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This is VAERS ID 27430

Case Details

VAERS ID: 27430 (history)  
Form: Version 1.0  
Age: 70.0  
Sex: Female  
Location: North Carolina  
Vaccinated:1990-10-18
Onset:1990-10-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1991-01-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Doxepin, Fluoxetine, Hydroxyzine
Current Illness:
Preexisting Conditions: Has received such vaccines previously without complications.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated with Influenza developed erythematous, warm, raised area localized to site of inject. Resolved w/o significant complications. Low grade fever associated w/event. Treated w/ PO Acetaminophen & Diphenhydramine,Triamcinolone crm


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