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

This is VAERS ID 28578



Case Details

VAERS ID: 28578 (history)  
Form: Version 1.0  
Age: 10.0  
Sex: Male  
Location: Unknown  
Vaccinated:1989-10-17
Onset:1989-10-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1991-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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:
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: NA
CDC Split Type: CO3680

Write-up: Urticaria, mild, less tha 6 hrs duration;


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=28578

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