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This is VAERS ID 27078

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27078
VAERS Form:
Age:67.3
Sex:Male
Location:Oklahoma
Vaccinated:1990-11-13
Onset:1990-11-13
Submitted:1990-11-15
Entered:1991-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 0F11217 / - LA / IM
PPV: PNU-IMUNE(R)23 / LEDERLE 253978 / 0 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: ARTHRALGIA, VASODILAT

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: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: felt hot, arthralgia


Changed on 12/8/2009

VAERS ID: 27078 Before After
VAERS Form:
Age:67.3
Sex:Male
Location:Oklahoma
Vaccinated:1990-11-13
Onset:1990-11-13
Submitted:1990-11-15
Entered:1991-01-09 1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0F11217 / - LA / IM
PPV: PNU-IMUNE(R)23 PNEUMO (PNU-IMUNE) / LEDERLE LEDERLE LABORATORIES 253978 / 0 RA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Arthralgia, Vasodilatation, ARTHRALGIA, VASODILAT

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: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) OK903

Write-up: felt hot, arthralgia


Changed on 8/31/2010

VAERS ID: 27078 Before After
VAERS Form:
Age:67.3
Sex:Male
Location:Oklahoma
Vaccinated:1990-11-13
Onset:1990-11-13
Submitted:1990-11-15
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 253978 / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Vasodilatation

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: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK903

Write-up: felt hot, arthralgia


Changed on 7/7/2013

VAERS ID: 27078 Before After
VAERS Form:
Age:67.3
Sex:Male
Location:Oklahoma
Vaccinated:1990-11-13
Onset:1990-11-13
Submitted:1990-11-15
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / - LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 253978 / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Vasodilatation

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: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK903

Write-up: felt hot, arthralgia


Changed on 2/14/2017

VAERS ID: 27078 Before After
VAERS Form:
Age:67.3 67.0
Sex:Male
Location:Oklahoma
Vaccinated:1990-11-13
Onset:1990-11-13
Submitted:1990-11-15
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 253978 / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Vasodilatation

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: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK903

Write-up: felt hot, arthralgia


Changed on 5/14/2017

VAERS ID: 27078 Before After
VAERS Form:
Age:67.0
Sex:Male
Location:Oklahoma
Vaccinated:1990-11-13
Onset:1990-11-13
Submitted:1990-11-15
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 253978 / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Vasodilatation

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: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK903

Write-up: felt hot, arthralgia


Changed on 9/14/2017

VAERS ID: 27078 Before After
VAERS Form:(blank) 1
Age:67.0
Sex:Male
Location:Oklahoma
Vaccinated:1990-11-13
Onset:1990-11-13
Submitted:1990-11-15
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / - UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 253978 / 0 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Vasodilatation

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: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK903

Write-up: felt hot, arthralgia


Changed on 2/14/2018

VAERS ID: 27078 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Oklahoma
Vaccinated:1990-11-13
Onset:1990-11-13
Submitted:1990-11-15
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 253978 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Vasodilatation

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: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK903

Write-up: felt hot, arthralgia


Changed on 6/14/2018

VAERS ID: 27078 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Oklahoma
Vaccinated:1990-11-13
Onset:1990-11-13
Submitted:1990-11-15
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 253978 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Vasodilatation

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: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK903

Write-up: felt hot, arthralgia


Changed on 8/14/2018

VAERS ID: 27078 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Oklahoma
Vaccinated:1990-11-13
Onset:1990-11-13
Submitted:1990-11-15
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 253978 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Vasodilatation

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: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK903

Write-up: felt hot, arthralgia


Changed on 9/14/2018

VAERS ID: 27078 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Oklahoma
Vaccinated:1990-11-13
Onset:1990-11-13
Submitted:1990-11-15
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 253978 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Vasodilatation

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: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK903

Write-up: felt hot, arthralgia


Changed on 10/14/2018

VAERS ID: 27078 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Oklahoma
Vaccinated:1990-11-13
Onset:1990-11-13
Submitted:1990-11-15
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 253978 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Vasodilatation

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: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK903

Write-up: felt hot, arthralgia


Changed on 12/24/2020

VAERS ID: 27078 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Oklahoma
Vaccinated:1990-11-13
Onset:1990-11-13
Submitted:1990-11-15
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 253978 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Vasodilatation

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: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK903

Write-up: felt hot, arthralgia


Changed on 12/30/2020

VAERS ID: 27078 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Oklahoma
Vaccinated:1990-11-13
Onset:1990-11-13
Submitted:1990-11-15
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 253978 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Vasodilatation

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: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK903

Write-up: felt hot, arthralgia


Changed on 5/7/2021

VAERS ID: 27078 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Oklahoma
Vaccinated:1990-11-13
Onset:1990-11-13
Submitted:1990-11-15
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 253978 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Vasodilatation

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: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK903

Write-up: felt hot, arthralgia


Changed on 5/14/2021

VAERS ID: 27078 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Oklahoma
Vaccinated:1990-11-13
Onset:1990-11-13
Submitted:1990-11-15
Entered:1990-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11217 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 253978 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Arthralgia, Vasodilatation

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: has only one kidney
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': OK903

Write-up: felt hot, arthralgia

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