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This is VAERS ID 47189

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 47189
VAERS Form:
Age:83.1
Sex:Male
Location:New York
Vaccinated:1992-10-28
Onset:1992-11-03
Submitted:1992-11-09
Entered:1992-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1992-1993 / WYETH 4928217 / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: HYPOTENS, MALAISE, COUGH INC, RESPIRAT DIS, HYPERTENS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-03
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? No
Previous Vaccinations: NONE
Other Medications: Prozac, Synthroid, Trental, Tylenol, ASA, Senokot, Mult vit, Dulcolax;
Current Illness: NONE
Preexisting Conditions: no allergies-CVA rt hemopoisis, mild depression, plural effusions''
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': no allergies-CVA rt hemopoisis, mild depression, plural effusions''

Write-up: laughing, talking & eating well 2NOV92; 3NOV92 wake & vomited BP 180/110, P 100; 550 became listless, BP 75/50, P diff to count; twitching


Changed on 12/8/2009

VAERS ID: 47189 Before After
VAERS Form:
Age:83.1
Sex:Male
Location:New York
Vaccinated:1992-10-28
Onset:1992-11-03
Submitted:1992-11-09
Entered:1992-11-23 1992-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1992-1993 INFLUENZA (SEASONAL) (NO BRAND NAME, 92-93) / WYETH WYETH PHARMACEUTICALS, INC 4928217 / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Hypertension, Hypotension, Malaise, Muscle twitching, Respiratory disorder, Vomiting, HYPOTENS, MALAISE, COUGH INC, RESPIRAT DIS, HYPERTENS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-03
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? No
Previous Vaccinations: NONE
Other Medications: Prozac, Synthroid, Trental, Tylenol, ASA, Senokot, Mult vit, Dulcolax;
Current Illness: NONE
Preexisting Conditions: no allergies-CVA rt hemopoisis, mild depression, plural effusions''
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': no allergies-CVA rt hemopoisis, mild depression, plural effusions'' (blank)

Write-up: laughing, talking & eating well 2NOV92; 3NOV92 wake & vomited BP 180/110, P 100; 550 became listless, BP 75/50, P diff to count; twitching


Changed on 8/31/2010

VAERS ID: 47189 Before After
VAERS Form:
Age:83.1
Sex:Male
Location:New York
Vaccinated:1992-10-28
Onset:1992-11-03
Submitted:1992-11-09
Entered:1992-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 92-93) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4928217 / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Hypertension, Hypotension, Malaise, Muscle twitching, Respiratory disorder, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-03
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? No
Previous Vaccinations: NONE
Other Medications: Prozac, Synthroid, Trental, Tylenol, ASA, Senokot, Mult vit, Dulcolax;
Current Illness: NONE
Preexisting Conditions: no allergies-CVA rt hemopoisis, mild depression, plural effusions''
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: laughing, talking & eating well 2NOV92; 3NOV92 wake & vomited BP 180/110, P 100; 550 became listless, BP 75/50, P diff to count; twitching


Changed on 7/7/2013

VAERS ID: 47189 Before After
VAERS Form:
Age:83.1
Sex:Male
Location:New York
Vaccinated:1992-10-28
Onset:1992-11-03
Submitted:1992-11-09
Entered:1992-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 0 LA / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Hypertension, Hypotension, Malaise, Muscle twitching, Respiratory disorder, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-03
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? No
Previous Vaccinations: NONE
Other Medications: Prozac, Synthroid, Trental, Tylenol, ASA, Senokot, Mult vit, Dulcolax;
Current Illness: NONE
Preexisting Conditions: no allergies-CVA rt hemopoisis, mild depression, plural effusions''
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: laughing, talking & eating well 2NOV92; 3NOV92 wake & vomited BP 180/110, P 100; 550 became listless, BP 75/50, P diff to count; twitching


Changed on 12/14/2016

VAERS ID: 47189 Before After
VAERS Form:
Age:83.1
Sex:Male
Location:New York
Vaccinated:1992-10-28
Onset:1992-11-03
Submitted:1992-11-09
Entered:1992-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 0 LA / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Hypertension, Hypotension, Malaise, Muscle twitching, Respiratory disorder, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-03
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? No
Previous Vaccinations: NONE
Other Medications: Prozac, Synthroid, Trental, Tylenol, ASA, Senokot, Mult vit, Dulcolax;
Current Illness: NONE
Preexisting Conditions: no allergies-CVA rt hemopoisis, mild depression, plural effusions''
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: laughing, talking & eating well 2NOV92; 3NOV92 wake & vomited BP 180/110, P 100; 550 became listless, BP 75/50, P diff to count; twitching


Changed on 2/14/2017

VAERS ID: 47189 Before After
VAERS Form:
Age:83.1 83.0
Sex:Male
Location:New York
Vaccinated:1992-10-28
Onset:1992-11-03
Submitted:1992-11-09
Entered:1992-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Hypertension, Hypotension, Malaise, Muscle twitching, Respiratory disorder, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-03
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? No
Previous Vaccinations: NONE
Other Medications: Prozac, Synthroid, Trental, Tylenol, ASA, Senokot, Mult vit, Dulcolax;
Current Illness: NONE
Preexisting Conditions: no allergies-CVA rt hemopoisis, mild depression, plural effusions''
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: laughing, talking & eating well 2NOV92; 3NOV92 wake & vomited BP 180/110, P 100; 550 became listless, BP 75/50, P diff to count; twitching


