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From the 9/17/2021 release of VAERS data:

This is VAERS ID 27217



Case Details

VAERS ID: 27217 (history)  
Form: Version 1.0  
Age: 65.0  
Sex: Female  
Location: Louisiana  
Vaccinated:1990-11-02
Onset:1990-11-02
   Days after vaccination:0
Submitted: 1990-11-19
   Days after onset:17
Entered: 1990-12-27
   Days after submission:38
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 1 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data:
CDC Split Type: LA90122

Write-up: Leg became painful from 6" above ankle, up leg, radiating to back.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=27217


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