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This is VAERS ID 93771

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 93771
VAERS Form:
Age:77.1
Sex:Female
Location:New Jersey
Vaccinated:1996-09-30
Onset:1996-10-02
Submitted:1996-10-09
Entered:1997-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE / UNCLASSIFIED - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: ARTHRALGIA, MYALGIA, PAIN ABDO, THINKING ABNORM

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:
Current Illness:
Preexisting Conditions: hx of renal stone
Allergies:
Diagnostic Lab Data: no spinal tap done as per daughter
CDC 'Split Type':

Write-up: pt recv vax & devel myalgia & arthralgia, abd pain followed by change of mental status;


Changed on 12/8/2009

VAERS ID: 93771 Before After
VAERS Form:
Age:77.1
Sex:Female
Location:New Jersey
Vaccinated:1996-09-30
Onset:1996-10-02
Submitted:1996-10-09
Entered:1997-01-17 1997-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE INFLUENZA (SEASONAL) (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Myalgia, Thinking abnormal, ARTHRALGIA, MYALGIA, PAIN ABDO, THINKING ABNORM

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:
Current Illness:
Preexisting Conditions: hx of renal stone
Allergies:
Diagnostic Lab Data: no spinal tap done as per daughter
CDC 'Split Type':

Write-up: pt recv vax & devel myalgia & arthralgia, abd pain followed by change of mental status;


Changed on 7/7/2013

VAERS ID: 93771 Before After
VAERS Form:
Age:77.1
Sex:Female
Location:New Jersey
Vaccinated:1996-09-30
Onset:1996-10-02
Submitted:1996-10-09
Entered:1997-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Myalgia, Thinking abnormal

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:
Current Illness:
Preexisting Conditions: hx of renal stone
Allergies:
Diagnostic Lab Data: no spinal tap done as per daughter
CDC 'Split Type':

Write-up: pt recv vax & devel myalgia & arthralgia, abd pain followed by change of mental status;


Changed on 12/14/2016

VAERS ID: 93771 Before After
VAERS Form:
Age:77.1
Sex:Female
Location:New Jersey
Vaccinated:1996-09-30
Onset:1996-10-02
Submitted:1996-10-09
Entered:1997-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Myalgia, Thinking abnormal

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:
Current Illness:
Preexisting Conditions: hx of renal stone
Allergies:
Diagnostic Lab Data: no spinal tap done as per daughter
CDC 'Split Type':

Write-up: pt recv vax & devel myalgia & arthralgia, abd pain followed by change of mental status;


Changed on 2/14/2017

VAERS ID: 93771 Before After
VAERS Form:
Age:77.1 77.0
Sex:Female
Location:New Jersey
Vaccinated:1996-09-30
Onset:1996-10-02
Submitted:1996-10-09
Entered:1997-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Myalgia, Thinking abnormal

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:
Current Illness:
Preexisting Conditions: hx of renal stone
Allergies:
Diagnostic Lab Data: no spinal tap done as per daughter
CDC 'Split Type':

Write-up: pt recv vax & devel myalgia & arthralgia, abd pain followed by change of mental status;


Changed on 5/14/2017

VAERS ID: 93771 Before After
VAERS Form:
Age:77.0
Sex:Female
Location:New Jersey
Vaccinated:1996-09-30
Onset:1996-10-02
Submitted:1996-10-09
Entered:1997-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Myalgia, Thinking abnormal

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:
Current Illness:
Preexisting Conditions: hx of renal stone
Allergies:
Diagnostic Lab Data: no spinal tap done as per daughter
CDC 'Split Type':

Write-up: pt recv vax & devel myalgia & arthralgia, abd pain followed by change of mental status;


Changed on 9/14/2017

VAERS ID: 93771 Before After
VAERS Form:(blank) 1
Age:77.0
Sex:Female
Location:New Jersey
Vaccinated:1996-09-30
Onset:1996-10-02
Submitted:1996-10-09
Entered:1997-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Myalgia, Thinking abnormal

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:
Current Illness:
Preexisting Conditions: hx of renal stone
Allergies:
Diagnostic Lab Data: no spinal tap done as per daughter
CDC 'Split Type':

Write-up: pt recv vax & devel myalgia & arthralgia, abd pain followed by change of mental status;


Changed on 2/14/2018

VAERS ID: 93771 Before After
VAERS Form:1
Age:77.0
Sex:Female
Location:New Jersey
Vaccinated:1996-09-30
Onset:1996-10-02
Submitted:1996-10-09
Entered:1997-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Myalgia, Thinking abnormal

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:
Current Illness:
Preexisting Conditions: hx of renal stone
Allergies:
Diagnostic Lab Data: no spinal tap done as per daughter
CDC 'Split Type':

