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This is VAERS ID 94664

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 94664
VAERS Form:
Age:40.8
Sex:Unknown
Location:New Jersey
Vaccinated:1996-11-18
Onset:1996-11-20
Submitted:0000-00-00
Entered:1997-02-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE / UNCLASSIFIED - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: RASH, ALLERG REACT, LYMPHANGITIS

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CBC, SMAC, LFT''s all nl;
CDC 'Split Type':

Write-up: pt recv vax 18NOV96 & 20NOV pt devel ipsilateral lymphangitis lasting 2 days;this was followed by an allergic rash which has been steroid resistant;


Changed on 12/8/2009

VAERS ID: 94664 Before After
VAERS Form:
Age:40.8
Sex:Unknown
Location:New Jersey
Vaccinated:1996-11-18
Onset:1996-11-20
Submitted:0000-00-00
Entered:1997-02-11 1997-02-06
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: Hypersensitivity, Lymphangitis, Rash, RASH, ALLERG REACT, LYMPHANGITIS

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CBC, SMAC, LFT''s all nl;
CDC 'Split Type':

Write-up: pt recv vax 18NOV96 & 20NOV pt devel ipsilateral lymphangitis lasting 2 days;this was followed by an allergic rash which has been steroid resistant;


Changed on 7/7/2013

VAERS ID: 94664 Before After
VAERS Form:
Age:40.8
Sex:Unknown
Location:New Jersey
Vaccinated:1996-11-18
Onset:1996-11-20
Submitted:0000-00-00
Entered:1997-02-06
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: Hypersensitivity, Lymphangitis, Rash

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CBC, SMAC, LFT''s all nl;
CDC 'Split Type':

Write-up: pt recv vax 18NOV96 & 20NOV pt devel ipsilateral lymphangitis lasting 2 days;this was followed by an allergic rash which has been steroid resistant;


Changed on 12/14/2016

VAERS ID: 94664 Before After
VAERS Form:
Age:40.8
Sex:Unknown
Location:New Jersey
Vaccinated:1996-11-18
Onset:1996-11-20
Submitted:0000-00-00
Entered:1997-02-06
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: Hypersensitivity, Lymphangitis, Rash

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CBC, SMAC, LFT''s all nl;
CDC 'Split Type':

Write-up: pt recv vax 18NOV96 & 20NOV pt devel ipsilateral lymphangitis lasting 2 days;this was followed by an allergic rash which has been steroid resistant;


Changed on 2/14/2017

VAERS ID: 94664 Before After
VAERS Form:
Age:40.8 40.0
Sex:Unknown
Location:New Jersey
Vaccinated:1996-11-18
Onset:1996-11-20
Submitted:0000-00-00
Entered:1997-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypersensitivity, Lymphangitis, Rash

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CBC, SMAC, LFT''s all nl;
CDC 'Split Type':

Write-up: pt recv vax 18NOV96 & 20NOV pt devel ipsilateral lymphangitis lasting 2 days;this was followed by an allergic rash which has been steroid resistant;


Changed on 5/14/2017

VAERS ID: 94664 Before After
VAERS Form:
Age:40.0
Sex:Unknown
Location:New Jersey
Vaccinated:1996-11-18
Onset:1996-11-20
Submitted:0000-00-00
Entered:1997-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypersensitivity, Lymphangitis, Rash

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CBC, SMAC, LFT''s all nl;
CDC 'Split Type':

Write-up: pt recv vax 18NOV96 & 20NOV pt devel ipsilateral lymphangitis lasting 2 days;this was followed by an allergic rash which has been steroid resistant;


Changed on 9/14/2017

VAERS ID: 94664 Before After
VAERS Form:(blank) 1
Age:40.0
Sex:Unknown
Location:New Jersey
Vaccinated:1996-11-18
Onset:1996-11-20
Submitted:0000-00-00
Entered:1997-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypersensitivity, Lymphangitis, Rash

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CBC, SMAC, LFT''s all nl;
CDC 'Split Type':

Write-up: pt recv vax 18NOV96 & 20NOV pt devel ipsilateral lymphangitis lasting 2 days;this was followed by an allergic rash which has been steroid resistant;


Changed on 2/14/2018

VAERS ID: 94664 Before After
VAERS Form:1
Age:40.0
Sex:Unknown
Location:New Jersey
Vaccinated:1996-11-18
Onset:1996-11-20
Submitted:0000-00-00
Entered:1997-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypersensitivity, Lymphangitis, Rash

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CBC, SMAC, LFT''s all nl;
CDC 'Split Type':

Write-up: pt recv vax 18NOV96 & 20NOV pt devel ipsilateral lymphangitis lasting 2 days;this was followed by an allergic rash which has been steroid resistant;


Changed on 6/14/2018

VAERS ID: 94664 Before After
VAERS Form:1
Age:40.0
Sex:Unknown
Location:New Jersey
Vaccinated:1996-11-18
Onset:1996-11-20
Submitted:0000-00-00
Entered:1997-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypersensitivity, Lymphangitis, Rash

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CBC, SMAC, LFT''s all nl;
CDC 'Split Type':

Write-up: pt recv vax 18NOV96 & 20NOV pt devel ipsilateral lymphangitis lasting 2 days;this was followed by an allergic rash which has been steroid resistant;


Changed on 8/14/2018

VAERS ID: 94664 Before After
VAERS Form:1
Age:40.0
Sex:Unknown
Location:New Jersey
Vaccinated:1996-11-18
Onset:1996-11-20
Submitted:0000-00-00
Entered:1997-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypersensitivity, Lymphangitis, Rash

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CBC, SMAC, LFT''s all nl;
CDC 'Split Type':

Write-up: pt recv vax 18NOV96 & 20NOV pt devel ipsilateral lymphangitis lasting 2 days;this was followed by an allergic rash which has been steroid resistant;


Changed on 9/14/2018

VAERS ID: 94664 Before After
VAERS Form:1
Age:40.0
Sex:Unknown
Location:New Jersey
Vaccinated:1996-11-18
Onset:1996-11-20
Submitted:0000-00-00
Entered:1997-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypersensitivity, Lymphangitis, Rash

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CBC, SMAC, LFT''s all nl;
CDC 'Split Type':

Write-up: pt recv vax 18NOV96 & 20NOV pt devel ipsilateral lymphangitis lasting 2 days;this was followed by an allergic rash which has been steroid resistant;


Changed on 10/14/2018

VAERS ID: 94664 Before After
VAERS Form:1
Age:40.0
Sex:Unknown
Location:New Jersey
Vaccinated:1996-11-18
Onset:1996-11-20
Submitted:0000-00-00
Entered:1997-02-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hypersensitivity, Lymphangitis, Rash

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CBC, SMAC, LFT''s all nl;
CDC 'Split Type':

Write-up: pt recv vax 18NOV96 & 20NOV pt devel ipsilateral lymphangitis lasting 2 days;this was followed by an allergic rash which has been steroid resistant;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=94664&WAYBACKHISTORY=ON


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