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This is VAERS ID 27197

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27197
VAERS Form:
Age:57.6
Sex:Female
Location:California
Vaccinated:1990-12-06
Onset:1990-12-07
Submitted:1990-12-07
Entered:1991-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS OFF11203 / 0 LA / IM
PPV: PNU-IMUNE(R)23 / LEDERLE 285909 / 0 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: EDEMA INJECT SITE, PAIN

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: smog, grass, trees, milk, chocolate, Iodine.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/Flu experienced pain, then swelling at site.


Changed on 12/8/2009

VAERS ID: 27197 Before After
VAERS Form:
Age:57.6
Sex:Female
Location:California
Vaccinated:1990-12-06
Onset:1990-12-07
Submitted:1990-12-07
Entered:1991-01-02 1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABS CONNAUGHT LABORATORIES OFF11203 / 0 LA / IM
PPV: PNU-IMUNE(R)23 PNEUMO (PNU-IMUNE) / LEDERLE LEDERLE LABORATORIES 285909 / 0 RA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Injection site oedema, Pain, EDEMA INJECT SITE, PAIN

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: smog, grass, trees, milk, chocolate, Iodine.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) CA9019

Write-up: Pt vaccinated with Pneumococcal/Flu experienced pain, then swelling at site.


Changed on 8/31/2010

VAERS ID: 27197 Before After
VAERS Form:
Age:57.6
Sex:Female
Location:California
Vaccinated:1990-12-06
Onset:1990-12-07
Submitted:1990-12-07
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OFF11203 / 0 LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 285909 / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site oedema, Pain

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: smog, grass, trees, milk, chocolate, Iodine.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9019

Write-up: Pt vaccinated with Pneumococcal/Flu experienced pain, then swelling at site.


Changed on 7/7/2013

VAERS ID: 27197 Before After
VAERS Form:
Age:57.6
Sex:Female
Location:California
Vaccinated:1990-12-06
Onset:1990-12-07
Submitted:1990-12-07
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OFF11203 / 0 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OFF11203 / 0 LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 285909 / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site oedema, Pain

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: smog, grass, trees, milk, chocolate, Iodine.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9019

Write-up: Pt vaccinated with Pneumococcal/Flu experienced pain, then swelling at site.


Changed on 2/14/2017

VAERS ID: 27197 Before After
VAERS Form:
Age:57.6 57.0
Sex:Female
Location:California
Vaccinated:1990-12-06
Onset:1990-12-07
Submitted:1990-12-07
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OFF11203 / 0 LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 285909 / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site oedema, Pain

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: smog, grass, trees, milk, chocolate, Iodine.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9019

Write-up: Pt vaccinated with Pneumococcal/Flu experienced pain, then swelling at site.


Changed on 5/14/2017

VAERS ID: 27197 Before After
VAERS Form:
Age:57.0
Sex:Female
Location:California
Vaccinated:1990-12-06
Onset:1990-12-07
Submitted:1990-12-07
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OFF11203 / 0 LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 285909 / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site oedema, Pain

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: smog, grass, trees, milk, chocolate, Iodine.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9019

Write-up: Pt vaccinated with Pneumococcal/Flu experienced pain, then swelling at site.


Changed on 9/14/2017

VAERS ID: 27197 Before After
VAERS Form:(blank) 1
Age:57.0
Sex:Female
Location:California
Vaccinated:1990-12-06
Onset:1990-12-07
Submitted:1990-12-07
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OFF11203 / 0 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 0 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site oedema, Pain

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: smog, grass, trees, milk, chocolate, Iodine.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9019

Write-up: Pt vaccinated with Pneumococcal/Flu experienced pain, then swelling at site.


Changed on 2/14/2018

VAERS ID: 27197 Before After
VAERS Form:1
Age:57.0
Sex:Female
Location:California
Vaccinated:1990-12-06
Onset:1990-12-07
Submitted:1990-12-07
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OFF11203 / 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site oedema, Pain

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: smog, grass, trees, milk, chocolate, Iodine.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9019

Write-up: Pt vaccinated with Pneumococcal/Flu experienced pain, then swelling at site.


