VAERS ID: |
25071 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
Minnesota |
Vaccinated: | 1989-10-27 |
Onset: | 1989-10-27 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
1990-07-09 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH |
4898137 / UNK |
- / IM |
Administered by: Private Purchased by: Unknown Symptoms: Dizziness,
Headache,
Influenza,
Injection site oedema,
Injection site pain,
Injection site reaction,
Nausea SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Infective pneumonia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient Other Medications: Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: B073089142
Write-up: pt developed erythema, edema, warmth, itching, stinging & pain in approx. 4" X 6" area at site of injection /p receiving vaccine. Experienced flu-like symptoms. That include haedache, light-headedness, dizziness, nausea within 3 hrs /p vacc |