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This is VAERS ID 26600

Case Details

VAERS ID: 26600 (history)  
Form: Version 1.0  
Age: 42.0  
Sex: Male  
Location: Texas  
Vaccinated:1990-10-09
Onset:1990-10-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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: Diazepam; Biscodyl, Demerol
Current Illness:
Preexisting Conditions: Spastic & dystomiquadraplegia, Cerebral palsy
Allergies:
Diagnostic Lab Data: CBC
CDC Split Type:

Write-up: Pt vaccinated with Influenza Vaccine developed hives over entire body, low grade fever.


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