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This is VAERS ID 26251

Case Details

VAERS ID: 26251 (history)  
Form: Version 1.0  
Age: 23.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:1990-10-09
Onset:1990-10-09
   Days after vaccination:0
Submitted: 1990-10-09
   Days after onset:0
Entered: 1990-10-15
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908180 / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Dysphagia, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), 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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated with Influenza developed breathing difficulty, chocking snesatins. Given Epinphrine


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