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This is VAERS ID 46496

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 46496
VAERS Form:
Age:82.5
Sex:Female
Location:Hawaii
Vaccinated:1991-11-13
Onset:1992-01-13
Submitted:1992-07-10
Entered:1992-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1991-1992 / PARKE-DAVIS 148P / - - / -
PPV: PNU-IMUNE(R)23 / LEDERLE 314914 / - - / -

Administered by: Public      Purchased by: Unknown
Symptoms: MYALGIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NONE
Other Medications: Dioxin, Baby ASA, Seldane, Maxide, Potassium, Premarin
Current Illness: NONE
Preexisting Conditions: arthritis, diverticulitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': arthritis, diverticulitis

Write-up: aching in rt arm began 2 mons p/vax recvd, & still aches @ noc, p/writing/baking; hx of arthritis, rx past 10 yrs Seldane ""this is not an arthritis-like pain;

Changed on 12/8/2009

VAERS ID: 46496 Before After
VAERS Form:
Age:82.5
Sex:Female
Location:Hawaii
Vaccinated:1991-11-13
Onset:1992-01-13
Submitted:1992-07-10
Entered:1992-10-29 1992-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1991-1992 INFLUENZA (SEASONAL) (FLUOGEN 91-92) / PARKE-DAVIS 148P / - - / -
PPV: PNU-IMUNE(R)23 PNEUMO (PNU-IMUNE) / LEDERLE LEDERLE LABORATORIES 314914 / - - / -

Administered by: Public      Purchased by: Unknown Public
Symptoms: Myalgia, MYALGIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NONE
Other Medications: Dioxin, Baby ASA, Seldane, Maxide, Potassium, Premarin
Current Illness: NONE
Preexisting Conditions: arthritis, diverticulitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': arthritis, diverticulitis HI9210

Write-up: aching in rt arm began 2 mons p/vax recvd, & still aches @ noc, p/writing/baking; hx of arthritis, rx past 10 yrs Seldane ""this "this is not an arthritis-like pain;

Changed on 8/31/2010

VAERS ID: 46496 Before After
VAERS Form:
Age:82.5
Sex:Female
Location:Hawaii
Vaccinated:1991-11-13
Onset:1992-01-13
Submitted:1992-07-10
Entered:1992-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 91-92) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 148P / - - / -
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 314914 / - - / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NONE
Other Medications: Dioxin, Baby ASA, Seldane, Maxide, Potassium, Premarin
Current Illness: NONE
Preexisting Conditions: arthritis, diverticulitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': HI9210

Write-up: aching in rt arm began 2 mons p/vax recvd, & still aches @ noc, p/writing/baking; hx of arthritis, rx past 10 yrs Seldane "this is not an arthritis-like pain;

Changed on 7/7/2013

VAERS ID: 46496 Before After
VAERS Form:
Age:82.5
Sex:Female
Location:Hawaii
Vaccinated:1991-11-13
Onset:1992-01-13
Submitted:1992-07-10
Entered:1992-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 148P / - - / -
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 148P / - - / -
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 314914 / - - / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NONE
Other Medications: Dioxin, Baby ASA, Seldane, Maxide, Potassium, Premarin
Current Illness: NONE
Preexisting Conditions: arthritis, diverticulitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': HI9210

Write-up: aching in rt arm began 2 mons p/vax recvd, & still aches @ noc, p/writing/baking; hx of arthritis, rx past 10 yrs Seldane "this is not an arthritis-like pain;

Changed on 2/14/2017

VAERS ID: 46496 Before After
VAERS Form:
Age:82.5 82.0
Sex:Female
Location:Hawaii
Vaccinated:1991-11-13
Onset:1992-01-13
Submitted:1992-07-10
Entered:1992-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 148P / - - / -
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 314914 / - - / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NONE
Other Medications: Dioxin, Baby ASA, Seldane, Maxide, Potassium, Premarin
Current Illness: NONE
Preexisting Conditions: arthritis, diverticulitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': HI9210

Write-up: aching in rt arm began 2 mons p/vax recvd, & still aches @ noc, p/writing/baking; hx of arthritis, rx past 10 yrs Seldane "this is not an arthritis-like pain;

Changed on 5/14/2017

VAERS ID: 46496 Before After
VAERS Form:
Age:82.0
Sex:Female
Location:Hawaii
Vaccinated:1991-11-13
Onset:1992-01-13
Submitted:1992-07-10
Entered:1992-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 148P / - - / -
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 314914 / - - / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NONE NONE~ ()~~~In patient
Other Medications: Dioxin, Baby ASA, Seldane, Maxide, Potassium, Premarin
Current Illness: NONE
Preexisting Conditions: arthritis, diverticulitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': HI9210

Write-up: aching in rt arm began 2 mons p/vax recvd, & still aches @ noc, p/writing/baking; hx of arthritis, rx past 10 yrs Seldane "this is not an arthritis-like pain;

Changed on 9/14/2017

VAERS ID: 46496 Before After
VAERS Form:(blank) 1
Age:82.0
Sex:Female
Location:Hawaii
Vaccinated:1991-11-13
Onset:1992-01-13
Submitted:1992-07-10
Entered:1992-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 148P / - UNK - / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 314914 / - UNK - / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NONE~ ()~~~In patient
Other Medications: Dioxin, Baby ASA, Seldane, Maxide, Potassium, Premarin
Current Illness: NONE
Preexisting Conditions: arthritis, diverticulitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': HI9210

