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From the 8/14/2018 release of VAERS data (an older release, current is 11/26/2021):

This is VAERS ID 27063

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Case Details

VAERS ID: 27063 (history)  
Form: Version 1.0  
Age: 27.0  
Sex: Male  
Location: Ohio  
Vaccinated:1990-11-05
Onset:0000-00-00
Submitted: 1990-12-12
Entered: 1990-12-17
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK LA / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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: ~ ()~~~In patient
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


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