National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 29510

Case Details

VAERS ID: 29510 (history)  
Form: Version 1.0  
Age: 60.0  
Sex: Male  
Location: Unknown  
   Days after vaccination:1
Submitted: 1991-03-26
   Days after onset:100
Entered: 1991-04-03
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Anorexia, Asthenia, Atelectasis, Chills, Cough, Headache, Myalgia, Paraesthesia, Pharyngitis, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: ASA
Current Illness: NONE
Preexisting Conditions: No egg allergy
Diagnostic Lab Data: CBC, Sed RAT, Cold agglutinins, chemistry profile, CT scan of head & abdomin, Legionella titer - all WNL; CXR mild basilar; atelectasis during acute phase;
CDC Split Type: 914090005

Write-up: Polymyalgia rheumatica reported in MD receiving FLUOGEN 1st shot 15DEC90; sx of URI, fevers to 101, chills w/rigors, myalgia, headache, fatigue, anorexia, non productive cough & dysesthesias of scalp; Atelectasis on CXR;

New Search

Link To This Search Result:

Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166