VAERS ID: 25025

AGE: | SEX: U|STATE: FL (United States)

Description

rash, pruritus

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Symptoms

Rash, Pruritus

Vaccines

VAX DATE: | ONSET DATE: 01-10-1990| DAYS TO ONSET:
NameDose #TypeManufacturerLotRouteSite
INFLUENZA (SEASONAL) (FLUZONE) 0 FLU3 CONNAUGHT LABORATORIES 9J01133

RECVDATE:07-09-1990
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:
V_ADMINBY:
OTHER_MEDS:treated with Hydroxazine
CUR_ILL:
HISTORY:
PRIOR_VAX:~ ()~~~In patient
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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