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This is VAERS ID 26490

Case Details

VAERS ID: 26490 (history)  
Form: Version 1.0  
Age: 36.0  
Sex: Female  
Location: Wisconsin  
Vaccinated:1990-10-23
Onset:1990-10-23
   Days after vaccination:0
Submitted: 1990-10-24
   Days after onset:1
Entered: 1990-11-05
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK RA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH - / 1 LA / SC

Administered by: Private       Purchased by: Private
Symptoms: Injection site reaction, Pharyngitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Pepcid; Lo-ovral
Current Illness:
Preexisting Conditions: Hx similar response to flu vaccine last yr, no problem this yr when flue vaccine given in divided doses.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated with Pneumococcal/Influenza developed local erythema& induration at inject site, sensation of tightness in throat; occurred 4 hrs after pt took Benadryl 50mg; tighness relieved; took 2nd dose in AM, size of erythema decreased.


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