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This is VAERS ID 26248

Case Details

VAERS ID: 26248 (history)  
Form: Version 1.0  
Age: 86.0  
Sex: Male  
Location: Michigan  
Vaccinated:1990-10-09
Onset:1990-10-09
   Days after vaccination:0
Submitted: 1990-10-11
   Days after onset:2
Entered: 1990-10-15
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11210 / UNK - / IM A

Administered by: Private       Purchased by: Public
Symptoms: Dizziness, Ear pain, Headache, Myalgia, Rhinitis
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (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: Cordizem; Seldane
Current Illness: SLight Sinus Drainage
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated with Fluzone became light headed legs & ears started to ache by the afternoon also headache. Felt a little funny soon after the vaccine. Rest, Tylenol, Fluids advised.


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