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This is VAERS ID 26896

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

Case Details

VAERS ID: 26896 (history)  
Form: Version .0  
Age:   
Sex: Unknown  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1990-11-30
Entered: 1990-12-07
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 4918P2 / - - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: ASTHENIA, ASTHMA, CHILLS, FEVER
SMQs:

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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt vaccinated with Fluzone developed temp. not recorded, but believed to be over 37 chills, weakness, asthma worsened.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=26896


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