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This is VAERS ID 1833430

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History of Changes from the VAERS Wayback Machine

First Appeared on 11/5/2021

VAERS ID: 1833430
VAERS Form:2
Age:3.0
Sex:Female
Location:Minnesota
Vaccinated:2021-10-28
Onset:2021-10-30
Submitted:0000-00-00
Entered:2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C5774AA / 3 RL / IM
FLU4: INFLUENZA (SEASONAL) (FLULAVAL QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS 3477H / 2 LL / IM

Administered by: Private      Purchased by: ??
Symptoms: Injection site erythema, Injection site oedema, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Mild cough
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient given influenza vaccine and 2 days later, parent reported had raised red edematous area to injection site

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