National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 10/8/2021 release of VAERS data:

This is VAERS ID 134075



Case Details

VAERS ID: 134075 (history)  
Form: Version 1.0  
Age: 47.0  
Sex: Female  
Location: Missouri  
Vaccinated:1999-11-02
Onset:1999-11-05
   Days after vaccination:3
Submitted: 2000-02-07
   Days after onset:94
Entered: 2000-02-16
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES U0163AA / 4 RA / IM

Administered by: Public       Purchased by: Public
Symptoms: Arthralgia, Oedema peripheral, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: tested for lupus, lyme, etc
CDC Split Type:

Write-up: 1 wk following vax, pt dvlped rash & was dxed w/ poison ivy. 2 wks following vax, pt dvlped pain in joints; tx w/ Celebrex & cortisone. On 11/18, pain was so bad & hands were swollen that pt went to ER.Tx w/ Tylenol w/ codeine.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=134075

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166