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This is VAERS ID 46496

Case Details

VAERS ID: 46496 (history)  
Form: Version 1.0  
Age: 82.0  
Sex: Female  
Location: Hawaii  
Vaccinated:1991-11-13
Onset:1992-01-13
   Days after vaccination:61
Submitted: 1992-07-10
   Days after onset:178
Entered: 1992-10-26
   Days after submission:108
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 148P / UNK - / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 314914 / UNK - / -

Administered by: Public       Purchased by: Public
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Dioxin, Baby ASA, Seldane, Maxide, Potassium, Premarin
Current Illness: NONE
Preexisting Conditions: arthritis, diverticulitis
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: HI9210

Write-up: aching in rt arm began 2 mons p/vax recvd, & still aches @ noc, p/writing/baking; hx of arthritis, rx past 10 yrs Seldane "this is not an arthritis-like pain;


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