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This is VAERS ID 46497

Case Details

VAERS ID: 46497 (history)  
Form: Version 1.0  
Age: 83.0  
Sex: Male  
Location: Hawaii  
Vaccinated:1991-11-13
Onset:1991-11-13
   Days after vaccination:0
Submitted: 1992-07-10
   Days after onset:239
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: Hypokinesia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (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: Feldene
Current Illness: NONE
Preexisting Conditions: brucitis rt arm, back (surgery x 3) injury, arthritis;
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: HI9209

Write-up: aching in lt arm since vax recvd, difficulty using arm; still aches everyday cannot raise arms to reach for things up high; hx of brucitis in rt arm, arthritis & bad back (surgery 3 times);


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