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This is VAERS ID 26708

Case Details

VAERS ID: 26708 (history)  
Form: Version 1.0  
Age: 44.0  
Sex: Male  
Location: New York  
Vaccinated:1990-11-07
Onset:1990-11-07
   Days after vaccination:0
Submitted: 1990-11-08
   Days after onset:1
Entered: 1990-11-21
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Private       Purchased by: Public
Symptoms: Chills, Cough, Hyperhidrosis, Pyrexia, Rhinitis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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 pt at 38yo flu.~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated with FLU developed fever, chills & sweating, cough, runny nose.


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