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This is VAERS ID 25067

Case Details

VAERS ID: 25067 (history)  
Form: Version 1.0  
Age:   
Sex: Unknown  
Location: Wisconsin  
Vaccinated:1989-11-15
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4898038 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cellulitis, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: CLL (sic)
Allergies:
Diagnostic Lab Data: none
CDC Split Type: B034189159

Write-up: Pt experienced extreme edema & was hospitalized following adm. of Td vaccine. Condition was described as cellulitis of the lt arm. the pt fully recovered /p treatment /w antibiotics.


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