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This is VAERS ID 26046

Case Details

VAERS ID: 26046 (history)  
Form: Version 1.0  
Age: 34.0  
Sex: Female  
Location: New York  
Vaccinated:1989-11-06
Onset:1989-11-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 44991 / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Chills, Injection site reaction, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: WAES89111057

Write-up: Pt vaccinated with Pneumovax 23 developed severe swelling, erythema, pain & difficulty in moving her arm over the next 24 to 36 hrs. Also, developed a fever of 101.5 w/chills. Later presented w/moderate tenderness w/erythema.


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