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This is VAERS ID 27217

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27217
VAERS Form:
Age:65.3
Sex:Female
Location:Louisiana
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-19
Entered:1991-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 0F11221 / 0 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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


Changed on 12/8/2009

VAERS ID: 27217 Before After
VAERS Form:
Age:65.3
Sex:Female
Location:Louisiana
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-19
Entered:1991-01-03 1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0F11221 / 0 LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Pain, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: arthritis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) LA90122

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


Changed on 8/31/2010

VAERS ID: 27217 Before After
VAERS Form:
Age:65.3
Sex:Female
Location:Louisiana
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-19
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
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.


Changed on 7/7/2013

VAERS ID: 27217 Before After
VAERS Form:
Age:65.3
Sex:Female
Location:Louisiana
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-19
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 0 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
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.


Changed on 2/14/2017

VAERS ID: 27217 Before After
VAERS Form:
Age:65.3 65.0
Sex:Female
Location:Louisiana
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-19
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
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.


Changed on 5/14/2017

VAERS ID: 27217 Before After
VAERS Form:
Age:65.0
Sex:Female
Location:Louisiana
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-19
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: 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)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 9/14/2017

VAERS ID: 27217 Before After
VAERS Form:(blank) 1
Age:65.0
Sex:Female
Location:Louisiana
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-19
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 0 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: 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)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 2/14/2018

VAERS ID: 27217 Before After
VAERS Form:1
Age:65.0
Sex:Female
Location:Louisiana
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-19
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: 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)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 6/14/2018

VAERS ID: 27217 Before After
VAERS Form:1
Age:65.0
Sex:Female
Location:Louisiana
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-19
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: 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)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 8/14/2018

VAERS ID: 27217 Before After
VAERS Form:1
Age:65.0
Sex:Female
Location:Louisiana
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-19
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: 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)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 9/14/2018

VAERS ID: 27217 Before After
VAERS Form:1
Age:65.0
Sex:Female
Location:Louisiana
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-19
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: 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)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 10/14/2018

VAERS ID: 27217 Before After
VAERS Form:1
Age:65.0
Sex:Female
Location:Louisiana
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-19
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: 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)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 12/24/2020

VAERS ID: 27217 Before After
VAERS Form:1
Age:65.0
Sex:Female
Location:Louisiana
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-19
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: 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)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 12/30/2020

VAERS ID: 27217 Before After
VAERS Form:1
Age:65.0
Sex:Female
Location:Louisiana
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-19
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: 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)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 5/7/2021

VAERS ID: 27217 Before After
VAERS Form:1
Age:65.0
Sex:Female
Location:Louisiana
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-19
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: 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)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 5/14/2021

VAERS ID: 27217 Before After
VAERS Form:1
Age:65.0
Sex:Female
Location:Louisiana
Vaccinated:1990-11-02
Onset:1990-11-02
Submitted:1990-11-19
Entered:1990-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: 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)? Yes
ER or ED Visit (V2.0)? 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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Link To This Search Result:

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


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