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From the 12/31/2003 release of VAERS data (an older release, current is 1/15/2021):

This is VAERS ID 26600

Case Details

VAERS ID: 26600 (history)  
Form: Version .0  
Age: 42.0  
Sex: Male  
Location: Texas  
Vaccinated:1990-10-09
Onset:1990-10-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH - / - - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: URTICARIA
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:
Other Medications: Diazepam; Biscodyl, Demerol
Current Illness:
Preexisting Conditions: Spastic & dystomiquadraplegia, Cerebral palsy
Allergies:
Diagnostic Lab Data: CBC
CDC Split Type:

Write-up: Pt vaccinated with Influenza Vaccine developed hives over entire body, low grade fever.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=26600


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