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This is VAERS ID 370905

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 370905 (history)  
Form: Version 1.0  
Age: 26.0  
Gender: Female  
Location: Ohio  
Vaccinated:2009-11-22
Onset:2009-11-22
   Days after vaccination:0
Submitted: 2009-11-22
   Days after onset:0
Entered: 2009-12-01
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3239AA / 1 LA / UN

Administered by: Other       Purchased by: Private
Symptoms: Throat tightness, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METFORMIN; CLARITIN; ORTHO-TRYCYCLIC
Current Illness: Denies
Preexisting Conditions: Sulfa; PCN; Codeine; Vicodin; Bee stings; nuts; latex; pollen
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt reports throat feels tight. Reports h/o "rxn" after GARDASIL. Taken BENADRYL 50 mg x 1. Observed x 45 min. Vitals stable. Pt returned home. Called pt 2 hours later - doing better. No resp/skin issues. Sister vaccinated (latex allergy as well) without incident.


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