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This is VAERS ID 29302

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 29302
VAERS Form:
Age:61.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1991-02-19
Entered:1991-03-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 0F11203 / - LA / IM
PPV: PNU-IMUNE(R)23 / LEDERLE 285909 / 0 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: HYSN INJECT SITE, PAIN, MOVEMENT DIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness:
Preexisting Conditions: Heart valve condition, lower back pathology, allergic Iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Rt arm "extremely sore since pneumonia shot"; States "fever @ site when touched @ exactly where needle went in"; "Can''t raise arm w/out excruciating pain"; "cannot hook bra"; Sleeping w/heating pad; Has not seen MD for arm; Aches X 8 hrs/dy


Changed on 12/8/2009

VAERS ID: 29302 Before After
VAERS Form:
Age:61.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1991-02-19
Entered:1991-03-28 1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0F11203 / - LA / IM
PPV: PNU-IMUNE(R)23 PNEUMO (PNU-IMUNE) / LEDERLE LEDERLE LABORATORIES 285909 / 0 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Movement disorder, Pain, HYSN INJECT SITE, PAIN, MOVEMENT DIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness:
Preexisting Conditions: Heart valve condition, lower back pathology, allergic Iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) CA9131

Write-up: Rt arm "extremely sore since pneumonia shot"; States "fever @ site when touched @ exactly where needle went in"; "Can''t raise arm w/out excruciating pain"; "cannot hook bra"; Sleeping w/heating pad; Has not seen MD for arm; Aches X 8 hrs/dy


Changed on 8/31/2010

VAERS ID: 29302 Before After
VAERS Form:
Age:61.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1991-02-19
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 285909 / 0 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Movement disorder, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Heart valve condition, lower back pathology, allergic Iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9131

Write-up: Rt arm "extremely sore since pneumonia shot"; States "fever @ site when touched @ exactly where needle went in"; "Can''t raise arm w/out excruciating pain"; "cannot hook bra"; Sleeping w/heating pad; Has not seen MD for arm; Aches X 8 hrs/dy


Changed on 7/7/2013

VAERS ID: 29302 Before After
VAERS Form:
Age:61.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1991-02-19
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / - LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 285909 / 0 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Movement disorder, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Heart valve condition, lower back pathology, allergic Iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9131

Write-up: Rt arm "extremely sore since pneumonia shot"; States "fever @ site when touched @ exactly where needle went in"; "Can''t raise arm w/out excruciating pain"; "cannot hook bra"; Sleeping w/heating pad; Has not seen MD for arm; Aches X 8 hrs/dy


Changed on 5/14/2017

VAERS ID: 29302 Before After
VAERS Form:
Age:61.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1991-02-19
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 285909 / 0 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Movement disorder, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Heart valve condition, lower back pathology, allergic Iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9131

Write-up: Rt arm "extremely sore since pneumonia shot"; States "fever @ site when touched @ exactly where needle went in"; "Can''t raise arm w/out excruciating pain"; "cannot hook bra"; Sleeping w/heating pad; Has not seen MD for arm; Aches X 8 hrs/dy


Changed on 9/14/2017

VAERS ID: 29302 Before After
VAERS Form:(blank) 1
Age:61.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1991-02-19
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / - UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 0 1 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Movement disorder, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Heart valve condition, lower back pathology, allergic Iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9131

Write-up: Rt arm "extremely sore since pneumonia shot"; States "fever @ site when touched @ exactly where needle went in"; "Can''t raise arm w/out excruciating pain"; "cannot hook bra"; Sleeping w/heating pad; Has not seen MD for arm; Aches X 8 hrs/dy


Changed on 2/14/2018

VAERS ID: 29302 Before After
VAERS Form:1
Age:61.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1991-02-19
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Movement disorder, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Heart valve condition, lower back pathology, allergic Iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9131

Write-up: Rt arm "extremely sore since pneumonia shot"; States "fever @ site when touched @ exactly where needle went in"; "Can''t raise arm w/out excruciating pain"; "cannot hook bra"; Sleeping w/heating pad; Has not seen MD for arm; Aches X 8 hrs/dy


