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This is VAERS ID 37794

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 37794
VAERS Form:
Age:48.2
Gender:Female
Location:Florida
Vaccinated:1991-11-08
Onset:1991-11-08
Submitted:1991-11-13
Entered:1991-12-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1991-1992 / PARKE-DAVIS 01581P / - LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: DYSPNEA, ASTHMA, MALAISE, PAIN CHEST, COUGH INC

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: childhood hayfever, multiple alleergies to dust-mold, plants, trees-Wisconsin; no problem in FL
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': childhood hayfever, multiple alleergies to dust-mold, plants, trees-Wisconsin; no problem in FL

Write-up: 8NOV91 pt recvd flu shot @ 4PM abrupt onset of bronchial asthma @ 6PM; SOB, wheezing, anterior chest pain w/coughing, sore throat, malaise; duration of rxn approx 10 hrs until 4AM; no treatment;


Changed on 12/8/2009

VAERS ID: 37794 Before After
VAERS Form:
Age:48.2
Gender:Female
Location:Florida
Vaccinated:1991-11-08
Onset:1991-11-08
Submitted:1991-11-13
Entered:1991-12-10 1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1991-1992 INFLUENZA (SEASONAL) (FLUOGEN 91-92) / PARKE-DAVIS 01581P / - LA / -

Administered by: Public      Purchased by: Unknown Public
Symptoms: Asthma, Chest pain, Cough, Dyspnoea, Malaise, Pharyngitis, DYSPNEA, ASTHMA, MALAISE, PAIN CHEST, COUGH INC

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: childhood hayfever, multiple alleergies to dust-mold, plants, trees-Wisconsin; no problem in FL
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': childhood hayfever, multiple alleergies to dust-mold, plants, trees-Wisconsin; no problem in FL FL91061

Write-up: 8NOV91 pt recvd flu shot @ 4PM abrupt onset of bronchial asthma @ 6PM; SOB, wheezing, anterior chest pain w/coughing, sore throat, malaise; duration of rxn approx 10 hrs until 4AM; no treatment;


Changed on 8/31/2010

VAERS ID: 37794 Before After
VAERS Form:
Age:48.2
Gender:Female
Location:Florida
Vaccinated:1991-11-08
Onset:1991-11-08
Submitted:1991-11-13
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 91-92) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01581P / - LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Chest pain, Cough, Dyspnoea, Malaise, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: childhood hayfever, multiple alleergies to dust-mold, plants, trees-Wisconsin; no problem in FL
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': FL91061

Write-up: 8NOV91 pt recvd flu shot @ 4PM abrupt onset of bronchial asthma @ 6PM; SOB, wheezing, anterior chest pain w/coughing, sore throat, malaise; duration of rxn approx 10 hrs until 4AM; no treatment;


Changed on 7/7/2013

VAERS ID: 37794 Before After
VAERS Form:
Age:48.2
Gender:Female
Location:Florida
Vaccinated:1991-11-08
Onset:1991-11-08
Submitted:1991-11-13
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01581P / - LA / -
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01581P / - LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Chest pain, Cough, Dyspnoea, Malaise, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: childhood hayfever, multiple alleergies to dust-mold, plants, trees-Wisconsin; no problem in FL
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': FL91061

Write-up: 8NOV91 pt recvd flu shot @ 4PM abrupt onset of bronchial asthma @ 6PM; SOB, wheezing, anterior chest pain w/coughing, sore throat, malaise; duration of rxn approx 10 hrs until 4AM; no treatment;


Changed on 2/14/2017

VAERS ID: 37794 Before After
VAERS Form:
Age:48.2 48.0
Gender:Female
Location:Florida
Vaccinated:1991-11-08
Onset:1991-11-08
Submitted:1991-11-13
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01581P / - LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Chest pain, Cough, Dyspnoea, Malaise, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: childhood hayfever, multiple alleergies to dust-mold, plants, trees-Wisconsin; no problem in FL
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': FL91061

