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This is VAERS ID 70576

Case Details

VAERS ID: 70576 (history)  
Form: Version 1.0  
Age: 76.0  
Sex: Male  
Location: North Carolina  
Vaccinated:1990-10-15
Onset:0000-00-00
Submitted: 1990-11-12
Entered: 1990-11-16
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908189 / 1 - / -

Administered by: Private       Purchased by: Private
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: calcijex, epogen;
Current Illness: end stage renal disease,2d nephroscle
Preexisting Conditions: dialysis
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: vax was given intravenously through dialysis blood tubing as an IV push med;pt had no complaints; no adverse signs/sxs;


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