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This is VAERS ID 95597

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 95597
VAERS Form:
Age:78.1
Sex:Female
Location:Michigan
Vaccinated:1996-10-08
Onset:1996-10-09
Submitted:1997-01-15
Entered:1997-03-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1996-1997 / WYETH 4968172 / - RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: HYPOKINESIA, INFECT, PAIN, ASTHENIA, NEURALGIA

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: pt son devel eczema as teenger p/flu vax;
Other Medications: NONE weekly allergy inj
Current Illness: NONE
Preexisting Conditions: allergies to tree, grass & molds;no food allergies;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': allergies to tree, grass & molds;no food allergies;

Write-up: pt devel weakness (total body) 9OCT96 AM;pain localized to upper rt arm (?deltoid muscle);felt like tightness-nerve pain that radiated to back (rt scapula area over the next few days);pain went up into face;saw MD-sinus infect/teeth p


Changed on 12/8/2009

VAERS ID: 95597 Before After
VAERS Form:
Age:78.1
Sex:Female
Location:Michigan
Vaccinated:1996-10-08
Onset:1996-10-09
Submitted:1997-01-15
Entered:1997-03-14 1997-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1996-1997 INFLUENZA (SEASONAL) (FLUSHIELD 96-97) / WYETH WYETH PHARMACEUTICALS, INC 4968172 / - RA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Asthenia, Back pain, Hypokinesia, Infection, Injection site pain, Neuralgia, Pain, Rhinitis, HYPOKINESIA, INFECT, PAIN, ASTHENIA, NEURALGIA

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: pt son devel eczema as teenger p/flu vax;
Other Medications: NONE weekly allergy inj
Current Illness: NONE
Preexisting Conditions: allergies to tree, grass & molds;no food allergies;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': allergies to tree, grass & molds;no food allergies; MI97009

Write-up: pt devel weakness (total body) 9OCT96 AM;pain localized to upper rt arm (?deltoid muscle);felt like tightness-nerve pain that radiated to back (rt scapula area over the next few days);pain went up into face;saw MD-sinus infect/teeth p


Changed on 8/31/2010

VAERS ID: 95597 Before After
VAERS Form:
Age:78.1
Sex:Female
Location:Michigan
Vaccinated:1996-10-08
Onset:1996-10-09
Submitted:1997-01-15
Entered:1997-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 96-97) INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4968172 / - RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Back pain, Hypokinesia, Infection, Injection site pain, Neuralgia, Pain, Rhinitis

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: pt son devel eczema as teenger p/flu vax;
Other Medications: NONE weekly allergy inj
Current Illness: NONE
Preexisting Conditions: allergies to tree, grass & molds;no food allergies;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MI97009

Write-up: pt devel weakness (total body) 9OCT96 AM;pain localized to upper rt arm (?deltoid muscle);felt like tightness-nerve pain that radiated to back (rt scapula area over the next few days);pain went up into face;saw MD-sinus infect/teeth p


Changed on 7/7/2013

VAERS ID: 95597 Before After
VAERS Form:
Age:78.1
Sex:Female
Location:Michigan
Vaccinated:1996-10-08
Onset:1996-10-09
Submitted:1997-01-15
Entered:1997-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968172 / - RA / IM
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968172 / - RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Back pain, Hypokinesia, Infection, Injection site pain, Neuralgia, Pain, Rhinitis

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: pt son devel eczema as teenger p/flu vax;
Other Medications: NONE weekly allergy inj
Current Illness: NONE
Preexisting Conditions: allergies to tree, grass & molds;no food allergies;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MI97009

Write-up: pt devel weakness (total body) 9OCT96 AM;pain localized to upper rt arm (?deltoid muscle);felt like tightness-nerve pain that radiated to back (rt scapula area over the next few days);pain went up into face;saw MD-sinus infect/teeth p


Changed on 2/14/2017

VAERS ID: 95597 Before After
VAERS Form:
Age:78.1 78.0
Sex:Female
Location:Michigan
Vaccinated:1996-10-08
Onset:1996-10-09
Submitted:1997-01-15
Entered:1997-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968172 / - RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Back pain, Hypokinesia, Infection, Injection site pain, Neuralgia, Pain, Rhinitis

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: pt son devel eczema as teenger p/flu vax;
Other Medications: NONE weekly allergy inj
Current Illness: NONE
Preexisting Conditions: allergies to tree, grass & molds;no food allergies;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MI97009

Write-up: pt devel weakness (total body) 9OCT96 AM;pain localized to upper rt arm (?deltoid muscle);felt like tightness-nerve pain that radiated to back (rt scapula area over the next few days);pain went up into face;saw MD-sinus infect/teeth p


Changed on 5/14/2017

VAERS ID: 95597 Before After
VAERS Form:
Age:78.0
Sex:Female
Location:Michigan
Vaccinated:1996-10-08
Onset:1996-10-09
Submitted:1997-01-15
Entered:1997-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968172 / - RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Back pain, Hypokinesia, Infection, Injection site pain, Neuralgia, Pain, Rhinitis

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: pt son devel eczema as teenger p/flu vax; vax;~ ()~~~In patient
Other Medications: NONE weekly allergy inj
Current Illness: NONE
Preexisting Conditions: allergies to tree, grass & molds;no food allergies;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MI97009

Write-up: pt devel weakness (total body) 9OCT96 AM;pain localized to upper rt arm (?deltoid muscle);felt like tightness-nerve pain that radiated to back (rt scapula area over the next few days);pain went up into face;saw MD-sinus infect/teeth p


