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This is VAERS ID 27174

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27174
VAERS Form:
Age:20.5
Sex:Female
Location:Colorado
Vaccinated:1990-12-07
Onset:1990-12-07
Submitted:1990-12-11
Entered:1991-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS / PARKE-DAVIS 02480P / 0 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: DIZZINESS, NAUSEA, TINNITUS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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 vacc''d w/influenza. Within 10 min., developed dizziness, nausea, & ears rang; assisted to supine position on floor. Felt better in 5 mins. BP 130/70, Pulse 84. No swelling. ER doctor said vasovagal reaction.


Changed on 12/8/2009

VAERS ID: 27174 Before After
VAERS Form:
Age:20.5
Sex:Female
Location:Colorado
Vaccinated:1990-12-07
Onset:1990-12-07
Submitted:1990-12-11
Entered:1991-01-11 1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1990-1991 PARKE-DAVIS INFLUENZA (SEASONAL) (FLUOGEN 90-91) / PARKE-DAVIS 02480P / 0 LA / -

Administered by: Public      Purchased by: Unknown Public
Symptoms: Dizziness, Nausea, Tinnitus, DIZZINESS, NAUSEA, TINNITUS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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) CO901

Write-up: Pt vacc''d w/influenza. Within 10 min., developed dizziness, nausea, & ears rang; assisted to supine position on floor. Felt better in 5 mins. BP 130/70, Pulse 84. No swelling. ER doctor said vasovagal reaction.


Changed on 8/31/2010

VAERS ID: 27174 Before After
VAERS Form:
Age:20.5
Sex:Female
Location:Colorado
Vaccinated:1990-12-07
Onset:1990-12-07
Submitted:1990-12-11
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 90-91) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02480P / 0 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Dizziness, Nausea, Tinnitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO901

Write-up: Pt vacc''d w/influenza. Within 10 min., developed dizziness, nausea, & ears rang; assisted to supine position on floor. Felt better in 5 mins. BP 130/70, Pulse 84. No swelling. ER doctor said vasovagal reaction.


Changed on 7/7/2013

VAERS ID: 27174 Before After
VAERS Form:
Age:20.5
Sex:Female
Location:Colorado
Vaccinated:1990-12-07
Onset:1990-12-07
Submitted:1990-12-11
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02480P / 0 LA / -
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02480P / 0 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Dizziness, Nausea, Tinnitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO901

Write-up: Pt vacc''d w/influenza. Within 10 min., developed dizziness, nausea, & ears rang; assisted to supine position on floor. Felt better in 5 mins. BP 130/70, Pulse 84. No swelling. ER doctor said vasovagal reaction.


Changed on 2/14/2017

VAERS ID: 27174 Before After
VAERS Form:
Age:20.5 20.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-07
Onset:1990-12-07
Submitted:1990-12-11
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02480P / 0 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Dizziness, Nausea, Tinnitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CO901

Write-up: Pt vacc''d w/influenza. Within 10 min., developed dizziness, nausea, & ears rang; assisted to supine position on floor. Felt better in 5 mins. BP 130/70, Pulse 84. No swelling. ER doctor said vasovagal reaction.


Changed on 5/14/2017

VAERS ID: 27174 Before After
VAERS Form:
Age:20.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-07
Onset:1990-12-07
Submitted:1990-12-11
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02480P / 0 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Dizziness, Nausea, Tinnitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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': CO901

Write-up: Pt vacc''d w/influenza. Within 10 min., developed dizziness, nausea, & ears rang; assisted to supine position on floor. Felt better in 5 mins. BP 130/70, Pulse 84. No swelling. ER doctor said vasovagal reaction.


Changed on 9/14/2017

VAERS ID: 27174 Before After
VAERS Form:(blank) 1
Age:20.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-07
Onset:1990-12-07
Submitted:1990-12-11
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02480P / 0 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Dizziness, Nausea, Tinnitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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': CO901

Write-up: Pt vacc''d w/influenza. Within 10 min., developed dizziness, nausea, & ears rang; assisted to supine position on floor. Felt better in 5 mins. BP 130/70, Pulse 84. No swelling. ER doctor said vasovagal reaction.


