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This is VAERS ID 27278

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27278
VAERS Form:
Age:57.1
Sex:Male
Location:Maine
Vaccinated:1990-12-19
Onset:1990-12-20
Submitted:1990-12-20
Entered:1991-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 0F11200 / - LA / IM
PPV: PNU-IMUNE(R)23 / LEDERLE 287907 / 0 RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: EDEMA INJECT SITE, INJECT SITE REACT, VOMIT, MALAISE

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Advil, Theolair
Current Illness: Emphysema no acute
Preexisting Conditions: emphysema/Rt shoulder injury/smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/FLU ZONE developed malaise, vomited x 1, redness across site rt arm w/swelling. Improved by 12/26/90.


Changed on 12/8/2009

VAERS ID: 27278 Before After
VAERS Form:
Age:57.1
Sex:Male
Location:Maine
Vaccinated:1990-12-19
Onset:1990-12-20
Submitted:1990-12-20
Entered:1991-01-07 1991-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0F11200 / - LA / IM
PPV: PNU-IMUNE(R)23 PNEUMO (PNU-IMUNE) / LEDERLE LEDERLE LABORATORIES 287907 / 0 RA / SC

Administered by: Private      Purchased by: Unknown Private
Symptoms: Injection site oedema, Injection site reaction, Malaise, Vomiting, EDEMA INJECT SITE, INJECT SITE REACT, VOMIT, MALAISE

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Advil, Theolair
Current Illness: Emphysema no acute
Preexisting Conditions: emphysema/Rt shoulder injury/smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/FLU ZONE developed malaise, vomited x 1, redness across site rt arm w/swelling. Improved by 12/26/90.


Changed on 8/31/2010

VAERS ID: 27278 Before After
VAERS Form:
Age:57.1
Sex:Male
Location:Maine
Vaccinated:1990-12-19
Onset:1990-12-20
Submitted:1990-12-20
Entered:1991-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 287907 / 0 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Malaise, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Advil, Theolair
Current Illness: Emphysema no acute
Preexisting Conditions: emphysema/Rt shoulder injury/smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/FLU ZONE developed malaise, vomited x 1, redness across site rt arm w/swelling. Improved by 12/26/90.


Changed on 7/7/2013

VAERS ID: 27278 Before After
VAERS Form:
Age:57.1
Sex:Male
Location:Maine
Vaccinated:1990-12-19
Onset:1990-12-20
Submitted:1990-12-20
Entered:1991-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / - LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 287907 / 0 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Malaise, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Advil, Theolair
Current Illness: Emphysema no acute
Preexisting Conditions: emphysema/Rt shoulder injury/smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/FLU ZONE developed malaise, vomited x 1, redness across site rt arm w/swelling. Improved by 12/26/90.


Changed on 2/14/2017

VAERS ID: 27278 Before After
VAERS Form:
Age:57.1 57.0
Sex:Male
Location:Maine
Vaccinated:1990-12-19
Onset:1990-12-20
Submitted:1990-12-20
Entered:1991-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 287907 / 0 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Malaise, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Advil, Theolair
Current Illness: Emphysema no acute
Preexisting Conditions: emphysema/Rt shoulder injury/smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/FLU ZONE developed malaise, vomited x 1, redness across site rt arm w/swelling. Improved by 12/26/90.


Changed on 5/14/2017

VAERS ID: 27278 Before After
VAERS Form:
Age:57.0
Sex:Male
Location:Maine
Vaccinated:1990-12-19
Onset:1990-12-20
Submitted:1990-12-20
Entered:1991-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 287907 / 0 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Malaise, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Advil, Theolair
Current Illness: Emphysema no acute
Preexisting Conditions: emphysema/Rt shoulder injury/smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/FLU ZONE developed malaise, vomited x 1, redness across site rt arm w/swelling. Improved by 12/26/90.


Changed on 9/14/2017

VAERS ID: 27278 Before After
VAERS Form:(blank) 1
Age:57.0
Sex:Male
Location:Maine
Vaccinated:1990-12-19
Onset:1990-12-20
Submitted:1990-12-20
Entered:1991-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / - UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 287907 / 0 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Malaise, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Advil, Theolair
Current Illness: Emphysema no acute
Preexisting Conditions: emphysema/Rt shoulder injury/smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/FLU ZONE developed malaise, vomited x 1, redness across site rt arm w/swelling. Improved by 12/26/90.


