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This is VAERS ID 26897

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26897
VAERS Form:
Age:
Sex:Unknown
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-11-30
Entered:1990-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 4918P2 / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: CHILLS, FEVER, ASTHENIA

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Fluzone developed asthenia, chills, fever.


Changed on 12/8/2009

VAERS ID: 26897 Before After
VAERS Form:
Age:
Sex:Unknown
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-11-30
Entered:1990-12-07 1990-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABS CONNAUGHT LABORATORIES 4918P2 / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Asthenia, Chills, Pyrexia, CHILLS, FEVER, ASTHENIA

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) CO3708

Write-up: Pt vaccinated with Fluzone developed asthenia, chills, fever.


Changed on 8/31/2010

VAERS ID: 26897 Before After
VAERS Form:
Age:
Sex:Unknown
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-11-30
Entered:1990-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4918P2 / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Chills, Pyrexia

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO3708

Write-up: Pt vaccinated with Fluzone developed asthenia, chills, fever.


Changed on 7/7/2013

VAERS ID: 26897 Before After
VAERS Form:
Age:
Sex:Unknown
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-11-30
Entered:1990-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4918P2 / - - / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4918P2 / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Chills, Pyrexia

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:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO3708

Write-up: Pt vaccinated with Fluzone developed asthenia, chills, fever.


Changed on 5/14/2017

VAERS ID: 26897 Before After
VAERS Form:
Age:
Sex:Unknown
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-11-30
Entered:1990-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4918P2 / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Chills, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO3708

Write-up: Pt vaccinated with Fluzone developed asthenia, chills, fever.


Changed on 9/14/2017

VAERS ID: 26897 Before After
VAERS Form:(blank) 1
Age:
Sex:Unknown
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-11-30
Entered:1990-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4918P2 / - UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Chills, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO3708

Write-up: Pt vaccinated with Fluzone developed asthenia, chills, fever.


Changed on 2/14/2018

VAERS ID: 26897 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-11-30
Entered:1990-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4918P2 / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Chills, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO3708

Write-up: Pt vaccinated with Fluzone developed asthenia, chills, fever.


Changed on 6/14/2018

VAERS ID: 26897 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-11-30
Entered:1990-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4918P2 / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Chills, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO3708

Write-up: Pt vaccinated with Fluzone developed asthenia, chills, fever.


Changed on 8/14/2018

VAERS ID: 26897 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-11-30
Entered:1990-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4918P2 / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Chills, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO3708

Write-up: Pt vaccinated with Fluzone developed asthenia, chills, fever.


Changed on 9/14/2018

VAERS ID: 26897 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-11-30
Entered:1990-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4918P2 / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Chills, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO3708

Write-up: Pt vaccinated with Fluzone developed asthenia, chills, fever.


Changed on 10/14/2018

VAERS ID: 26897 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-11-30
Entered:1990-12-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 4918P2 / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Chills, Pyrexia

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO3708

Write-up: Pt vaccinated with Fluzone developed asthenia, chills, fever.

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