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This is VAERS ID 33219

Case Details

VAERS ID: 33219 (history)  
Form: Version 1.0  
Age: 66.0  
Sex: Male  
Location: New York  
Vaccinated:1990-09-21
Onset:1990-11-18
   Days after vaccination:58
Submitted: 1991-06-20
   Days after onset:213
Entered: 1991-08-05
   Days after submission:46
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 287973 / 1 LA / -

Administered by: Private       Purchased by: Private
Symptoms: Corneal lesion
SMQs:, Corneal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Cardizam, tenorim, Isordil
Current Illness: NONE
Preexisting Conditions: Glaucoma rt eye since 1968; Cataract surgery lens implant; corneal graft rt eye 3JUL90
Allergies:
Diagnostic Lab Data: exam by opthalmologist
CDC Split Type:

Write-up: pt exp corneal graft reject of rt eye;


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