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This is VAERS ID 48672

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 48672
VAERS Form:
Age:82.8
Sex:Female
Location:West Virginia
Vaccinated:1992-10-29
Onset:1992-11-22
Submitted:1992-11-30
Entered:1993-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1992-1993 / WYETH 4928217 / 1 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: DYSPNEA, HEART ARREST, HYPERVENTIL, HYPERTENS, ANXIETY

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-22
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:
Other Medications: Lasix, Lanoxin, Calan SR, Humulin, Axid, Nitrobid, Elavil, Nifedipineoth
Current Illness: NONE
Preexisting Conditions: CAD, IDDM, Hypertension, chronic CHF, cardiomegaly;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: dyspnea, anxiety, P56, R36, BP 200/90, 02 on transferred to hosp; causes of death-cardiac failure, CHF, Ischemic cardiomyopathy, COPD; also exp discomfort & tingling in arms; R36 shallow & labored;


Changed on 12/8/2009

VAERS ID: 48672 Before After
VAERS Form:
Age:82.8
Sex:Female
Location:West Virginia
Vaccinated:1992-10-29
Onset:1992-11-22
Submitted:1992-11-30
Entered:1993-01-11 1993-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1992-1993 INFLUENZA (SEASONAL) (NO BRAND NAME, 92-93) / WYETH WYETH PHARMACEUTICALS, INC 4928217 / 1 RA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Anxiety, Cardiac arrest, Condition aggravated, Dyspnoea, Hypertension, Hyperventilation, Myocardial infarction, Paraesthesia, DYSPNEA, HEART ARREST, HYPERVENTIL, HYPERTENS, ANXIETY

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-22
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:
Other Medications: Lasix, Lanoxin, Calan SR, Humulin, Axid, Nitrobid, Elavil, Nifedipineoth
Current Illness: NONE
Preexisting Conditions: CAD, IDDM, Hypertension, chronic CHF, cardiomegaly;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': (blank) WV9242

Write-up: dyspnea, anxiety, P56, R36, BP 200/90, 02 on transferred to hosp; causes of death-cardiac failure, CHF, Ischemic cardiomyopathy, COPD; also exp discomfort & tingling in arms; R36 shallow & labored;


Changed on 8/31/2010

VAERS ID: 48672 Before After
VAERS Form:
Age:82.8
Sex:Female
Location:West Virginia
Vaccinated:1992-10-29
Onset:1992-11-22
Submitted:1992-11-30
Entered:1993-01-04
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 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Anxiety, Cardiac arrest, Condition aggravated, Dyspnoea, Hypertension, Hyperventilation, Myocardial infarction, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-22
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:
Other Medications: Lasix, Lanoxin, Calan SR, Humulin, Axid, Nitrobid, Elavil, Nifedipineoth
Current Illness: NONE
Preexisting Conditions: CAD, IDDM, Hypertension, chronic CHF, cardiomegaly;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WV9242

Write-up: dyspnea, anxiety, P56, R36, BP 200/90, 02 on transferred to hosp; causes of death-cardiac failure, CHF, Ischemic cardiomyopathy, COPD; also exp discomfort & tingling in arms; R36 shallow & labored;


Changed on 7/7/2013

VAERS ID: 48672 Before After
VAERS Form:
Age:82.8
Sex:Female
Location:West Virginia
Vaccinated:1992-10-29
Onset:1992-11-22
Submitted:1992-11-30
Entered:1993-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 1 RA / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Anxiety, Cardiac arrest, Condition aggravated, Dyspnoea, Hypertension, Hyperventilation, Myocardial infarction, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-22
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:
Other Medications: Lasix, Lanoxin, Calan SR, Humulin, Axid, Nitrobid, Elavil, Nifedipineoth
Current Illness: NONE
Preexisting Conditions: CAD, IDDM, Hypertension, chronic CHF, cardiomegaly;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WV9242

Write-up: dyspnea, anxiety, P56, R36, BP 200/90, 02 on transferred to hosp; causes of death-cardiac failure, CHF, Ischemic cardiomyopathy, COPD; also exp discomfort & tingling in arms; R36 shallow & labored;


