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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 91441 |
VAERS Form: | |
Age: | 47.1 |
Sex: | Male |
Location: | Pennsylvania |
Vaccinated: | 1996-10-28 |
Onset: | 1996-10-28 |
Submitted: | 1996-10-28 |
Entered: | 1996-11-04 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: FLUSHIELD 1996-1997 / WYETH | 4968202 / - | RA / IM |
Administered by: Military Purchased by: Unknown
Symptoms: DIZZINESS, DYSPNEA, MYALGIA, PAIN CHEST, HYPOXIA
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1996-10-28
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: NONE
Current Illness: NONE
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: EKG-nl sinus thythm-nl ECG;
CDC 'Split Type':
Write-up: pt became diaphoretic, lightheaded, dizzy w/soreness in joints, sl heaviness in chest & SOB relieved w/02, ntg, IV NS;
Vaccinated: | 1996-10-28 |
Onset: | 1996-10-28 |
Submitted: | 1996-10-28 |
Entered: | 1996-11-04 1996-11-01 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: FLUSHIELD 1996-1997 INFLUENZA (SEASONAL) (FLUSHIELD 96-97) / WYETH WYETH PHARMACEUTICALS, INC | 4968202 / - | RA / IM |
Administered by: Military Purchased by: Unknown Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Hyperhidrosis, Hypoxia, Myalgia, DIZZINESS, DYSPNEA, MYALGIA, PAIN CHEST, HYPOXIA
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1996-10-28
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: NONE
Current Illness: NONE
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: EKG-nl sinus thythm-nl ECG;
CDC 'Split Type':
Write-up: pt became diaphoretic, lightheaded, dizzy w/soreness in joints, sl heaviness in chest & SOB relieved w/02, ntg, IV NS;
Vaccinated: | 1996-10-28 |
Onset: | 1996-10-28 |
Submitted: | 1996-10-28 |
Entered: | 1996-11-01 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 96-97) / WYETH PHARMACEUTICALS, INC | 4968202 / - | RA / IM |
Administered by: Military Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Hyperhidrosis, Hypoxia, Myalgia
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1996-10-28
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: NONE
Current Illness: NONE
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: EKG-nl sinus thythm-nl ECG;
CDC 'Split Type':
Write-up: pt became diaphoretic, lightheaded, dizzy w/soreness in joints, sl heaviness in chest & SOB relieved w/02, ntg, IV NS;
Vaccinated: | 1996-10-28 |
Onset: | 1996-10-28 |
Submitted: | 1996-10-28 |
Entered: | 1996-11-01 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 96-97) INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH | 4968202 / - | RA / IM |
Administered by: Military Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Hyperhidrosis, Hypoxia, Myalgia
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1996-10-28
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: NONE
Current Illness: NONE
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: EKG-nl sinus thythm-nl ECG;
CDC 'Split Type':
Write-up: pt became diaphoretic, lightheaded, dizzy w/soreness in joints, sl heaviness in chest & SOB relieved w/02, ntg, IV NS;
Vaccinated: | 1996-10-28 |
Onset: | 1996-10-28 |
Submitted: | 1996-10-28 |
Entered: | 1996-11-01 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH | 4968202 / - | RA / IM |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH | 4968202 / - | RA / IM |
Administered by: Military Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Hyperhidrosis, Hypoxia, Myalgia
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1996-10-28
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: NONE
Current Illness: NONE
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: EKG-nl sinus thythm-nl ECG;
CDC 'Split Type':
Write-up: pt became diaphoretic, lightheaded, dizzy w/soreness in joints, sl heaviness in chest & SOB relieved w/02, ntg, IV NS;
Vaccinated: | 1996-10-28 |
Onset: | 1996-10-28 |
Submitted: | 1996-10-28 |
Entered: | 1996-11-01 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH | 4968202 / - | RA / IM |
Administered by: Military Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Hyperhidrosis, Hypoxia, Myalgia
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1996-10-28
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: NONE
Current Illness: NONE
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: EKG-nl sinus thythm-nl ECG;
CDC 'Split Type':
Write-up: pt became diaphoretic, lightheaded, dizzy w/soreness in joints, sl heaviness in chest & SOB relieved w/02, ntg, IV NS;
Vaccinated: | 1996-10-28 |
Onset: | 1996-10-28 |
Submitted: | 1996-10-28 |
Entered: | 1996-11-01 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH | 4968202 / - | RA / IM |
Administered by: Military Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Hyperhidrosis, Hypoxia, Myalgia
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1996-10-28
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:
Current Illness: NONE
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: EKG-nl sinus thythm-nl ECG;
CDC 'Split Type':
Write-up: pt became diaphoretic, lightheaded, dizzy w/soreness in joints, sl heaviness in chest & SOB relieved w/02, ntg, IV NS;
Vaccinated: | 1996-10-28 |
Onset: | 1996-10-28 |
Submitted: | 1996-10-28 |
Entered: | 1996-11-01 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH | 4968202 / - | RA / IM |
Administered by: Military Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Hyperhidrosis, Hypoxia, Myalgia
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1996-10-28
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 ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: EKG-nl sinus thythm-nl ECG;
