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This is VAERS ID 91441

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

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;


Changed on 12/8/2009

VAERS ID: 91441 Before After
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 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;


Changed on 1/5/2010

VAERS ID: 91441 Before After
VAERS Form:
Age:47.1 47.0
Sex:Male
Location:Pennsylvania
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;


Changed on 8/31/2010

VAERS ID: 91441 Before After
VAERS Form:
Age:47.0
Sex:Male
Location:Pennsylvania
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;


Changed on 7/7/2013

VAERS ID: 91441 Before After
VAERS Form:
Age:47.0
Sex:Male
Location:Pennsylvania
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;


Changed on 6/14/2014

VAERS ID: 91441 Before After
VAERS Form:
Age:47.0
Sex:Male
Location:Pennsylvania
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;


Changed on 2/14/2017

VAERS ID: 91441 Before After
VAERS Form:
Age:47.0
Sex:Male
Location:Pennsylvania
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;


Changed on 5/14/2017

VAERS ID: 91441 Before After
VAERS Form:
Age:47.0
Sex:Male
Location:Pennsylvania
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;


Changed on 9/14/2017

VAERS ID: 91441 Before After
VAERS Form:(blank) 1
Age:47.0
Sex:Male
Location:Pennsylvania
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;


Changed on 2/14/2018

VAERS ID: 91441 Before After
VAERS Form:1
Age:47.0
Sex:Male
Location:Pennsylvania
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;


Changed on 6/14/2018

VAERS ID: 91441 Before After
VAERS Form:1
Age:47.0
Sex:Male
Location:Pennsylvania
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;


Changed on 8/14/2018

VAERS ID: 91441 Before After
VAERS Form:1
Age:47.0
Sex:Male
Location:Pennsylvania
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;


Changed on 9/14/2018

VAERS ID: 91441 Before After
VAERS Form:1
Age:47.0
Sex:Male
Location:Pennsylvania
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;


Changed on 10/14/2018

VAERS ID: 91441 Before After
VAERS Form:1
Age:47.0
Sex:Male
Location:Pennsylvania
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;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=91441&WAYBACKHISTORY=ON


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