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This is VAERS ID 27303

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27303
VAERS Form:
Age:74.0
Sex:Male
Location:Florida
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-12-11
Entered:1991-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: NEOPL SKIN

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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.


Changed on 12/8/2009

VAERS ID: 27303 Before After
VAERS Form:
Age:74.0
Sex:Male
Location:Florida
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-12-11
Entered:1991-01-08 1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) / WYETH WYETH PHARMACEUTICALS, INC - / - - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Neoplasm skin, NEOPL SKIN

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 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.


Changed on 8/31/2010

VAERS ID: 27303 Before After
VAERS Form:
Age:74.0
Sex:Male
Location:Florida
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-12-11
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 90-91) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Neoplasm skin

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
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.


Changed on 7/7/2013

VAERS ID: 27303 Before After
VAERS Form:
Age:74.0
Sex:Male
Location:Florida
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-12-11
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Neoplasm skin

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
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.


Changed on 12/14/2016

VAERS ID: 27303 Before After
VAERS Form:
Age:74.0
Sex:Male
Location:Florida
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-12-11
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Private      Purchased by: Private
Symptoms: Neoplasm skin

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
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.


Changed on 5/14/2017

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

Administered by: Private      Purchased by: Private
Symptoms: Neoplasm skin

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? 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.


Changed on 9/14/2017

VAERS ID: 27303 Before After
VAERS Form:(blank) 1
Age:74.0
Sex:Male
Location:Florida
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-12-11
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Neoplasm skin

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? 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.


Changed on 2/14/2018

VAERS ID: 27303 Before After
VAERS Form:1
Age:74.0
Sex:Male
Location:Florida
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-12-11
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Neoplasm skin

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? 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.


Changed on 6/14/2018

VAERS ID: 27303 Before After
VAERS Form:1
Age:74.0
Sex:Male
Location:Florida
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-12-11
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Neoplasm skin

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? 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.


Changed on 8/14/2018

VAERS ID: 27303 Before After
VAERS Form:1
Age:74.0
Sex:Male
Location:Florida
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-12-11
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Neoplasm skin

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? 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.


Changed on 9/14/2018

VAERS ID: 27303 Before After
VAERS Form:1
Age:74.0
Sex:Male
Location:Florida
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-12-11
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Neoplasm skin

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? 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.


Changed on 10/14/2018

VAERS ID: 27303 Before After
VAERS Form:1
Age:74.0
Sex:Male
Location:Florida
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1990-12-11
Entered:1991-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / -

Administered by: Private      Purchased by: Private
Symptoms: Neoplasm skin

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? 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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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=27303&WAYBACKHISTORY=ON


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