National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 608049

History of Changes from the VAERS Wayback Machine

First Appeared on 11/14/2015

VAERS ID: 608049
VAERS Form:
Age:59.0
Gender:Male
Location:Vermont
Vaccinated:2015-11-02
Onset:2015-11-04
Submitted:2015-11-05
Entered:2015-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U5310CA / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site erythema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Nasal congestion/Cough
Preexisting Conditions: Penicillin Allergy
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Erythema at injection site (4 x 5 cm) nontender. Full function of (L) arm. Given Rx for BENADRYL 25 mg QHS.


Changed on 9/14/2017

VAERS ID: 608049 Before After
VAERS Form:(blank) 1
Age:59.0
Gender:Male
Location:Vermont
Vaccinated:2015-11-02
Onset:2015-11-04
Submitted:2015-11-05
Entered:2015-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U5310CA / 1 2 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site erythema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Nasal congestion/Cough
Preexisting Conditions: Penicillin Allergy
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Erythema at injection site (4 x 5 cm) nontender. Full function of (L) arm. Given Rx for BENADRYL 25 mg QHS.


Changed on 2/14/2018

VAERS ID: 608049 Before After
VAERS Form:1
Age:59.0
Gender:Male
Location:Vermont
Vaccinated:2015-11-02
Onset:2015-11-04
Submitted:2015-11-05
Entered:2015-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U5310CA / 2 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site erythema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Nasal congestion/Cough
Preexisting Conditions: Penicillin Allergy
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Erythema at injection site (4 x 5 cm) nontender. Full function of (L) arm. Given Rx for BENADRYL 25 mg QHS.


Changed on 6/14/2018

VAERS ID: 608049 Before After
VAERS Form:1
Age:59.0
Gender:Male
Location:Vermont
Vaccinated:2015-11-02
Onset:2015-11-04
Submitted:2015-11-05
Entered:2015-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U5310CA / 2 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site erythema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Nasal congestion/Cough
Preexisting Conditions: Penicillin Allergy
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Erythema at injection site (4 x 5 cm) nontender. Full function of (L) arm. Given Rx for BENADRYL 25 mg QHS.


Changed on 8/14/2018

VAERS ID: 608049 Before After
VAERS Form:1
Age:59.0
Gender:Male
Location:Vermont
Vaccinated:2015-11-02
Onset:2015-11-04
Submitted:2015-11-05
Entered:2015-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U5310CA / 2 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site erythema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Nasal congestion/Cough
Preexisting Conditions: Penicillin Allergy
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Erythema at injection site (4 x 5 cm) nontender. Full function of (L) arm. Given Rx for BENADRYL 25 mg QHS.


Changed on 9/14/2018

VAERS ID: 608049 Before After
VAERS Form:1
Age:59.0
Gender:Male
Location:Vermont
Vaccinated:2015-11-02
Onset:2015-11-04
Submitted:2015-11-05
Entered:2015-11-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U5310CA / 2 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site erythema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Nasal congestion/Cough
Preexisting Conditions: Penicillin Allergy
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Erythema at injection site (4 x 5 cm) nontender. Full function of (L) arm. Given Rx for BENADRYL 25 mg QHS.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=608049&WAYBACKHISTORY=ON


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166