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This is VAERS ID 27303

Case Details

VAERS ID: 27303 (history)  
Form: Version 1.0  
Age: 74.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1990-12-11
Entered: 1991-01-04
   Days after submission:24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Neoplasm skin
SMQs:, Skin tumours of unspecified malignancy (narrow), Non-haematological tumours of unspecified malignancy (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 890346008B

Write-up: Pt vaccinated with Influenza developed keratoacanthoma at the site of injection four wks after receiving influenza vaccine. Hospitalized and the lesion was surgically removed.


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