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This is VAERS ID 26504

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26504
VAERS Form:
Age:66.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-09-26
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1989-1990 / PARKE-DAVIS 01770P / - LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: HEADACHE, COUGH INC, PHARYNGITIS, SINUSITIS, PAIN EAR

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Physical Exam only
CDC 'Split Type':

Write-up: Pt vaccinated with FLUOGEN developed sore throat, headache, earache, sinus drainage thru 22OCT90. Cough, congestion chest appt w/ Dr. Given antibiotic & expectorant by MD dx URI. ""Symptoms not due to influenza injection.""

Changed on 12/30/2006

VAERS ID: 26504 Before After
VAERS Form:
Age:66.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-09-26
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1989-1990 / PARKE-DAVIS 01770P / - LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: HEADACHE, COUGH INC, PHARYNGITIS, SINUSITIS, PAIN EAR

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Physical Exam only
CDC 'Split Type':

Write-up: Pt vaccinated with FLUOGEN developed sore throat, headache, earache, sinus drainage thru 22OCT90. Cough, congestion chest appt w/ Dr. Given antibiotic & expectorant by MD dx URI. ""Symptoms /"Symptoms not due to influenza injection."" injection./"

Changed on 12/8/2009

VAERS ID: 26504 Before After
VAERS Form:
Age:66.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-09-26
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-12 1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1989-1990 INFLUENZA (SEASONAL) (FLUOGEN 89-90) / PARKE-DAVIS 01770P / - LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Ear pain, Headache, Pharyngitis, Sinusitis, HEADACHE, COUGH INC, PHARYNGITIS, SINUSITIS, PAIN EAR

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Physical Exam only
CDC 'Split Type':

Write-up: Pt vaccinated with FLUOGEN developed sore throat, headache, earache, sinus drainage thru 22OCT90. Cough, congestion chest appt w/ Dr. Given antibiotic & expectorant by MD dx URI. /"Symptoms "Symptoms not due to influenza injection./" injection."

Changed on 8/31/2010

VAERS ID: 26504 Before After
VAERS Form:
Age:66.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-09-26
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 89-90) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / - LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Ear pain, Headache, Pharyngitis, Sinusitis

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Physical Exam only
CDC 'Split Type':

Write-up: Pt vaccinated with FLUOGEN developed sore throat, headache, earache, sinus drainage thru 22OCT90. Cough, congestion chest appt w/ Dr. Given antibiotic & expectorant by MD dx URI. "Symptoms not due to influenza injection."

Changed on 7/7/2013

VAERS ID: 26504 Before After
VAERS Form:
Age:66.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-09-26
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / - LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / - LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Ear pain, Headache, Pharyngitis, Sinusitis

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Physical Exam only
CDC 'Split Type':

Write-up: Pt vaccinated with FLUOGEN developed sore throat, headache, earache, sinus drainage thru 22OCT90. Cough, congestion chest appt w/ Dr. Given antibiotic & expectorant by MD dx URI. "Symptoms not due to influenza injection."

Changed on 5/14/2017

VAERS ID: 26504 Before After
VAERS Form:
Age:66.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-09-26
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / - LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Ear pain, Headache, Pharyngitis, Sinusitis

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Physical Exam only
CDC 'Split Type':

Write-up: Pt vaccinated with FLUOGEN developed sore throat, headache, earache, sinus drainage thru 22OCT90. Cough, congestion chest appt w/ Dr. Given antibiotic & expectorant by MD dx URI. "Symptoms not due to influenza injection."

Changed on 9/14/2017

VAERS ID: 26504 Before After
VAERS Form:(blank) 1
Age:66.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-09-26
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / - UNK LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Ear pain, Headache, Pharyngitis, Sinusitis

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Physical Exam only
CDC 'Split Type':

Write-up: Pt vaccinated with FLUOGEN developed sore throat, headache, earache, sinus drainage thru 22OCT90. Cough, congestion chest appt w/ Dr. Given antibiotic & expectorant by MD dx URI. "Symptoms not due to influenza injection."

Changed on 2/14/2018

VAERS ID: 26504 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-09-26
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / UNK LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Ear pain, Headache, Pharyngitis, Sinusitis

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Physical Exam only
CDC 'Split Type':

Write-up: Pt vaccinated with FLUOGEN developed sore throat, headache, earache, sinus drainage thru 22OCT90. Cough, congestion chest appt w/ Dr. Given antibiotic & expectorant by MD dx URI. "Symptoms not due to influenza injection."

Changed on 6/14/2018

VAERS ID: 26504 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-09-26
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / UNK LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Ear pain, Headache, Pharyngitis, Sinusitis

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Physical Exam only
CDC 'Split Type':

Write-up: Pt vaccinated with FLUOGEN developed sore throat, headache, earache, sinus drainage thru 22OCT90. Cough, congestion chest appt w/ Dr. Given antibiotic & expectorant by MD dx URI. "Symptoms not due to influenza injection."

Changed on 8/14/2018

VAERS ID: 26504 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-09-26
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / UNK LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Ear pain, Headache, Pharyngitis, Sinusitis

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Physical Exam only
CDC 'Split Type':

Write-up: Pt vaccinated with FLUOGEN developed sore throat, headache, earache, sinus drainage thru 22OCT90. Cough, congestion chest appt w/ Dr. Given antibiotic & expectorant by MD dx URI. "Symptoms not due to influenza injection."

Changed on 9/14/2018

VAERS ID: 26504 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-09-26
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / UNK LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Ear pain, Headache, Pharyngitis, Sinusitis

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Physical Exam only
CDC 'Split Type':

Write-up: Pt vaccinated with FLUOGEN developed sore throat, headache, earache, sinus drainage thru 22OCT90. Cough, congestion chest appt w/ Dr. Given antibiotic & expectorant by MD dx URI. "Symptoms not due to influenza injection."

Changed on 10/14/2018

VAERS ID: 26504 Before After
VAERS Form:1
Age:66.0
Sex:Female
Location:Pennsylvania
Vaccinated:1990-09-26
Onset:1990-10-14
Submitted:0000-00-00
Entered:1990-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01770P / UNK LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Ear pain, Headache, Pharyngitis, Sinusitis

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Physical Exam only
CDC 'Split Type':

Write-up: Pt vaccinated with FLUOGEN developed sore throat, headache, earache, sinus drainage thru 22OCT90. Cough, congestion chest appt w/ Dr. Given antibiotic & expectorant by MD dx URI. "Symptoms not due to influenza injection."

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=26504&WAYBACKHISTORY=ON


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