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From the 11/26/2021 release of VAERS data:

This is VAERS ID 30355

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Case Details

VAERS ID: 30355 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Male  
Location: California  
Vaccinated:1991-01-28
Onset:0000-00-00
Submitted: 1991-03-19
Entered: 1991-05-09
   Days after submission:50
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11073 / 3 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. - / UNK MO / PO

Administered by: Military       Purchased by: Military
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Urticarial rash - hives trunk & neck;


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