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This is VAERS ID 26871

(NOTE: This result is from the 2/14/2018 version of the VAERS database)

Case Details

VAERS ID: 26871 (history)  
Form: Version 1.0  
Age: 77.0  
Sex: Female  
Location: Michigan  
Vaccinated:1990-11-02
Onset:1990-11-02
   Days after vaccination:0
Submitted: 1990-11-02
   Days after onset:0
Entered: 1990-12-03
   Days after submission:31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4908208 / UNK LA / -

Administered by: Public       Purchased by: Public
Symptoms: Injection site reaction
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Diabetic, Arthritis, Hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type: MI9002

Write-up: Pt vaccinated with Influenza red edematous area noted at injection site 3 min after injection. Pt did not bleed at time of injection or later- no bandage applied. Pt denies all questioned possible rxn- local & systemic (itching, dizzy).


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180214&IDNUMBER=26871


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