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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 108979 |
VAERS Form: | |
Age: | 63.6 |
Sex: | Male |
Location: | Texas |
Vaccinated: | 1997-10-24 |
Onset: | 1997-10-27 |
Submitted: | 1998-02-23 |
Entered: | 1998-04-01 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: FLUZONE 1997-1998 / CONNAUGHT LABS | 7F81735 / - | LA / IM |
Administered by: Unknown Purchased by: Unknown
Symptoms: PAIN, PARESTHESIA
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NONE
Write-up: cont severe pain in lt arm, lt shoulder, lt shoulder blade & numb forefinger lt hand;
Vaccinated: | 1997-10-24 |
Onset: | 1997-10-27 |
Submitted: | 1998-02-23 |
Entered: | 1998-04-01 1998-03-31 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: FLUZONE 1997-1998 INFLUENZA (SEASONAL) (FLUZONE 97-98) / CONNAUGHT LABS CONNAUGHT LABORATORIES | 7F81735 / - | LA / IM |
Administered by: Unknown Purchased by: Unknown Private
Symptoms: Pain, Paraesthesia, PAIN, PARESTHESIA
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NONE TX98031
Write-up: cont severe pain in lt arm, lt shoulder, lt shoulder blade & numb forefinger lt hand;
Vaccinated: | 1997-10-24 |
Onset: | 1997-10-27 |
Submitted: | 1998-02-23 |
Entered: | 1998-03-31 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (SEASONAL) (FLUZONE 97-98) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES | 7F81735 / - | LA / IM |
Administered by: Unknown Purchased by: Private
Symptoms: Pain, Paraesthesia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TX98031
Write-up: cont severe pain in lt arm, lt shoulder, lt shoulder blade & numb forefinger lt hand;
Vaccinated: | 1997-10-24 |
Onset: | 1997-10-27 |
Submitted: | 1998-02-23 |
Entered: | 1998-03-31 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES | 7F81735 / - | LA / IM |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES | 7F81735 / - | LA / IM |
Administered by: Unknown Purchased by: Private
Symptoms: Pain, Paraesthesia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TX98031
Write-up: cont severe pain in lt arm, lt shoulder, lt shoulder blade & numb forefinger lt hand;
Vaccinated: | 1997-10-24 |
Onset: | 1997-10-27 |
Submitted: | 1998-02-23 |
Entered: | 1998-03-31 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES | 7F81735 / - | LA / IM |
Administered by: Unknown Purchased by: Private
Symptoms: Pain, Paraesthesia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TX98031
Write-up: cont severe pain in lt arm, lt shoulder, lt shoulder blade & numb forefinger lt hand;
Vaccinated: | 1997-10-24 |
Onset: | 1997-10-27 |
Submitted: | 1998-02-23 |
Entered: | 1998-03-31 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES | 7F81735 / - | LA / IM |
Administered by: Unknown Purchased by: Private
Symptoms: Pain, Paraesthesia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TX98031
Write-up: cont severe pain in lt arm, lt shoulder, lt shoulder blade & numb forefinger lt hand;
Vaccinated: | 1997-10-24 |
Onset: | 1997-10-27 |
Submitted: | 1998-02-23 |
Entered: | 1998-03-31 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES | 7F81735 / - UNK | LA / IM |
Administered by: Unknown Purchased by: Private
Symptoms: Pain, Paraesthesia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TX98031
Write-up: cont severe pain in lt arm, lt shoulder, lt shoulder blade & numb forefinger lt hand;
Vaccinated: | 1997-10-24 |
Onset: | 1997-10-27 |
Submitted: | 1998-02-23 |
Entered: | 1998-03-31 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES | 7F81735 / UNK | LA / IM |
Administered by: Unknown Purchased by: Private
Symptoms: Pain, Paraesthesia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TX98031
Write-up: cont severe pain in lt arm, lt shoulder, lt shoulder blade & numb forefinger lt hand;
Vaccinated: | 1997-10-24 |
Onset: | 1997-10-27 |
Submitted: | 1998-02-23 |
Entered: | 1998-03-31 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES | 7F81735 / UNK | LA / IM |
Administered by: Unknown Purchased by: Private
Symptoms: Pain, Paraesthesia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TX98031
Write-up: cont severe pain in lt arm, lt shoulder, lt shoulder blade & numb forefinger lt hand;
Vaccinated: | 1997-10-24 |
Onset: | 1997-10-27 |
Submitted: | 1998-02-23 |
Entered: | 1998-03-31 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES | 7F81735 / UNK | LA / IM |
Administered by: Unknown Purchased by: Private
Symptoms: Pain, Paraesthesia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TX98031
Write-up: cont severe pain in lt arm, lt shoulder, lt shoulder blade & numb forefinger lt hand;
Vaccinated: | 1997-10-24 |
Onset: | 1997-10-27 |
Submitted: | 1998-02-23 |
Entered: | 1998-03-31 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES | 7F81735 / UNK | LA / IM |
Administered by: Unknown Purchased by: Private
Symptoms: Pain, Paraesthesia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TX98031
Write-up: cont severe pain in lt arm, lt shoulder, lt shoulder blade & numb forefinger lt hand;
Vaccinated: | 1997-10-24 |
Onset: | 1997-10-27 |
Submitted: | 1998-02-23 |
Entered: | 1998-03-31 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES | 7F81735 / UNK | LA / IM |
Administered by: Unknown Purchased by: Private
Symptoms: Pain, Paraesthesia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TX98031
Write-up: cont severe pain in lt arm, lt shoulder, lt shoulder blade & numb forefinger lt hand;
Vaccinated: | 1997-10-24 |
Onset: | 1997-10-27 |
Submitted: | 1998-02-23 |
Entered: | 1998-03-31 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES | 7F81735 / UNK | LA / IM |
Administered by: Unknown Purchased by: Private
Symptoms: Pain, Paraesthesia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TX98031
Write-up: cont severe pain in lt arm, lt shoulder, lt shoulder blade & numb forefinger lt hand;
Vaccinated: | 1997-10-24 |
Onset: | 1997-10-27 |
Submitted: | 1998-02-23 |
Entered: | 1998-03-31 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES | 7F81735 / UNK | LA / IM |
Administered by: Unknown Purchased by: Private
Symptoms: Pain, Paraesthesia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': TX98031
Write-up: cont severe pain in lt arm, lt shoulder, lt shoulder blade & numb forefinger lt hand;
Link To This Search Result:
https://medalerts.org/vaersdb/findfield.php?IDNUMBER=108979&WAYBACKHISTORY=ON
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