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This is VAERS ID 601520

Case Details

VAERS ID: 601520 (history)  
Form: Version 1.0  
Age: 84.0  
Gender: Female  
Location: Vermont  
Vaccinated:2015-09-24
Onset:2015-09-25
   Days after vaccination:1
Submitted: 2015-10-08
   Days after onset:13
Entered: 2015-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UI428AB / UNK LA / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH U361230 / 1 LA / IM

Administered by: Other       Purchased by: Unknown
Symptoms: Erythema, Injection site pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine; BENICAR; CENTRUM; B12; DITROPAN; EVISTA; KLOR-CON; MIROLAX; NEXIUM; Loratidine
Current Illness: None
Preexisting Conditions: GERD; HTN
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Right upper extremity erythema, pruritis surrounding injection site. Onset 12 hours after vaccination. Improving with BENADRYL, loratadine added. Erythema persistent $g 1 week after vaccination.


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