed on 10/14/2018

VAERS ID: 46528 Before After
VAERS Form:1
Age:94.0
Sex:Female
Location:Michigan
Vaccinated:1992-10-06
Onset:1992-10-07
Submitted:1992-10-13
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Atrial fibrillation, Dermatitis bullous, Hallucination, Herpes zoster, Hypertension, Pyrexia, Rash

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892289001E

Write-up: Pt recvd flu vax the next evening devel a rash & some blisters on breasts & back; dx w/herpes zoster; tx Zovirax & DPH; also exp inc BP & hallucinations; adm to hosp 12OCT92;

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=46528&WAYBACKHISTORY=ON


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