National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 7/16/2021 release of VAERS data:

This is VAERS ID 27081



Case Details

VAERS ID: 27081 (history)  
Form: Version 1.0  
Age: 62.0  
Sex: Male  
Location: Michigan  
Vaccinated:1990-11-19
Onset:1990-11-21
   Days after vaccination:2
Submitted: 1990-11-26
   Days after onset:5
Entered: 1990-12-17
   Days after submission:21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11222 / 2 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Dyspnoea, Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (broad), 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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Theophyllin, Nifedipine, Captopril
Current Illness:
Preexisting Conditions: allergies to Penicillin, Naprosyn, ASA, Motrin
Allergies:
Diagnostic Lab Data:
CDC Split Type: MI9005

Write-up: shoulder & chest lt side were itching, discovered area numb when trying to scratch area, c/o SOB, numbness, denies numbness in neck afebrile advised to contact physician to r/o cardiac problems


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=27081


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166