Changed on 5/14/2017

VAERS ID: 47189 Before After
VAERS Form:
Age:83.0
Sex:Male
Location:New York
Vaccinated:1992-10-28
Onset:1992-11-03
Submitted:1992-11-09
Entered:1992-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Hypertension, Hypotension, Malaise, Muscle twitching, Respiratory disorder, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-03
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? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: Prozac, Synthroid, Trental, Tylenol, ASA, Senokot, Mult vit, Dulcolax;
Current Illness: NONE
Preexisting Conditions: no allergies-CVA rt hemopoisis, mild depression, plural effusions''
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: laughing, talking & eating well 2NOV92; 3NOV92 wake & vomited BP 180/110, P 100; 550 became listless, BP 75/50, P diff to count; twitching


Changed on 9/14/2017

VAERS ID: 47189 Before After
VAERS Form:(blank) 1
Age:83.0
Sex:Male
Location:New York
Vaccinated:1992-10-28
Onset:1992-11-03
Submitted:1992-11-09
Entered:1992-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 0 1 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Hypertension, Hypotension, Malaise, Muscle twitching, Respiratory disorder, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-03
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Prozac, Synthroid, Trental, Tylenol, ASA, Senokot, Mult vit, Dulcolax;
Current Illness: NONE
Preexisting Conditions: no allergies-CVA rt hemopoisis, mild depression, plural effusions''
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: laughing, talking & eating well 2NOV92; 3NOV92 wake & vomited BP 180/110, P 100; 550 became listless, BP 75/50, P diff to count; twitching


Changed on 2/14/2018

VAERS ID: 47189 Before After
VAERS Form:1
Age:83.0
Sex:Male
Location:New York
Vaccinated:1992-10-28
Onset:1992-11-03
Submitted:1992-11-09
Entered:1992-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 1 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Hypertension, Hypotension, Malaise, Muscle twitching, Respiratory disorder, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-03
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Prozac, Synthroid, Trental, Tylenol, ASA, Senokot, Mult vit, Dulcolax;
Current Illness: NONE
Preexisting Conditions: no allergies-CVA rt hemopoisis, mild depression, plural effusions''
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: laughing, talking & eating well 2NOV92; 3NOV92 wake & vomited BP 180/110, P 100; 550 became listless, BP 75/50, P diff to count; twitching


Changed on 6/14/2018

VAERS ID: 47189 Before After
VAERS Form:1
Age:83.0
Sex:Male
Location:New York
Vaccinated:1992-10-28
Onset:1992-11-03
Submitted:1992-11-09
Entered:1992-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 1 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Hypertension, Hypotension, Malaise, Muscle twitching, Respiratory disorder, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-03
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Prozac, Synthroid, Trental, Tylenol, ASA, Senokot, Mult vit, Dulcolax;
Current Illness: NONE
Preexisting Conditions: no allergies-CVA rt hemopoisis, mild depression, plural effusions''
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: laughing, talking & eating well 2NOV92; 3NOV92 wake & vomited BP 180/110, P 100; 550 became listless, BP 75/50, P diff to count; twitching


Changed on 8/14/2018

VAERS ID: 47189 Before After
VAERS Form:1
Age:83.0
Sex:Male
Location:New York
Vaccinated:1992-10-28
Onset:1992-11-03
Submitted:1992-11-09
Entered:1992-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 1 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Hypertension, Hypotension, Malaise, Muscle twitching, Respiratory disorder, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-03
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Prozac, Synthroid, Trental, Tylenol, ASA, Senokot, Mult vit, Dulcolax;
Current Illness: NONE
Preexisting Conditions: no allergies-CVA rt hemopoisis, mild depression, plural effusions''
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: laughing, talking & eating well 2NOV92; 3NOV92 wake & vomited BP 180/110, P 100; 550 became listless, BP 75/50, P diff to count; twitching


Changed on 9/14/2018

VAERS ID: 47189 Before After
VAERS Form:1
Age:83.0
Sex:Male
Location:New York
Vaccinated:1992-10-28
Onset:1992-11-03
Submitted:1992-11-09
Entered:1992-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 1 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Hypertension, Hypotension, Malaise, Muscle twitching, Respiratory disorder, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-03
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Prozac, Synthroid, Trental, Tylenol, ASA, Senokot, Mult vit, Dulcolax;
Current Illness: NONE
Preexisting Conditions: no allergies-CVA rt hemopoisis, mild depression, plural effusions''
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: laughing, talking & eating well 2NOV92; 3NOV92 wake & vomited BP 180/110, P 100; 550 became listless, BP 75/50, P diff to count; twitching


Changed on 10/14/2018

VAERS ID: 47189 Before After
VAERS Form:1
Age:83.0
Sex:Male
Location:New York
Vaccinated:1992-10-28
Onset:1992-11-03
Submitted:1992-11-09
Entered:1992-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 1 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Cough, Hypertension, Hypotension, Malaise, Muscle twitching, Respiratory disorder, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-03
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? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Prozac, Synthroid, Trental, Tylenol, ASA, Senokot, Mult vit, Dulcolax;
Current Illness: NONE
Preexisting Conditions: no allergies-CVA rt hemopoisis, mild depression, plural effusions''
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: laughing, talking & eating well 2NOV92; 3NOV92 wake & vomited BP 180/110, P 100; 550 became listless, BP 75/50, P diff to count; twitching

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