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From the 12/31/2003 release of VAERS data (an older release, current is 10/8/2021):

This is VAERS ID 98497



Case Details

VAERS ID: 98497 (history)  
Form: Version .0  
Age: 39.0  
Sex: Female  
Location: Iowa  
Vaccinated:1996-11-03
Onset:1996-11-03
   Days after vaccination:0
Submitted: 1996-11-03
   Days after onset:0
Entered: 1997-06-05
   Days after submission:213
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1996-1997 / WYETH 4968169 / 0 LA / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: ARTHRALGIA, HYPOKINESIA, LARYNGISMUS, PAIN, PAIN INJECT SITE
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergies to mold, pollens, sulfa, PCN;alcohol 1-2mo;I do have alot of low back pain, heel pain, bursitis hip, arthritis, psoriasis, asthma;
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt recv vax & felt tightness in throat;severe pain in arm & couldn''t lift arm;JAN97 call MD still couldn''t move arm;MD felt probable rotary cuff tendinitis;pt to physical therapy;arm & shoulder getting worse;still painful;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=98497

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