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This is VAERS ID 604128

Case Details

VAERS ID: 604128 (history)  
Form: Version 1.0  
Age: 60.0  
Gender: Female  
Location: Vermont  
Vaccinated:2015-10-19
Onset:2015-10-20
   Days after vaccination:1
Submitted: 2015-10-21
   Days after onset:1
Entered: 2015-10-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK LA / UN
VARZOS: ZOSTER (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK RA / UN

Administered by: Private       Purchased by: Unknown
Symptoms: Injection site reaction, Local reaction
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Local reaction - zoster vaccine (R) deltoid. Recommended Topical hydrocortisone.


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