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From the 7/7/2013 release of VAERS data (an older release, current is 10/8/2021):

This is VAERS ID 27337



Case Details

VAERS ID: 27337 (history)  
Form: Version .0  
Age: 62.0  
Sex: Male  
Location: California  
Vaccinated:1990-12-06
Onset:1990-12-07
   Days after vaccination:1
Submitted: 1990-12-07
   Days after onset:0
Entered: 1991-01-08
   Days after submission:32
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 285909 / 0 RA / IM

Administered by: Public       Purchased by: Public
Symptoms: Injection site reaction, Osteoarthritis
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: Bee''s/Wasps, bad back
Allergies:
Diagnostic Lab Data:
CDC Split Type: CA9025

Write-up: Pt vaccinated with Pneumococcal/FLU noted heat at injection site- rt arm extending to elbow w/fluid accumulation at elbow, making elbow "sagy" looking. No other symptoms, pain, or irritation.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20130707&IDNUMBER=27337

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