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VAERS ID: 1000252

AGE: UNK| SEX: F|State: FR

Description

allergic reaction to the influenza vaccine; cold; Initial information received on 22-Jan-2021 regarding an unsolicited valid serious case received from a other health professional. This case involves a adult female patient (unspecified age) who had allergic reaction to the influenza vaccine (hypersensitivity) and cold (nasopharyngitis), while she received INFLUENZA VACCINE. Medical history, medical treatment(s), vaccination(s), concomitant medications and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer (lot number and expiry date not reported) via unknown route in unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a serious allergic reaction to the influenza vaccine (hypersensitivity) unknown latency following the administration of INFLUENZA VACCINE. The patient was hospitalized for this event. On an unknown date, the patient developed a non-serious cold (nasopharyngitis) unknown latency following the administration of INFLUENZA VACCINE. No laboratory data was provided. It was not reported if the patient received a corrective treatment. At the time of reporting, the outcome of event was unknown. Information on lot number was requested in the case.; Sender's Comments: This case concerns a adult female patient (unspecified age) who had hypersensitivity and nasopharyngitis after vaccination with INFLUENZA VACCINE produced by unknown manufacturer. The time to onset is unknown. Additional information regarding medical history, condition at the time of vaccination, lab data excluding other predisposing etiologies would be needed for complete assessment of the case. Based upon the reported information, the role of the suspect vaccine cannot be assessed.

Symptoms

Hypersensitivity, Nasopharyngitis

Vaccines

VAX DATE: | ONSET DATE: | DAYS TO ONSET:
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • FLUX
  • UNKNOWN MANUFACTURER
  • INFLUENZA (SEASONAL) (NO BRAND NAME)

        RECVDATE:
        04 February 2021
        CAGE_YR:
        CAGE_MO:
        RPT_DATE:
        DIED:
        DATEDIED:
        L_THREAT:
        ER_VISIT:
        HOSPITAL:
        Y
        HOSPDAYS:
        X_STAY:
        DISABLE:
        RECOVD:
        U
        LAB_DATA:
        V_ADMINBY:
        OTH
        OTHER_MEDS:
        CUR_ILL:
        HISTORY:
        PRIOR_VAX:
        SPLTTYPE:
        BRSA2021SA027414
        FORM_VERS:
        2
        TODAYS_DATE:
        03 February 2021
        BIRTH_DEFECT:
        OFC_VISIT:
        ER_ED_VISIT:
        ALLERGIES:
        V_FUNDBY:
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