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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)

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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