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This is VAERS ID 48837

Case Details

VAERS ID: 48837 (history)  
Form: Version 1.0  
Age: 60.0  
Sex: Female  
Location: Connecticut  
Vaccinated:1991-11-06
Onset:1991-11-20
   Days after vaccination:14
Submitted: 1993-01-05
   Days after onset:412
Entered: 1993-01-11
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 312973 / 1 - / IM A

Administered by: Public       Purchased by: Unknown
Symptoms: Arthralgia, Bronchitis, Osteoarthritis, Rheumatoid arthritis
SMQs:, Arthritis (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: bone scan & blood test pos;
CDC Split Type:

Write-up: bronchitis, inflamed sternum, pains & swelling in joints of hands knees & toes severe rheumatoid arthritis; reaction started p/flu shot;


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