Changed on 6/14/2018

VAERS ID: 29302 Before After
VAERS Form:1
Age:61.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1991-02-19
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Movement disorder, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Heart valve condition, lower back pathology, allergic Iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9131

Write-up: Rt arm "extremely sore since pneumonia shot"; States "fever @ site when touched @ exactly where needle went in"; "Can''t raise arm w/out excruciating pain"; "cannot hook bra"; Sleeping w/heating pad; Has not seen MD for arm; Aches X 8 hrs/dy


Changed on 8/14/2018

VAERS ID: 29302 Before After
VAERS Form:1
Age:61.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1991-02-19
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Movement disorder, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Heart valve condition, lower back pathology, allergic Iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9131

Write-up: Rt arm "extremely sore since pneumonia shot"; States "fever @ site when touched @ exactly where needle went in"; "Can''t raise arm w/out excruciating pain"; "cannot hook bra"; Sleeping w/heating pad; Has not seen MD for arm; Aches X 8 hrs/dy


Changed on 9/14/2018

VAERS ID: 29302 Before After
VAERS Form:1
Age:61.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1991-02-19
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Movement disorder, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Heart valve condition, lower back pathology, allergic Iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9131

Write-up: Rt arm "extremely sore since pneumonia shot"; States "fever @ site when touched @ exactly where needle went in"; "Can''t raise arm w/out excruciating pain"; "cannot hook bra"; Sleeping w/heating pad; Has not seen MD for arm; Aches X 8 hrs/dy


Changed on 10/14/2018

VAERS ID: 29302 Before After
VAERS Form:1
Age:61.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1991-02-19
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Movement disorder, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Heart valve condition, lower back pathology, allergic Iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9131

Write-up: Rt arm "extremely sore since pneumonia shot"; States "fever @ site when touched @ exactly where needle went in"; "Can''t raise arm w/out excruciating pain"; "cannot hook bra"; Sleeping w/heating pad; Has not seen MD for arm; Aches X 8 hrs/dy


Changed on 12/24/2020

VAERS ID: 29302 Before After
VAERS Form:1
Age:61.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1991-02-19
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Movement disorder, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Heart valve condition, lower back pathology, allergic Iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9131

Write-up: Rt arm "extremely sore since pneumonia shot"; States "fever @ site when touched @ exactly where needle went in"; "Can''t raise arm w/out excruciating pain"; "cannot hook bra"; Sleeping w/heating pad; Has not seen MD for arm; Aches X 8 hrs/dy


Changed on 12/30/2020

VAERS ID: 29302 Before After
VAERS Form:1
Age:61.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1991-02-19
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Movement disorder, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Heart valve condition, lower back pathology, allergic Iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9131

Write-up: Rt arm "extremely sore since pneumonia shot"; States "fever @ site when touched @ exactly where needle went in"; "Can''t raise arm w/out excruciating pain"; "cannot hook bra"; Sleeping w/heating pad; Has not seen MD for arm; Aches X 8 hrs/dy


Changed on 5/7/2021

VAERS ID: 29302 Before After
VAERS Form:1
Age:61.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1991-02-19
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Movement disorder, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Heart valve condition, lower back pathology, allergic Iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9131

Write-up: Rt arm "extremely sore since pneumonia shot"; States "fever @ site when touched @ exactly where needle went in"; "Can''t raise arm w/out excruciating pain"; "cannot hook bra"; Sleeping w/heating pad; Has not seen MD for arm; Aches X 8 hrs/dy


Changed on 5/14/2021

VAERS ID: 29302 Before After
VAERS Form:1
Age:61.0
Sex:Female
Location:California
Vaccinated:1990-11-01
Onset:1990-11-01
Submitted:1991-02-19
Entered:1991-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 285909 / 1 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Movement disorder, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Heart valve condition, lower back pathology, allergic Iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA9131

Write-up: Rt arm "extremely sore since pneumonia shot"; States "fever @ site when touched @ exactly where needle went in"; "Can''t raise arm w/out excruciating pain"; "cannot hook bra"; Sleeping w/heating pad; Has not seen MD for arm; Aches X 8 hrs/dy

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=29302&WAYBACKHISTORY=ON


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