National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 26614

(NOTE: This result is from the 12/31/2003 version of the VAERS database)

Case Details

VAERS ID: 26614 (history)  
Form: Version .0  
Age: 44.1  
Sex: Female  
Location: Michigan  
Vaccinated:1990-11-01
Onset:1990-11-01
   Days after vaccination:0
Submitted: 1990-11-03
   Days after onset:2
Entered: 1990-11-14
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1990-1991 TYPES A&B WYETH / WYETH 4908509 / - LA / IM

Administered by: Other       Purchased by: Unknown
Symptoms: INJECT SITE REACT, MASS INJECT SITE
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: Ogen
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated with Influenza Vaccine became itchy in area lt arm; hard in area; sl swollen, red & warm started evening 1NOV90 has continued stated less red & swollen today 3NOV90.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=26614


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166