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

This is VAERS ID 28565



Case Details

VAERS ID: 28565 (history)  
Form: Version 1.0  
Age: 68.0  
Sex: Female  
Location: California  
Vaccinated:1990-09-25
Onset:1990-09-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11202 / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Influenza, Injection site pain, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (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:
Preexisting Conditions: not available
Allergies:
Diagnostic Lab Data: not available
CDC Split Type: CO3667

Write-up: severe itchy scalp in evening of inject; Also flu-like sx; Itchiness subsided but had pain & tenderness @ inject site; Rash developed on chest & back;


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