CDC 'Split Type':
Write-up: pt became diaphoretic, lightheaded, dizzy w/soreness in joints, sl heaviness in chest & SOB relieved w/02, ntg, IV NS;
Vaccinated: | 1996-10-28 |
Onset: | 1996-10-28 |
Submitted: | 1996-10-28 |
Entered: | 1996-11-01 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH | 4968202 / - UNK | RA / IM |
Administered by: Military Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Hyperhidrosis, Hypoxia, Myalgia
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1996-10-28
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: NONE
Current Illness: NONE
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: EKG-nl sinus thythm-nl ECG;
CDC 'Split Type':
Write-up: pt became diaphoretic, lightheaded, dizzy w/soreness in joints, sl heaviness in chest & SOB relieved w/02, ntg, IV NS;
Vaccinated: | 1996-10-28 |
Onset: | 1996-10-28 |
Submitted: | 1996-10-28 |
Entered: | 1996-11-01 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH | 4968202 / UNK | RA / IM |
Administered by: Military Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Hyperhidrosis, Hypoxia, Myalgia
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1996-10-28
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: NONE
Current Illness: NONE
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: EKG-nl sinus thythm-nl ECG;
CDC 'Split Type':
Write-up: pt became diaphoretic, lightheaded, dizzy w/soreness in joints, sl heaviness in chest & SOB relieved w/02, ntg, IV NS;
Vaccinated: | 1996-10-28 |
Onset: | 1996-10-28 |
Submitted: | 1996-10-28 |
Entered: | 1996-11-01 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH | 4968202 / UNK | RA / IM |
Administered by: Military Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Hyperhidrosis, Hypoxia, Myalgia
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1996-10-28
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: NONE
Current Illness: NONE
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: EKG-nl sinus thythm-nl ECG;
CDC 'Split Type':
Write-up: pt became diaphoretic, lightheaded, dizzy w/soreness in joints, sl heaviness in chest & SOB relieved w/02, ntg, IV NS;
Vaccinated: | 1996-10-28 |
Onset: | 1996-10-28 |
Submitted: | 1996-10-28 |
Entered: | 1996-11-01 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH | 4968202 / UNK | RA / IM |
Administered by: Military Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Hyperhidrosis, Hypoxia, Myalgia
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1996-10-28
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: NONE
Current Illness: NONE
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: EKG-nl sinus thythm-nl ECG;
CDC 'Split Type':
Write-up: pt became diaphoretic, lightheaded, dizzy w/soreness in joints, sl heaviness in chest & SOB relieved w/02, ntg, IV NS;
Vaccinated: | 1996-10-28 |
Onset: | 1996-10-28 |
Submitted: | 1996-10-28 |
Entered: | 1996-11-01 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH | 4968202 / UNK | RA / IM |
Administered by: Military Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Hyperhidrosis, Hypoxia, Myalgia
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1996-10-28
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: NONE
Current Illness: NONE
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: EKG-nl sinus thythm-nl ECG;
CDC 'Split Type':
Write-up: pt became diaphoretic, lightheaded, dizzy w/soreness in joints, sl heaviness in chest & SOB relieved w/02, ntg, IV NS;
Vaccinated: | 1996-10-28 |
Onset: | 1996-10-28 |
Submitted: | 1996-10-28 |
Entered: | 1996-11-01 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH | 4968202 / UNK | RA / IM |
Administered by: Military Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Hyperhidrosis, Hypoxia, Myalgia
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1996-10-28
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: NONE
Current Illness: NONE
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: EKG-nl sinus thythm-nl ECG;
CDC 'Split Type':
Write-up: pt became diaphoretic, lightheaded, dizzy w/soreness in joints, sl heaviness in chest & SOB relieved w/02, ntg, IV NS;
Vaccinated: | 1996-10-28 |
Onset: | 1996-10-28 |
Submitted: | 1996-10-28 |
Entered: | 1996-11-01 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH | 4968202 / UNK | RA / IM |
Administered by: Military Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Hyperhidrosis, Hypoxia, Myalgia
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1996-10-28
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: NONE
Current Illness: NONE
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: EKG-nl sinus thythm-nl ECG;
CDC 'Split Type':
Write-up: pt became diaphoretic, lightheaded, dizzy w/soreness in joints, sl heaviness in chest & SOB relieved w/02, ntg, IV NS;
Vaccinated: | 1996-10-28 |
Onset: | 1996-10-28 |
Submitted: | 1996-10-28 |
Entered: | 1996-11-01 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH | 4968202 / UNK | RA / IM |
Administered by: Military Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Hyperhidrosis, Hypoxia, Myalgia
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:1996-10-28
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: NONE
Current Illness: NONE
Preexisting Conditions: HTN
Allergies:
Diagnostic Lab Data: EKG-nl sinus thythm-nl ECG;
CDC 'Split Type':
Write-up: pt became diaphoretic, lightheaded, dizzy w/soreness in joints, sl heaviness in chest & SOB relieved w/02, ntg, IV NS;
Link To This Search Result:
https://medalerts.org/vaersdb/findfield.php?IDNUMBER=91441&WAYBACKHISTORY=ON
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