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This is VAERS ID 57284

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 57284
VAERS Form:
Age:84.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1993-10-28
Entered:1993-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE / UNCLASSIFIED - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: CEREBROVASC ACCID

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt recvd vax & suffered a stroke; reporter has only seen pt once; reporter has no past medical records for this pt, therefore, no further info is available;


Changed on 12/8/2009

VAERS ID: 57284 Before After
VAERS Form:
Age:84.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1993-10-28
Entered:1993-11-19 1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE INFLUENZA (SEASONAL) (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Cerebrovascular accident, CEREBROVASC ACCID

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 893302002J

Write-up: Pt recvd vax & suffered a stroke; reporter has only seen pt once; reporter has no past medical records for this pt, therefore, no further info is available;


Changed on 7/7/2013

VAERS ID: 57284 Before After
VAERS Form:
Age:84.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1993-10-28
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Cerebrovascular accident

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893302002J

Write-up: Pt recvd vax & suffered a stroke; reporter has only seen pt once; reporter has no past medical records for this pt, therefore, no further info is available;


Changed on 12/14/2016

VAERS ID: 57284 Before After
VAERS Form:
Age:84.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1993-10-28
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Cerebrovascular accident

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893302002J

Write-up: Pt recvd vax & suffered a stroke; reporter has only seen pt once; reporter has no past medical records for this pt, therefore, no further info is available;


Changed on 5/14/2017

VAERS ID: 57284 Before After
VAERS Form:
Age:84.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1993-10-28
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Cerebrovascular accident

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893302002J

Write-up: Pt recvd vax & suffered a stroke; reporter has only seen pt once; reporter has no past medical records for this pt, therefore, no further info is available;


Changed on 9/14/2017

VAERS ID: 57284 Before After
VAERS Form:(blank) 1
Age:84.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1993-10-28
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cerebrovascular accident

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893302002J

Write-up: Pt recvd vax & suffered a stroke; reporter has only seen pt once; reporter has no past medical records for this pt, therefore, no further info is available;


Changed on 2/14/2018

VAERS ID: 57284 Before After
VAERS Form:1
Age:84.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1993-10-28
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cerebrovascular accident

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893302002J

Write-up: Pt recvd vax & suffered a stroke; reporter has only seen pt once; reporter has no past medical records for this pt, therefore, no further info is available;


Changed on 6/14/2018

VAERS ID: 57284 Before After
VAERS Form:1
Age:84.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1993-10-28
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cerebrovascular accident

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893302002J

Write-up: Pt recvd vax & suffered a stroke; reporter has only seen pt once; reporter has no past medical records for this pt, therefore, no further info is available;


Changed on 8/14/2018

VAERS ID: 57284 Before After
VAERS Form:1
Age:84.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1993-10-28
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cerebrovascular accident

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893302002J

Write-up: Pt recvd vax & suffered a stroke; reporter has only seen pt once; reporter has no past medical records for this pt, therefore, no further info is available;


Changed on 9/14/2018

VAERS ID: 57284 Before After
VAERS Form:1
Age:84.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1993-10-28
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cerebrovascular accident

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893302002J

Write-up: Pt recvd vax & suffered a stroke; reporter has only seen pt once; reporter has no past medical records for this pt, therefore, no further info is available;


Changed on 10/14/2018

VAERS ID: 57284 Before After
VAERS Form:1
Age:84.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1993-10-28
Entered:1993-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cerebrovascular accident

Life Threatening? No
Birth Defect? No
Died? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893302002J

Write-up: Pt recvd vax & suffered a stroke; reporter has only seen pt once; reporter has no past medical records for this pt, therefore, no further info is available;

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