National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 12/31/2003 release of VAERS data (an older release, current is 10/8/2021):

This is VAERS ID 95639



Case Details

VAERS ID: 95639 (history)  
Form: Version .0  
Age: 72.3  
Sex: Female  
Location: Georgia  
Vaccinated:1996-09-01
Onset:1996-12-01
   Days after vaccination:91
Submitted: 1997-03-06
   Days after onset:95
Entered: 1997-03-17
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1996-1997 / PARKE-DAVIS - / 0 A / IM

Administered by: Private       Purchased by: Unknown
Symptoms: FLU SYND, INFECT, PAROSMIA, RHINITIS, SINUSITIS
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: pt medical history is remarkable for phlebitis, hysterectomy & back trouble;
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt recv vax SEP96 & devel flu sx, loss of taste x/events to the present, loss of smell & sinus drainage in DEC96 & cont w/these events to present;pt states these events have affected daily living;pt to MD & given ATB;


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=95639

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166