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This is VAERS ID 668677

Case Details

VAERS ID: 668677 (history)  
Form: Version 1.0  
Age: 33.0  
Gender: Male  
Location: Vermont  
Vaccinated:2016-11-17
Onset:2016-11-18
   Days after vaccination:1
Submitted: 2016-11-25
   Days after onset:7
Entered: 2016-11-29
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (AFLURIA) / CSL LIMITED WT57208 / 2 LA / UN

Administered by: Other       Purchased by: Other
Symptoms: Inflammation, Mobility decreased, Pain in extremity
SMQs:, Parkinson-like events (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin; clonazepam; sertraline
Current Illness: No
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient has inflammation and pain up and down arm and in shoulder. Patient has significant decrease in range of motion in arm.


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