Changed on 2/14/2018

VAERS ID: 27174 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-07
Onset:1990-12-07
Submitted:1990-12-11
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02480P / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Dizziness, Nausea, Tinnitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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': CO901

Write-up: Pt vacc''d w/influenza. Within 10 min., developed dizziness, nausea, & ears rang; assisted to supine position on floor. Felt better in 5 mins. BP 130/70, Pulse 84. No swelling. ER doctor said vasovagal reaction.


Changed on 6/14/2018

VAERS ID: 27174 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-07
Onset:1990-12-07
Submitted:1990-12-11
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02480P / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Dizziness, Nausea, Tinnitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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': CO901

Write-up: Pt vacc''d w/influenza. Within 10 min., developed dizziness, nausea, & ears rang; assisted to supine position on floor. Felt better in 5 mins. BP 130/70, Pulse 84. No swelling. ER doctor said vasovagal reaction.


Changed on 8/14/2018

VAERS ID: 27174 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-07
Onset:1990-12-07
Submitted:1990-12-11
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02480P / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Dizziness, Nausea, Tinnitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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': CO901

Write-up: Pt vacc''d w/influenza. Within 10 min., developed dizziness, nausea, & ears rang; assisted to supine position on floor. Felt better in 5 mins. BP 130/70, Pulse 84. No swelling. ER doctor said vasovagal reaction.


Changed on 9/14/2018

VAERS ID: 27174 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-07
Onset:1990-12-07
Submitted:1990-12-11
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02480P / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Dizziness, Nausea, Tinnitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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': CO901

Write-up: Pt vacc''d w/influenza. Within 10 min., developed dizziness, nausea, & ears rang; assisted to supine position on floor. Felt better in 5 mins. BP 130/70, Pulse 84. No swelling. ER doctor said vasovagal reaction.


Changed on 10/14/2018

VAERS ID: 27174 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-07
Onset:1990-12-07
Submitted:1990-12-11
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02480P / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Dizziness, Nausea, Tinnitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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': CO901

Write-up: Pt vacc''d w/influenza. Within 10 min., developed dizziness, nausea, & ears rang; assisted to supine position on floor. Felt better in 5 mins. BP 130/70, Pulse 84. No swelling. ER doctor said vasovagal reaction.


Changed on 12/24/2020

VAERS ID: 27174 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-07
Onset:1990-12-07
Submitted:1990-12-11
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02480P / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Dizziness, Nausea, Tinnitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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': CO901

Write-up: Pt vacc''d w/influenza. Within 10 min., developed dizziness, nausea, & ears rang; assisted to supine position on floor. Felt better in 5 mins. BP 130/70, Pulse 84. No swelling. ER doctor said vasovagal reaction.


Changed on 12/30/2020

VAERS ID: 27174 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-07
Onset:1990-12-07
Submitted:1990-12-11
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02480P / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Dizziness, Nausea, Tinnitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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': CO901

Write-up: Pt vacc''d w/influenza. Within 10 min., developed dizziness, nausea, & ears rang; assisted to supine position on floor. Felt better in 5 mins. BP 130/70, Pulse 84. No swelling. ER doctor said vasovagal reaction.


Changed on 5/7/2021

VAERS ID: 27174 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-07
Onset:1990-12-07
Submitted:1990-12-11
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02480P / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Dizziness, Nausea, Tinnitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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': CO901

Write-up: Pt vacc''d w/influenza. Within 10 min., developed dizziness, nausea, & ears rang; assisted to supine position on floor. Felt better in 5 mins. BP 130/70, Pulse 84. No swelling. ER doctor said vasovagal reaction.


Changed on 5/14/2021

VAERS ID: 27174 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-07
Onset:1990-12-07
Submitted:1990-12-11
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 02480P / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Dizziness, Nausea, Tinnitus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
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': CO901

Write-up: Pt vacc''d w/influenza. Within 10 min., developed dizziness, nausea, & ears rang; assisted to supine position on floor. Felt better in 5 mins. BP 130/70, Pulse 84. No swelling. ER doctor said vasovagal reaction.

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