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This is VAERS ID 26042

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26042
VAERS Form:
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE / UNCLASSIFIED - / - - / -
PPV: PNEUMOVAX 23 / MSD - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: ASTHMA

Life Threatening? No
Birth Defect? No
Died? No
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: Theophylline
Current Illness:
Preexisting Conditions: COPD
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumovax/Influenza experienced an asthma attack which required a visit to a hospital ER & therapy with steroids.


Changed on 12/8/2009

VAERS ID: 26042 Before After
VAERS Form:
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-12-10 1990-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE INFLUENZA (SEASONAL) (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -
PPV: PNEUMOVAX 23 PNEUMO (PNEUMOVAX) / MSD MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthma, ASTHMA

Life Threatening? No
Birth Defect? No
Died? No
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: Theophylline
Current Illness:
Preexisting Conditions: COPD
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES89100945

Write-up: Pt vaccinated with Pneumovax/Influenza experienced an asthma attack which required a visit to a hospital ER & therapy with steroids.


Changed on 7/7/2013

VAERS ID: 26042 Before After
VAERS Form:
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthma

Life Threatening? No
Birth Defect? No
Died? No
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: Theophylline
Current Illness:
Preexisting Conditions: COPD
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES89100945

Write-up: Pt vaccinated with Pneumovax/Influenza experienced an asthma attack which required a visit to a hospital ER & therapy with steroids.


Changed on 12/14/2016

VAERS ID: 26042 Before After
VAERS Form:
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthma

Life Threatening? No
Birth Defect? No
Died? No
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: Theophylline
Current Illness:
Preexisting Conditions: COPD
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES89100945

Write-up: Pt vaccinated with Pneumovax/Influenza experienced an asthma attack which required a visit to a hospital ER & therapy with steroids.


Changed on 5/14/2017

VAERS ID: 26042 Before After
VAERS Form:
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthma

Life Threatening? No
Birth Defect? No
Died? No
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: Theophylline
Current Illness:
Preexisting Conditions: COPD
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES89100945

Write-up: Pt vaccinated with Pneumovax/Influenza experienced an asthma attack which required a visit to a hospital ER & therapy with steroids.


Changed on 9/14/2017

VAERS ID: 26042 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthma

Life Threatening? No
Birth Defect? No
Died? No
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: Theophylline
Current Illness:
Preexisting Conditions: COPD
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES89100945

Write-up: Pt vaccinated with Pneumovax/Influenza experienced an asthma attack which required a visit to a hospital ER & therapy with steroids.


Changed on 2/14/2018

VAERS ID: 26042 Before After
VAERS Form:1
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthma

Life Threatening? No
Birth Defect? No
Died? No
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: Theophylline
Current Illness:
Preexisting Conditions: COPD
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES89100945

Write-up: Pt vaccinated with Pneumovax/Influenza experienced an asthma attack which required a visit to a hospital ER & therapy with steroids.


Changed on 6/14/2018

VAERS ID: 26042 Before After
VAERS Form:1
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthma

Life Threatening? No
Birth Defect? No
Died? No
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: Theophylline
Current Illness:
Preexisting Conditions: COPD
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES89100945

Write-up: Pt vaccinated with Pneumovax/Influenza experienced an asthma attack which required a visit to a hospital ER & therapy with steroids.


Changed on 8/14/2018

VAERS ID: 26042 Before After
VAERS Form:1
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Asthma

Life Threatening? No
Birth Defect? No
Died? No
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: Theophylline
Current Illness:
Preexisting Conditions: COPD
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES89100945

Write-up: Pt vaccinated with Pneumovax/Influenza experienced an asthma attack which required a visit to a hospital ER & therapy with steroids.

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