National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 12/31/2003 release of VAERS data (an older release, current is 11/26/2021):

This is VAERS ID 27063

Government Disclaimer on use of this data



Case Details

VAERS ID: 27063 (history)  
Form: Version .0  
Age: 27.2  
Sex: Male  
Location: Ohio  
Vaccinated:1990-11-05
Onset:0000-00-00
Submitted: 1990-12-12
Entered: 1991-01-10
   Days after submission:29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH - / - LA / IM

Administered by: Other       Purchased by: Unknown
Symptoms: PAIN INJECT SITE
SMQs:

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

Write-up: c/o lt upper arm soreness since vax given on 5Nov90, no visible or palpable rxn noted, treatment was to apply heat & follow up /w family md if symptoms persist


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=27063


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166