National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 36579

Case Details

VAERS ID: 36579 (history)  
Form: Version 1.0  
Age: 51.0  
Sex: Male  
Location: Alabama  
Vaccinated:1991-11-01
Onset:1991-11-08
   Days after vaccination:7
Submitted: 1991-11-14
   Days after onset:6
Entered: 1991-11-22
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4918132 / UNK LA / -

Administered by: Private       Purchased by: Private
Symptoms: Respiratory disorder
SMQs:, Acute central respiratory depression (broad), Respiratory failure (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, 3 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: stable @ time of vax
Preexisting Conditions: hx of asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type: AL91035

Write-up: Respiratory sx w/minimal bronchiolar infiltrate-needed hospitalization 9NOV91 to 11NOV91;


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=36579


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