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This is VAERS ID 608049

Case Details

VAERS ID: 608049 (history)  
Form: Version 1.0  
Age: 59.0  
Gender: Male  
Location: Vermont  
Vaccinated:2015-11-02
Onset:2015-11-04
   Days after vaccination:2
Submitted: 2015-11-05
   Days after onset:1
Entered: 2015-11-06
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U5310CA / 2 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Injection site erythema
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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Nasal congestion/Cough
Preexisting Conditions: Penicillin Allergy
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Erythema at injection site (4 x 5 cm) nontender. Full function of (L) arm. Given Rx for BENADRYL 25 mg QHS.


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