Write-up: 8NOV91 pt recvd flu shot @ 4PM abrupt onset of bronchial asthma @ 6PM; SOB, wheezing, anterior chest pain w/coughing, sore throat, malaise; duration of rxn approx 10 hrs until 4AM; no treatment;


Changed on 5/14/2017

VAERS ID: 37794 Before After
VAERS Form:
Age:48.0
Gender:Female
Location:Florida
Vaccinated:1991-11-08
Onset:1991-11-08
Submitted:1991-11-13
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01581P / - LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Chest pain, Cough, Dyspnoea, Malaise, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: childhood hayfever, multiple alleergies to dust-mold, plants, trees-Wisconsin; no problem in FL
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': FL91061

Write-up: 8NOV91 pt recvd flu shot @ 4PM abrupt onset of bronchial asthma @ 6PM; SOB, wheezing, anterior chest pain w/coughing, sore throat, malaise; duration of rxn approx 10 hrs until 4AM; no treatment;


Changed on 9/14/2017

VAERS ID: 37794 Before After
VAERS Form:(blank) 1
Age:48.0
Gender:Female
Location:Florida
Vaccinated:1991-11-08
Onset:1991-11-08
Submitted:1991-11-13
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01581P / - UNK LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Chest pain, Cough, Dyspnoea, Malaise, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: childhood hayfever, multiple alleergies to dust-mold, plants, trees-Wisconsin; no problem in FL
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': FL91061

Write-up: 8NOV91 pt recvd flu shot @ 4PM abrupt onset of bronchial asthma @ 6PM; SOB, wheezing, anterior chest pain w/coughing, sore throat, malaise; duration of rxn approx 10 hrs until 4AM; no treatment;


Changed on 2/14/2018

VAERS ID: 37794 Before After
VAERS Form:1
Age:48.0
Gender:Female
Location:Florida
Vaccinated:1991-11-08
Onset:1991-11-08
Submitted:1991-11-13
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01581P / UNK LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Chest pain, Cough, Dyspnoea, Malaise, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: childhood hayfever, multiple alleergies to dust-mold, plants, trees-Wisconsin; no problem in FL
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': FL91061

Write-up: 8NOV91 pt recvd flu shot @ 4PM abrupt onset of bronchial asthma @ 6PM; SOB, wheezing, anterior chest pain w/coughing, sore throat, malaise; duration of rxn approx 10 hrs until 4AM; no treatment;


Changed on 6/14/2018

VAERS ID: 37794 Before After
VAERS Form:1
Age:48.0
Gender:Female
Location:Florida
Vaccinated:1991-11-08
Onset:1991-11-08
Submitted:1991-11-13
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01581P / UNK LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Chest pain, Cough, Dyspnoea, Malaise, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: childhood hayfever, multiple alleergies to dust-mold, plants, trees-Wisconsin; no problem in FL
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': FL91061

Write-up: 8NOV91 pt recvd flu shot @ 4PM abrupt onset of bronchial asthma @ 6PM; SOB, wheezing, anterior chest pain w/coughing, sore throat, malaise; duration of rxn approx 10 hrs until 4AM; no treatment;


Changed on 8/14/2018

VAERS ID: 37794 Before After
VAERS Form:1
Age:48.0
Gender:Female
Location:Florida
Vaccinated:1991-11-08
Onset:1991-11-08
Submitted:1991-11-13
Entered:1991-12-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01581P / UNK LA / -

Administered by: Public      Purchased by: Public
Symptoms: Asthma, Chest pain, Cough, Dyspnoea, Malaise, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: childhood hayfever, multiple alleergies to dust-mold, plants, trees-Wisconsin; no problem in FL
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': FL91061

Write-up: 8NOV91 pt recvd flu shot @ 4PM abrupt onset of bronchial asthma @ 6PM; SOB, wheezing, anterior chest pain w/coughing, sore throat, malaise; duration of rxn approx 10 hrs until 4AM; no treatment;

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