National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 26899

(NOTE: This result is from the 7/7/2013 version of the VAERS database)

Case Details

VAERS ID: 26899 (history)  
Form: Version .0  
Age: 40.5  
Sex: Female  
Location: California  
Vaccinated:1990-11-15
Onset:1990-11-18
   Days after vaccination:3
Submitted: 1990-11-19
   Days after onset:1
Entered: 1990-12-05
   Days after submission:16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11203 / 0 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / SCLAVO 136A1 / - RA / IM

Administered by: Public       Purchased by: Unknown
Symptoms: Asthenia, Dyspnoea, Headache, Pharyngitis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ampicillin, Sudafed, Ear drops, Pain med
Current Illness: Ear infection that was reportedly clear
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CA907

Write-up: Pt vaccinated with FLU/TD developed headache, itching throat, weak, tight chested & SOB.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20130707&IDNUMBER=26899


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