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This is VAERS ID 27399

Case Details

VAERS ID: 27399 (history)  
Form: Version 1.0  
Age: 30.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:1990-11-13
Onset:1990-11-14
   Days after vaccination:1
Submitted: 1991-01-08
   Days after onset:55
Entered: 1991-01-14
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11221 / 1 RA / IM

Administered by: Other       Purchased by: Public
Symptoms: Arthralgia, Injection site oedema, Injection site reaction, Myalgia, Nausea, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: OK906

Write-up: Pain, slight swelling & warmth at inject site next day. Nausea & generalized myalgia/arthralgia lasting a couple of days.


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