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This is VAERS ID 212176

Event Details Report

VAERS ID:212176  Vaccinated:2003-11-08
Age:44.0  Onset:2003-11-10, Days after vaccination: 2
Gender:Female  Submitted:2003-11-12, Days after onset: 2
Location:Tennessee  Entered:2003-11-12, Days after submission: 0
Life Threatening Illness? No
Died? No
Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Current Illness: None
Diagnostic Lab Data:
Previous Vaccinations:
Other Medications: FloNase
Preexisting Conditions: Allergic to sulfa and thimersol
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUNMEDIMMUNE, INC./WYETH LABORATORIES, INCunknown0IN 
Administered by: Unknown     Purchased by: Private
Symptoms: Fatigue, Rhinorrhoea
Write-up: Runny nose, stuffy nose, sneezing, fatigue, scratchy throat

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