Write-up: pt recv vax & devel myalgia & arthralgia, abd pain followed by change of mental status;


Changed on 6/14/2018

VAERS ID: 93771 Before After
VAERS Form:1
Age:77.0
Sex:Female
Location:New Jersey
Vaccinated:1996-09-30
Onset:1996-10-02
Submitted:1996-10-09
Entered:1997-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Myalgia, Thinking abnormal

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:
Current Illness:
Preexisting Conditions: hx of renal stone
Allergies:
Diagnostic Lab Data: no spinal tap done as per daughter
CDC 'Split Type':

Write-up: pt recv vax & devel myalgia & arthralgia, abd pain followed by change of mental status;


Changed on 8/14/2018

VAERS ID: 93771 Before After
VAERS Form:1
Age:77.0
Sex:Female
Location:New Jersey
Vaccinated:1996-09-30
Onset:1996-10-02
Submitted:1996-10-09
Entered:1997-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Myalgia, Thinking abnormal

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:
Current Illness:
Preexisting Conditions: hx of renal stone
Allergies:
Diagnostic Lab Data: no spinal tap done as per daughter
CDC 'Split Type':

Write-up: pt recv vax & devel myalgia & arthralgia, abd pain followed by change of mental status;


Changed on 9/14/2018

VAERS ID: 93771 Before After
VAERS Form:1
Age:77.0
Sex:Female
Location:New Jersey
Vaccinated:1996-09-30
Onset:1996-10-02
Submitted:1996-10-09
Entered:1997-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Myalgia, Thinking abnormal

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:
Current Illness:
Preexisting Conditions: hx of renal stone
Allergies:
Diagnostic Lab Data: no spinal tap done as per daughter
CDC 'Split Type':

Write-up: pt recv vax & devel myalgia & arthralgia, abd pain followed by change of mental status;


Changed on 10/14/2018

VAERS ID: 93771 Before After
VAERS Form:1
Age:77.0
Sex:Female
Location:New Jersey
Vaccinated:1996-09-30
Onset:1996-10-02
Submitted:1996-10-09
Entered:1997-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Myalgia, Thinking abnormal

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:
Current Illness:
Preexisting Conditions: hx of renal stone
Allergies:
Diagnostic Lab Data: no spinal tap done as per daughter
CDC 'Split Type':

Write-up: pt recv vax & devel myalgia & arthralgia, abd pain followed by change of mental status;


Changed on 12/24/2020

VAERS ID: 93771 Before After
VAERS Form:1
Age:77.0
Sex:Female
Location:New Jersey
Vaccinated:1996-09-30
Onset:1996-10-02
Submitted:1996-10-09
Entered:1997-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Myalgia, Thinking abnormal

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:
Current Illness:
Preexisting Conditions: hx of renal stone
Allergies:
Diagnostic Lab Data: no spinal tap done as per daughter
CDC 'Split Type':

Write-up: pt recv vax & devel myalgia & arthralgia, abd pain followed by change of mental status;


Changed on 12/30/2020

VAERS ID: 93771 Before After
VAERS Form:1
Age:77.0
Sex:Female
Location:New Jersey
Vaccinated:1996-09-30
Onset:1996-10-02
Submitted:1996-10-09
Entered:1997-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Myalgia, Thinking abnormal

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:
Current Illness:
Preexisting Conditions: hx of renal stone
Allergies:
Diagnostic Lab Data: no spinal tap done as per daughter
CDC 'Split Type':

Write-up: pt recv vax & devel myalgia & arthralgia, abd pain followed by change of mental status;


Changed on 5/7/2021

VAERS ID: 93771 Before After
VAERS Form:1
Age:77.0
Sex:Female
Location:New Jersey
Vaccinated:1996-09-30
Onset:1996-10-02
Submitted:1996-10-09
Entered:1997-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Myalgia, Thinking abnormal

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:
Current Illness:
Preexisting Conditions: hx of renal stone
Allergies:
Diagnostic Lab Data: no spinal tap done as per daughter
CDC 'Split Type':

Write-up: pt recv vax & devel myalgia & arthralgia, abd pain followed by change of mental status;


Changed on 5/14/2021

VAERS ID: 93771 Before After
VAERS Form:1
Age:77.0
Sex:Female
Location:New Jersey
Vaccinated:1996-09-30
Onset:1996-10-02
Submitted:1996-10-09
Entered:1997-01-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Myalgia, Thinking abnormal

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:
Current Illness:
Preexisting Conditions: hx of renal stone
Allergies:
Diagnostic Lab Data: no spinal tap done as per daughter
CDC 'Split Type':

Write-up: pt recv vax & devel myalgia & arthralgia, abd pain followed by change of mental status;

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=93771&WAYBACKHISTORY=ON

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