Changed on 6/14/2018

VAERS ID: 27197 Before After
VAERS Form:1
Age:57.0
Sex:Female
Location:California
Vaccinated:1990-12-06
Onset:1990-12-07
Submitted:1990-12-07
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OFF11203 / 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site oedema, Pain

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: smog, grass, trees, milk, chocolate, Iodine.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9019

Write-up: Pt vaccinated with Pneumococcal/Flu experienced pain, then swelling at site.


Changed on 8/14/2018

VAERS ID: 27197 Before After
VAERS Form:1
Age:57.0
Sex:Female
Location:California
Vaccinated:1990-12-06
Onset:1990-12-07
Submitted:1990-12-07
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OFF11203 / 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site oedema, Pain

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: smog, grass, trees, milk, chocolate, Iodine.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9019

Write-up: Pt vaccinated with Pneumococcal/Flu experienced pain, then swelling at site.


Changed on 9/14/2018

VAERS ID: 27197 Before After
VAERS Form:1
Age:57.0
Sex:Female
Location:California
Vaccinated:1990-12-06
Onset:1990-12-07
Submitted:1990-12-07
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OFF11203 / 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site oedema, Pain

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: smog, grass, trees, milk, chocolate, Iodine.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9019

Write-up: Pt vaccinated with Pneumococcal/Flu experienced pain, then swelling at site.


Changed on 10/14/2018

VAERS ID: 27197 Before After
VAERS Form:1
Age:57.0
Sex:Female
Location:California
Vaccinated:1990-12-06
Onset:1990-12-07
Submitted:1990-12-07
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OFF11203 / 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site oedema, Pain

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: smog, grass, trees, milk, chocolate, Iodine.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9019

Write-up: Pt vaccinated with Pneumococcal/Flu experienced pain, then swelling at site.


Changed on 12/24/2020

VAERS ID: 27197 Before After
VAERS Form:1
Age:57.0
Sex:Female
Location:California
Vaccinated:1990-12-06
Onset:1990-12-07
Submitted:1990-12-07
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OFF11203 / 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site oedema, Pain

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: smog, grass, trees, milk, chocolate, Iodine.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9019

Write-up: Pt vaccinated with Pneumococcal/Flu experienced pain, then swelling at site.


Changed on 12/30/2020

VAERS ID: 27197 Before After
VAERS Form:1
Age:57.0
Sex:Female
Location:California
Vaccinated:1990-12-06
Onset:1990-12-07
Submitted:1990-12-07
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OFF11203 / 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site oedema, Pain

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: smog, grass, trees, milk, chocolate, Iodine.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9019

Write-up: Pt vaccinated with Pneumococcal/Flu experienced pain, then swelling at site.


Changed on 5/7/2021

VAERS ID: 27197 Before After
VAERS Form:1
Age:57.0
Sex:Female
Location:California
Vaccinated:1990-12-06
Onset:1990-12-07
Submitted:1990-12-07
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OFF11203 / 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site oedema, Pain

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: smog, grass, trees, milk, chocolate, Iodine.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9019

Write-up: Pt vaccinated with Pneumococcal/Flu experienced pain, then swelling at site.


Changed on 5/14/2021

VAERS ID: 27197 Before After
VAERS Form:1
Age:57.0
Sex:Female
Location:California
Vaccinated:1990-12-06
Onset:1990-12-07
Submitted:1990-12-07
Entered:1990-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES OFF11203 / 1 LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site oedema, Pain

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: smog, grass, trees, milk, chocolate, Iodine.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9019

Write-up: Pt vaccinated with Pneumococcal/Flu experienced pain, then swelling at site.

New Search

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=27197&WAYBACKHISTORY=ON


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