Changed on 9/14/2017

VAERS ID: 95597 Before After
VAERS Form:(blank) 1
Age:78.0
Sex:Female
Location:Michigan
Vaccinated:1996-10-08
Onset:1996-10-09
Submitted:1997-01-15
Entered:1997-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968172 / - UNK RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Back pain, Hypokinesia, Infection, Injection site pain, Neuralgia, Pain, Rhinitis

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: pt son devel eczema as teenger p/flu vax;~ ()~~~In patient
Other Medications: NONE weekly allergy inj
Current Illness: NONE
Preexisting Conditions: allergies to tree, grass & molds;no food allergies;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MI97009

Write-up: pt devel weakness (total body) 9OCT96 AM;pain localized to upper rt arm (?deltoid muscle);felt like tightness-nerve pain that radiated to back (rt scapula area over the next few days);pain went up into face;saw MD-sinus infect/teeth p


Changed on 2/14/2018

VAERS ID: 95597 Before After
VAERS Form:1
Age:78.0
Sex:Female
Location:Michigan
Vaccinated:1996-10-08
Onset:1996-10-09
Submitted:1997-01-15
Entered:1997-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968172 / UNK RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Back pain, Hypokinesia, Infection, Injection site pain, Neuralgia, Pain, Rhinitis

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: pt son devel eczema as teenger p/flu vax;~ ()~~~In patient
Other Medications: NONE weekly allergy inj
Current Illness: NONE
Preexisting Conditions: allergies to tree, grass & molds;no food allergies;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MI97009

Write-up: pt devel weakness (total body) 9OCT96 AM;pain localized to upper rt arm (?deltoid muscle);felt like tightness-nerve pain that radiated to back (rt scapula area over the next few days);pain went up into face;saw MD-sinus infect/teeth p


Changed on 6/14/2018

VAERS ID: 95597 Before After
VAERS Form:1
Age:78.0
Sex:Female
Location:Michigan
Vaccinated:1996-10-08
Onset:1996-10-09
Submitted:1997-01-15
Entered:1997-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968172 / UNK RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Back pain, Hypokinesia, Infection, Injection site pain, Neuralgia, Pain, Rhinitis

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: pt son devel eczema as teenger p/flu vax;~ ()~~~In patient
Other Medications: NONE weekly allergy inj
Current Illness: NONE
Preexisting Conditions: allergies to tree, grass & molds;no food allergies;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MI97009

Write-up: pt devel weakness (total body) 9OCT96 AM;pain localized to upper rt arm (?deltoid muscle);felt like tightness-nerve pain that radiated to back (rt scapula area over the next few days);pain went up into face;saw MD-sinus infect/teeth p


Changed on 8/14/2018

VAERS ID: 95597 Before After
VAERS Form:1
Age:78.0
Sex:Female
Location:Michigan
Vaccinated:1996-10-08
Onset:1996-10-09
Submitted:1997-01-15
Entered:1997-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968172 / UNK RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Back pain, Hypokinesia, Infection, Injection site pain, Neuralgia, Pain, Rhinitis

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: pt son devel eczema as teenger p/flu vax;~ ()~~~In patient
Other Medications: NONE weekly allergy inj
Current Illness: NONE
Preexisting Conditions: allergies to tree, grass & molds;no food allergies;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MI97009

Write-up: pt devel weakness (total body) 9OCT96 AM;pain localized to upper rt arm (?deltoid muscle);felt like tightness-nerve pain that radiated to back (rt scapula area over the next few days);pain went up into face;saw MD-sinus infect/teeth p


Changed on 9/14/2018

VAERS ID: 95597 Before After
VAERS Form:1
Age:78.0
Sex:Female
Location:Michigan
Vaccinated:1996-10-08
Onset:1996-10-09
Submitted:1997-01-15
Entered:1997-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968172 / UNK RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Back pain, Hypokinesia, Infection, Injection site pain, Neuralgia, Pain, Rhinitis

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: pt son devel eczema as teenger p/flu vax;~ ()~~~In patient
Other Medications: NONE weekly allergy inj
Current Illness: NONE
Preexisting Conditions: allergies to tree, grass & molds;no food allergies;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MI97009

Write-up: pt devel weakness (total body) 9OCT96 AM;pain localized to upper rt arm (?deltoid muscle);felt like tightness-nerve pain that radiated to back (rt scapula area over the next few days);pain went up into face;saw MD-sinus infect/teeth p


Changed on 10/14/2018

VAERS ID: 95597 Before After
VAERS Form:1
Age:78.0
Sex:Female
Location:Michigan
Vaccinated:1996-10-08
Onset:1996-10-09
Submitted:1997-01-15
Entered:1997-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4968172 / UNK RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Back pain, Hypokinesia, Infection, Injection site pain, Neuralgia, Pain, Rhinitis

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: pt son devel eczema as teenger p/flu vax;~ ()~~~In patient
Other Medications: NONE weekly allergy inj
Current Illness: NONE
Preexisting Conditions: allergies to tree, grass & molds;no food allergies;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': MI97009

Write-up: pt devel weakness (total body) 9OCT96 AM;pain localized to upper rt arm (?deltoid muscle);felt like tightness-nerve pain that radiated to back (rt scapula area over the next few days);pain went up into face;saw MD-sinus infect/teeth p

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=95597&WAYBACKHISTORY=ON


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