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This is VAERS ID 91626

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 91626
VAERS Form:
Age:47.4
Sex:Male
Location:New York
Vaccinated:1996-10-14
Onset:1996-10-23
Submitted:1996-10-24
Entered:1996-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1996-1997 / CONNAUGHT LABS 6F71292 / - RA / -
TD: TD ADSORBED, ADULTS / CONNAUGHT LABS GC81110 / - LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: ABSCESS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: .NONE
CDC 'Split Type': NONE

Write-up: sterile abscess lt arm;


Changed on 12/8/2009

VAERS ID: 91626 Before After
VAERS Form:
Age:47.4
Sex:Male
Location:New York
Vaccinated:1996-10-14
Onset:1996-10-23
Submitted:1996-10-24
Entered:1996-11-06 1996-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1996-1997 INFLUENZA (SEASONAL) (FLUZONE 96-97) / CONNAUGHT LABS CONNAUGHT LABORATORIES 6F71292 / - RA / -
TD: TD ADSORBED, ADULTS TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES GC81110 / - LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Abscess, ABSCESS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: .NONE
CDC 'Split Type': NONE (blank)

Write-up: sterile abscess lt arm;


Changed on 8/31/2010

VAERS ID: 91626 Before After
VAERS Form:
Age:47.4
Sex:Male
Location:New York
Vaccinated:1996-10-14
Onset:1996-10-23
Submitted:1996-10-24
Entered:1996-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 96-97) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71292 / - RA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES GC81110 / - LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abscess

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: .NONE
CDC 'Split Type':

Write-up: sterile abscess lt arm;


Changed on 7/7/2013

VAERS ID: 91626 Before After
VAERS Form:
Age:47.4
Sex:Male
Location:New York
Vaccinated:1996-10-14
Onset:1996-10-23
Submitted:1996-10-24
Entered:1996-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71292 / - RA / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71292 / - RA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES GC81110 / - LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abscess

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: .NONE
CDC 'Split Type':

Write-up: sterile abscess lt arm;


Changed on 2/14/2017

VAERS ID: 91626 Before After
VAERS Form:
Age:47.4 47.0
Sex:Male
Location:New York
Vaccinated:1996-10-14
Onset:1996-10-23
Submitted:1996-10-24
Entered:1996-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71292 / - RA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES GC81110 / - LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abscess

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: .NONE
CDC 'Split Type':

Write-up: sterile abscess lt arm;


Changed on 5/14/2017

VAERS ID: 91626 Before After
VAERS Form:
Age:47.0
Sex:Male
Location:New York
Vaccinated:1996-10-14
Onset:1996-10-23
Submitted:1996-10-24
Entered:1996-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71292 / - RA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES GC81110 / - LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abscess

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NA NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: .NONE
CDC 'Split Type':

Write-up: sterile abscess lt arm;


Changed on 9/14/2017

VAERS ID: 91626 Before After
VAERS Form:(blank) 1
Age:47.0
Sex:Male
Location:New York
Vaccinated:1996-10-14
Onset:1996-10-23
Submitted:1996-10-24
Entered:1996-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71292 / - UNK RA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES GC81110 / - UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abscess

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: .NONE
CDC 'Split Type':

Write-up: sterile abscess lt arm;


Changed on 2/14/2018

VAERS ID: 91626 Before After
VAERS Form:1
Age:47.0
Sex:Male
Location:New York
Vaccinated:1996-10-14
Onset:1996-10-23
Submitted:1996-10-24
Entered:1996-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71292 / UNK RA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES GC81110 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abscess

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: .NONE
CDC 'Split Type':

Write-up: sterile abscess lt arm;


Changed on 6/14/2018

VAERS ID: 91626 Before After
VAERS Form:1
Age:47.0
Sex:Male
Location:New York
Vaccinated:1996-10-14
Onset:1996-10-23
Submitted:1996-10-24
Entered:1996-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71292 / UNK RA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES GC81110 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abscess

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: .NONE
CDC 'Split Type':

Write-up: sterile abscess lt arm;


Changed on 8/14/2018

VAERS ID: 91626 Before After
VAERS Form:1
Age:47.0
Sex:Male
Location:New York
Vaccinated:1996-10-14
Onset:1996-10-23
Submitted:1996-10-24
Entered:1996-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71292 / UNK RA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES GC81110 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abscess

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: .NONE
CDC 'Split Type':

Write-up: sterile abscess lt arm;


Changed on 9/14/2018

VAERS ID: 91626 Before After
VAERS Form:1
Age:47.0
Sex:Male
Location:New York
Vaccinated:1996-10-14
Onset:1996-10-23
Submitted:1996-10-24
Entered:1996-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71292 / UNK RA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES GC81110 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abscess

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: .NONE
CDC 'Split Type':

Write-up: sterile abscess lt arm;


Changed on 10/14/2018

VAERS ID: 91626 Before After
VAERS Form:1
Age:47.0
Sex:Male
Location:New York
Vaccinated:1996-10-14
Onset:1996-10-23
Submitted:1996-10-24
Entered:1996-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71292 / UNK RA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES GC81110 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abscess

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: .NONE
CDC 'Split Type':

Write-up: sterile abscess lt arm;


Changed on 12/24/2020

VAERS ID: 91626 Before After
VAERS Form:1
Age:47.0
Sex:Male
Location:New York
Vaccinated:1996-10-14
Onset:1996-10-23
Submitted:1996-10-24
Entered:1996-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71292 / UNK RA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES GC81110 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abscess

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: .NONE
CDC 'Split Type':

Write-up: sterile abscess lt arm;


Changed on 12/30/2020

VAERS ID: 91626 Before After
VAERS Form:1
Age:47.0
Sex:Male
Location:New York
Vaccinated:1996-10-14
Onset:1996-10-23
Submitted:1996-10-24
Entered:1996-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71292 / UNK RA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES GC81110 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abscess

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: .NONE
CDC 'Split Type':

Write-up: sterile abscess lt arm;


Changed on 5/7/2021

VAERS ID: 91626 Before After
VAERS Form:1
Age:47.0
Sex:Male
Location:New York
Vaccinated:1996-10-14
Onset:1996-10-23
Submitted:1996-10-24
Entered:1996-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71292 / UNK RA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES GC81110 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abscess

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: .NONE
CDC 'Split Type':

Write-up: sterile abscess lt arm;


Changed on 5/14/2021

VAERS ID: 91626 Before After
VAERS Form:1
Age:47.0
Sex:Male
Location:New York
Vaccinated:1996-10-14
Onset:1996-10-23
Submitted:1996-10-24
Entered:1996-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 6F71292 / UNK RA / -
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES GC81110 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abscess

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: .NONE
CDC 'Split Type':

Write-up: sterile abscess lt arm;

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