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This is VAERS ID 53151

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 53151
VAERS Form:
Age:42.0
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:1992-10-10
Submitted:1993-05-11
Entered:1993-05-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1992-1993 / PARKE-DAVIS 01772P / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: HYPOKINESIA, INSOMNIA, PAIN

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Chronic intense pain from shoulder to 7-8"" down arm; This was the 1st time pt has been vaxed for influenza; pt stated that the pain started immed p/receiving the shot; pt exp limited movement in that arm, difficulty lifting arm overhead;


Changed on 12/8/2009

VAERS ID: 53151 Before After
VAERS Form:
Age:42.0
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:1992-10-10
Submitted:1993-05-11
Entered:1993-05-27 1993-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1992-1993 INFLUENZA (SEASONAL) (FLUOGEN 92-93) / PARKE-DAVIS 01772P / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Hypokinesia, Insomnia, Pain, HYPOKINESIA, INSOMNIA, PAIN

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 23591

Write-up: Chronic intense pain from shoulder to 7-8"" 7-8" down arm; This was the 1st time pt has been vaxed for influenza; pt stated that the pain started immed p/receiving the shot; pt exp limited movement in that arm, difficulty lifting arm overhead;


Changed on 8/31/2010

VAERS ID: 53151 Before After
VAERS Form:
Age:42.0
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:1992-10-10
Submitted:1993-05-11
Entered:1993-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 92-93) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01772P / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypokinesia, Insomnia, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 23591

Write-up: Chronic intense pain from shoulder to 7-8" down arm; This was the 1st time pt has been vaxed for influenza; pt stated that the pain started immed p/receiving the shot; pt exp limited movement in that arm, difficulty lifting arm overhead;


Changed on 7/7/2013

VAERS ID: 53151 Before After
VAERS Form:
Age:42.0
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:1992-10-10
Submitted:1993-05-11
Entered:1993-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01772P / 0 - / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01772P / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypokinesia, Insomnia, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 23591

Write-up: Chronic intense pain from shoulder to 7-8" down arm; This was the 1st time pt has been vaxed for influenza; pt stated that the pain started immed p/receiving the shot; pt exp limited movement in that arm, difficulty lifting arm overhead;


Changed on 5/14/2017

VAERS ID: 53151 Before After
VAERS Form:
Age:42.0
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:1992-10-10
Submitted:1993-05-11
Entered:1993-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01772P / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypokinesia, Insomnia, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 23591

Write-up: Chronic intense pain from shoulder to 7-8" down arm; This was the 1st time pt has been vaxed for influenza; pt stated that the pain started immed p/receiving the shot; pt exp limited movement in that arm, difficulty lifting arm overhead;


Changed on 9/14/2017

VAERS ID: 53151 Before After
VAERS Form:(blank) 1
Age:42.0
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:1992-10-10
Submitted:1993-05-11
Entered:1993-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01772P / 0 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypokinesia, Insomnia, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 23591

Write-up: Chronic intense pain from shoulder to 7-8" down arm; This was the 1st time pt has been vaxed for influenza; pt stated that the pain started immed p/receiving the shot; pt exp limited movement in that arm, difficulty lifting arm overhead;


Changed on 2/14/2018

VAERS ID: 53151 Before After
VAERS Form:1
Age:42.0
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:1992-10-10
Submitted:1993-05-11
Entered:1993-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01772P / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypokinesia, Insomnia, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 23591

Write-up: Chronic intense pain from shoulder to 7-8" down arm; This was the 1st time pt has been vaxed for influenza; pt stated that the pain started immed p/receiving the shot; pt exp limited movement in that arm, difficulty lifting arm overhead;


Changed on 6/14/2018

VAERS ID: 53151 Before After
VAERS Form:1
Age:42.0
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:1992-10-10
Submitted:1993-05-11
Entered:1993-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01772P / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypokinesia, Insomnia, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 23591

Write-up: Chronic intense pain from shoulder to 7-8" down arm; This was the 1st time pt has been vaxed for influenza; pt stated that the pain started immed p/receiving the shot; pt exp limited movement in that arm, difficulty lifting arm overhead;


Changed on 8/14/2018

VAERS ID: 53151 Before After
VAERS Form:1
Age:42.0
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:1992-10-10
Submitted:1993-05-11
Entered:1993-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01772P / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypokinesia, Insomnia, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 23591

Write-up: Chronic intense pain from shoulder to 7-8" down arm; This was the 1st time pt has been vaxed for influenza; pt stated that the pain started immed p/receiving the shot; pt exp limited movement in that arm, difficulty lifting arm overhead;


Changed on 9/14/2018

VAERS ID: 53151 Before After
VAERS Form:1
Age:42.0
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:1992-10-10
Submitted:1993-05-11
Entered:1993-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01772P / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypokinesia, Insomnia, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 23591

Write-up: Chronic intense pain from shoulder to 7-8" down arm; This was the 1st time pt has been vaxed for influenza; pt stated that the pain started immed p/receiving the shot; pt exp limited movement in that arm, difficulty lifting arm overhead;


Changed on 10/14/2018

VAERS ID: 53151 Before After
VAERS Form:1
Age:42.0
Sex:Female
Location:Indiana
Vaccinated:0000-00-00
Onset:1992-10-10
Submitted:1993-05-11
Entered:1993-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01772P / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypokinesia, Insomnia, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 23591

Write-up: Chronic intense pain from shoulder to 7-8" down arm; This was the 1st time pt has been vaxed for influenza; pt stated that the pain started immed p/receiving the shot; pt exp limited movement in that arm, difficulty lifting arm overhead;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=53151&WAYBACKHISTORY=ON


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