Changed on 2/14/2018

VAERS ID: 27278 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Maine
Vaccinated:1990-12-19
Onset:1990-12-20
Submitted:1990-12-20
Entered:1991-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 287907 / 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Malaise, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Advil, Theolair
Current Illness: Emphysema no acute
Preexisting Conditions: emphysema/Rt shoulder injury/smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/FLU ZONE developed malaise, vomited x 1, redness across site rt arm w/swelling. Improved by 12/26/90.


Changed on 6/14/2018

VAERS ID: 27278 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Maine
Vaccinated:1990-12-19
Onset:1990-12-20
Submitted:1990-12-20
Entered:1991-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 287907 / 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Malaise, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Advil, Theolair
Current Illness: Emphysema no acute
Preexisting Conditions: emphysema/Rt shoulder injury/smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/FLU ZONE developed malaise, vomited x 1, redness across site rt arm w/swelling. Improved by 12/26/90.


Changed on 8/14/2018

VAERS ID: 27278 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Maine
Vaccinated:1990-12-19
Onset:1990-12-20
Submitted:1990-12-20
Entered:1991-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 287907 / 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Malaise, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Advil, Theolair
Current Illness: Emphysema no acute
Preexisting Conditions: emphysema/Rt shoulder injury/smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/FLU ZONE developed malaise, vomited x 1, redness across site rt arm w/swelling. Improved by 12/26/90.


Changed on 9/14/2018

VAERS ID: 27278 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Maine
Vaccinated:1990-12-19
Onset:1990-12-20
Submitted:1990-12-20
Entered:1991-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 287907 / 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Malaise, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Advil, Theolair
Current Illness: Emphysema no acute
Preexisting Conditions: emphysema/Rt shoulder injury/smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/FLU ZONE developed malaise, vomited x 1, redness across site rt arm w/swelling. Improved by 12/26/90.


Changed on 10/14/2018

VAERS ID: 27278 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Maine
Vaccinated:1990-12-19
Onset:1990-12-20
Submitted:1990-12-20
Entered:1991-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 287907 / 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Malaise, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Advil, Theolair
Current Illness: Emphysema no acute
Preexisting Conditions: emphysema/Rt shoulder injury/smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/FLU ZONE developed malaise, vomited x 1, redness across site rt arm w/swelling. Improved by 12/26/90.


Changed on 12/24/2020

VAERS ID: 27278 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Maine
Vaccinated:1990-12-19
Onset:1990-12-20
Submitted:1990-12-20
Entered:1991-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 287907 / 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Malaise, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Advil, Theolair
Current Illness: Emphysema no acute
Preexisting Conditions: emphysema/Rt shoulder injury/smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/FLU ZONE developed malaise, vomited x 1, redness across site rt arm w/swelling. Improved by 12/26/90.


Changed on 12/30/2020

VAERS ID: 27278 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Maine
Vaccinated:1990-12-19
Onset:1990-12-20
Submitted:1990-12-20
Entered:1991-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 287907 / 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Malaise, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Advil, Theolair
Current Illness: Emphysema no acute
Preexisting Conditions: emphysema/Rt shoulder injury/smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/FLU ZONE developed malaise, vomited x 1, redness across site rt arm w/swelling. Improved by 12/26/90.


Changed on 5/7/2021

VAERS ID: 27278 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Maine
Vaccinated:1990-12-19
Onset:1990-12-20
Submitted:1990-12-20
Entered:1991-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 287907 / 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Malaise, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Advil, Theolair
Current Illness: Emphysema no acute
Preexisting Conditions: emphysema/Rt shoulder injury/smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/FLU ZONE developed malaise, vomited x 1, redness across site rt arm w/swelling. Improved by 12/26/90.


Changed on 5/14/2021

VAERS ID: 27278 Before After
VAERS Form:1
Age:57.0
Sex:Male
Location:Maine
Vaccinated:1990-12-19
Onset:1990-12-20
Submitted:1990-12-20
Entered:1991-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 287907 / 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site reaction, Malaise, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Advil, Theolair
Current Illness: Emphysema no acute
Preexisting Conditions: emphysema/Rt shoulder injury/smoker
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vaccinated with Pneumococcal/FLU ZONE developed malaise, vomited x 1, redness across site rt arm w/swelling. Improved by 12/26/90.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=27278&WAYBACKHISTORY=ON


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