Changed on 12/14/2016

VAERS ID: 48672 Before After
VAERS Form:
Age:82.8
Sex:Female
Location:West Virginia
Vaccinated:1992-10-29
Onset:1992-11-22
Submitted:1992-11-30
Entered:1993-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 1 RA / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Anxiety, Cardiac arrest, Condition aggravated, Dyspnoea, Hypertension, Hyperventilation, Myocardial infarction, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-22
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:
Other Medications: Lasix, Lanoxin, Calan SR, Humulin, Axid, Nitrobid, Elavil, Nifedipineoth
Current Illness: NONE
Preexisting Conditions: CAD, IDDM, Hypertension, chronic CHF, cardiomegaly;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WV9242

Write-up: dyspnea, anxiety, P56, R36, BP 200/90, 02 on transferred to hosp; causes of death-cardiac failure, CHF, Ischemic cardiomyopathy, COPD; also exp discomfort & tingling in arms; R36 shallow & labored;


Changed on 2/14/2017

VAERS ID: 48672 Before After
VAERS Form:
Age:82.8 82.0
Sex:Female
Location:West Virginia
Vaccinated:1992-10-29
Onset:1992-11-22
Submitted:1992-11-30
Entered:1993-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Anxiety, Cardiac arrest, Condition aggravated, Dyspnoea, Hypertension, Hyperventilation, Myocardial infarction, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-22
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:
Other Medications: Lasix, Lanoxin, Calan SR, Humulin, Axid, Nitrobid, Elavil, Nifedipineoth
Current Illness: NONE
Preexisting Conditions: CAD, IDDM, Hypertension, chronic CHF, cardiomegaly;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WV9242

Write-up: dyspnea, anxiety, P56, R36, BP 200/90, 02 on transferred to hosp; causes of death-cardiac failure, CHF, Ischemic cardiomyopathy, COPD; also exp discomfort & tingling in arms; R36 shallow & labored;


Changed on 5/14/2017

VAERS ID: 48672 Before After
VAERS Form:
Age:82.0
Sex:Female
Location:West Virginia
Vaccinated:1992-10-29
Onset:1992-11-22
Submitted:1992-11-30
Entered:1993-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Anxiety, Cardiac arrest, Condition aggravated, Dyspnoea, Hypertension, Hyperventilation, Myocardial infarction, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-22
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: ~ ()~~~In patient
Other Medications: Lasix, Lanoxin, Calan SR, Humulin, Axid, Nitrobid, Elavil, Nifedipineoth
Current Illness: NONE
Preexisting Conditions: CAD, IDDM, Hypertension, chronic CHF, cardiomegaly;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WV9242

Write-up: dyspnea, anxiety, P56, R36, BP 200/90, 02 on transferred to hosp; causes of death-cardiac failure, CHF, Ischemic cardiomyopathy, COPD; also exp discomfort & tingling in arms; R36 shallow & labored;


Changed on 9/14/2017

VAERS ID: 48672 Before After
VAERS Form:(blank) 1
Age:82.0
Sex:Female
Location:West Virginia
Vaccinated:1992-10-29
Onset:1992-11-22
Submitted:1992-11-30
Entered:1993-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 1 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Anxiety, Cardiac arrest, Condition aggravated, Dyspnoea, Hypertension, Hyperventilation, Myocardial infarction, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-22
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: ~ ()~~~In patient
Other Medications: Lasix, Lanoxin, Calan SR, Humulin, Axid, Nitrobid, Elavil, Nifedipineoth
Current Illness: NONE
Preexisting Conditions: CAD, IDDM, Hypertension, chronic CHF, cardiomegaly;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WV9242

Write-up: dyspnea, anxiety, P56, R36, BP 200/90, 02 on transferred to hosp; causes of death-cardiac failure, CHF, Ischemic cardiomyopathy, COPD; also exp discomfort & tingling in arms; R36 shallow & labored;


Changed on 2/14/2018

VAERS ID: 48672 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:West Virginia
Vaccinated:1992-10-29
Onset:1992-11-22
Submitted:1992-11-30
Entered:1993-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Anxiety, Cardiac arrest, Condition aggravated, Dyspnoea, Hypertension, Hyperventilation, Myocardial infarction, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-22
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: ~ ()~~~In patient
Other Medications: Lasix, Lanoxin, Calan SR, Humulin, Axid, Nitrobid, Elavil, Nifedipineoth
Current Illness: NONE
Preexisting Conditions: CAD, IDDM, Hypertension, chronic CHF, cardiomegaly;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WV9242

