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This is VAERS ID 370905

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 370905
VAERS Form:
Age:26.0
Gender:Female
Location:Ohio
Vaccinated:2009-11-22
Onset:2009-11-22
Submitted:2009-11-22
Entered:2009-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3239AA / 0 LA / UN

Administered by: Other      Purchased by: Private
Symptoms: Throat tightness, Vaccination complication

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 7/7/2013

VAERS ID: 370905 Before After
VAERS Form:
Age:26.0
Gender:Female
Location:Ohio
Vaccinated:2009-11-22
Onset:2009-11-22
Submitted:2009-11-22
Entered:2009-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3239AA / 0 LA / UN
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3239AA / 0 LA / UN

Administered by: Other      Purchased by: Private
Symptoms: Throat tightness, Vaccination complication

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 9/14/2017

VAERS ID: 370905 Before After
VAERS Form:(blank) 1
Age:26.0
Gender:Female
Location:Ohio
Vaccinated:2009-11-22
Onset:2009-11-22
Submitted:2009-11-22
Entered:2009-12-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U3239AA / 0 1 LA / UN

Administered by: Other      Purchased by: Private
Symptoms: Throat tightness, Vaccination complication

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 2/14/2018

VAERS ID: 370905 Before After
VAERS Form:1
Age:26.0
Gender:Female
Location:Ohio
Vaccinated:2009-11-22
Onset:2009-11-22
Submitted:2009-11-22
Entered:2009-12-01
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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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