National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 30720

Case Details

VAERS ID: 30720 (history)  
Form: Version 1.0  
Age: 69.0  
Sex: Female  
Location: Florida  
Vaccinated:1990-10-01
Onset:1991-02-15
   Days after vaccination:137
Submitted: 1991-05-16
   Days after onset:89
Entered: 1991-05-20
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS - / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Headache, Hypoxia, Infection, Lung disorder, Myalgia, Pyrexia, Respiratory disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Eosinophilic pneumonia (broad), Respiratory failure (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, 11 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Pos IgGtiter for Inf A, High Titer for IgG for inf B, pos Igm for infB mycoplasma neg
CDC Split Type: 914090047

Write-up: Acute Resp infect, pulmonary infiltrates, hypoxemia reported in pt receiving FLUOGEN; Approx 15FEB91 hosp for acute resp infect accompanied by fever, myalgia, ha/ & sputum initially not purulent; d/c p/11days & was well 2.5 wks later;


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=30720


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