Write-up: dyspnea, anxiety, P56, R36, BP 200/90, 02 on transferred to hosp; causes of death-cardiac failure, CHF, Ischemic cardiomyopathy, COPD; also exp discomfort & tingling in arms; R36 shallow & labored;


Changed on 6/14/2018

VAERS ID: 48672 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:West Virginia
Vaccinated:1992-10-29
Onset:1992-11-22
Submitted:1992-11-30
Entered:1993-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Anxiety, Cardiac arrest, Condition aggravated, Dyspnoea, Hypertension, Hyperventilation, Myocardial infarction, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-22
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: ~ ()~~~In patient
Other Medications: Lasix, Lanoxin, Calan SR, Humulin, Axid, Nitrobid, Elavil, Nifedipineoth
Current Illness: NONE
Preexisting Conditions: CAD, IDDM, Hypertension, chronic CHF, cardiomegaly;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WV9242

Write-up: dyspnea, anxiety, P56, R36, BP 200/90, 02 on transferred to hosp; causes of death-cardiac failure, CHF, Ischemic cardiomyopathy, COPD; also exp discomfort & tingling in arms; R36 shallow & labored;


Changed on 8/14/2018

VAERS ID: 48672 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:West Virginia
Vaccinated:1992-10-29
Onset:1992-11-22
Submitted:1992-11-30
Entered:1993-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Anxiety, Cardiac arrest, Condition aggravated, Dyspnoea, Hypertension, Hyperventilation, Myocardial infarction, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-22
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: ~ ()~~~In patient
Other Medications: Lasix, Lanoxin, Calan SR, Humulin, Axid, Nitrobid, Elavil, Nifedipineoth
Current Illness: NONE
Preexisting Conditions: CAD, IDDM, Hypertension, chronic CHF, cardiomegaly;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WV9242

Write-up: dyspnea, anxiety, P56, R36, BP 200/90, 02 on transferred to hosp; causes of death-cardiac failure, CHF, Ischemic cardiomyopathy, COPD; also exp discomfort & tingling in arms; R36 shallow & labored;


Changed on 9/14/2018

VAERS ID: 48672 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:West Virginia
Vaccinated:1992-10-29
Onset:1992-11-22
Submitted:1992-11-30
Entered:1993-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Anxiety, Cardiac arrest, Condition aggravated, Dyspnoea, Hypertension, Hyperventilation, Myocardial infarction, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-22
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: ~ ()~~~In patient
Other Medications: Lasix, Lanoxin, Calan SR, Humulin, Axid, Nitrobid, Elavil, Nifedipineoth
Current Illness: NONE
Preexisting Conditions: CAD, IDDM, Hypertension, chronic CHF, cardiomegaly;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WV9242

Write-up: dyspnea, anxiety, P56, R36, BP 200/90, 02 on transferred to hosp; causes of death-cardiac failure, CHF, Ischemic cardiomyopathy, COPD; also exp discomfort & tingling in arms; R36 shallow & labored;


Changed on 10/14/2018

VAERS ID: 48672 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:West Virginia
Vaccinated:1992-10-29
Onset:1992-11-22
Submitted:1992-11-30
Entered:1993-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Anxiety, Cardiac arrest, Condition aggravated, Dyspnoea, Hypertension, Hyperventilation, Myocardial infarction, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-22
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: ~ ()~~~In patient
Other Medications: Lasix, Lanoxin, Calan SR, Humulin, Axid, Nitrobid, Elavil, Nifedipineoth
Current Illness: NONE
Preexisting Conditions: CAD, IDDM, Hypertension, chronic CHF, cardiomegaly;
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': WV9242

Write-up: dyspnea, anxiety, P56, R36, BP 200/90, 02 on transferred to hosp; causes of death-cardiac failure, CHF, Ischemic cardiomyopathy, COPD; also exp discomfort & tingling in arms; R36 shallow & labored;

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