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From the 10/15/2021 release of VAERS data:

This is VAERS ID 28556



Case Details

VAERS ID: 28556 (history)  
Form: Version 1.0  
Age: 29.0  
Sex: Female  
Location: Texas  
Vaccinated:1989-12-02
Onset:1989-12-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 9F01201 / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Face oedema, Hypersensitivity, Injection site pain, Oedema, Pruritus, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), 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:
Current Illness: not available
Preexisting Conditions: No hx of allergies;
Allergies:
Diagnostic Lab Data: not available
CDC Split Type: CO3234

Write-up: Allergic rxn 4-6hrs post vax developed swelling & redness of hands & feet; Swelling & redness around mouth; Itching present; Inject site normal x/some soreness;


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=28556

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