Write-up: aching in rt arm began 2 mons p/vax recvd, & still aches @ noc, p/writing/baking; hx of arthritis, rx past 10 yrs Seldane "this is not an arthritis-like pain;

Changed on 2/14/2018

VAERS ID: 46496 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Hawaii
Vaccinated:1991-11-13
Onset:1992-01-13
Submitted:1992-07-10
Entered:1992-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 148P / UNK - / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 314914 / UNK - / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NONE~ ()~~~In patient
Other Medications: Dioxin, Baby ASA, Seldane, Maxide, Potassium, Premarin
Current Illness: NONE
Preexisting Conditions: arthritis, diverticulitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': HI9210

Write-up: aching in rt arm began 2 mons p/vax recvd, & still aches @ noc, p/writing/baking; hx of arthritis, rx past 10 yrs Seldane "this is not an arthritis-like pain;

Changed on 6/14/2018

VAERS ID: 46496 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Hawaii
Vaccinated:1991-11-13
Onset:1992-01-13
Submitted:1992-07-10
Entered:1992-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 148P / UNK - / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 314914 / UNK - / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NONE~ ()~~~In patient
Other Medications: Dioxin, Baby ASA, Seldane, Maxide, Potassium, Premarin
Current Illness: NONE
Preexisting Conditions: arthritis, diverticulitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': HI9210

Write-up: aching in rt arm began 2 mons p/vax recvd, & still aches @ noc, p/writing/baking; hx of arthritis, rx past 10 yrs Seldane "this is not an arthritis-like pain;

Changed on 8/14/2018

VAERS ID: 46496 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Hawaii
Vaccinated:1991-11-13
Onset:1992-01-13
Submitted:1992-07-10
Entered:1992-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 148P / UNK - / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 314914 / UNK - / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NONE~ ()~~~In patient
Other Medications: Dioxin, Baby ASA, Seldane, Maxide, Potassium, Premarin
Current Illness: NONE
Preexisting Conditions: arthritis, diverticulitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': HI9210

Write-up: aching in rt arm began 2 mons p/vax recvd, & still aches @ noc, p/writing/baking; hx of arthritis, rx past 10 yrs Seldane "this is not an arthritis-like pain;

Changed on 9/14/2018

VAERS ID: 46496 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Hawaii
Vaccinated:1991-11-13
Onset:1992-01-13
Submitted:1992-07-10
Entered:1992-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 148P / UNK - / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 314914 / UNK - / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NONE~ ()~~~In patient
Other Medications: Dioxin, Baby ASA, Seldane, Maxide, Potassium, Premarin
Current Illness: NONE
Preexisting Conditions: arthritis, diverticulitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': HI9210

Write-up: aching in rt arm began 2 mons p/vax recvd, & still aches @ noc, p/writing/baking; hx of arthritis, rx past 10 yrs Seldane "this is not an arthritis-like pain;

Changed on 10/14/2018

VAERS ID: 46496 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Hawaii
Vaccinated:1991-11-13
Onset:1992-01-13
Submitted:1992-07-10
Entered:1992-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 148P / UNK - / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 314914 / UNK - / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NONE~ ()~~~In patient
Other Medications: Dioxin, Baby ASA, Seldane, Maxide, Potassium, Premarin
Current Illness: NONE
Preexisting Conditions: arthritis, diverticulitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': HI9210

Write-up: aching in rt arm began 2 mons p/vax recvd, & still aches @ noc, p/writing/baking; hx of arthritis, rx past 10 yrs Seldane "this is not an arthritis-like pain;

Changed on 12/24/2020

VAERS ID: 46496 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Hawaii
Vaccinated:1991-11-13
Onset:1992-01-13
Submitted:1992-07-10
Entered:1992-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 148P / UNK - / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 314914 / UNK - / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NONE~ ()~~~In patient
Other Medications: Dioxin, Baby ASA, Seldane, Maxide, Potassium, Premarin
Current Illness: NONE
Preexisting Conditions: arthritis, diverticulitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': HI9210

Write-up: aching in rt arm began 2 mons p/vax recvd, & still aches @ noc, p/writing/baking; hx of arthritis, rx past 10 yrs Seldane "this is not an arthritis-like pain;

Changed on 12/30/2020

VAERS ID: 46496 Before After
VAERS Form:1
Age:82.0
Sex:Female
Location:Hawaii
Vaccinated:1991-11-13
Onset:1992-01-13
Submitted:1992-07-10
Entered:1992-10-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 148P / UNK - / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 314914 / UNK - / -

Administered by: Public      Purchased by: Public
Symptoms: Myalgia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: NONE~ ()~~~In patient
Other Medications: Dioxin, Baby ASA, Seldane, Maxide, Potassium, Premarin
Current Illness: NONE
Preexisting Conditions: arthritis, diverticulitis
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': HI9210

Write-up: aching in rt arm began 2 mons p/vax recvd, & still aches @ noc, p/writing/baking; hx of arthritis, rx past 10 yrs Seldane "this is not an arthritis-like pain;

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