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History of Changes from the VAERS Wayback Machine |
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;
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;
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;
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;
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;
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;
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;
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;
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;
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;
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;
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;
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;
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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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=91626&WAYBACKHISTORY=ON
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