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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 150596 |
VAERS Form: | |
Age: | 60.0 |
Sex: | Male |
Location: | New Jersey |
Vaccinated: | 2000-02-09 |
Onset: | 2000-02-09 |
Submitted: | 2000-03-28 |
Entered: | 2000-03-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HIBV: UNK. HAEMOPHILUS B / UNCLASSIFIED | - / 0 | - / IM |
MEN: UNK. MENINGOCOCCAL POLYSACCHARIDE / UNCLASSIFIED | - / 0 | - / SC |
PPV: PNU-IMUNE(R)23 / LEDERLE | 463727 / 0 | - / - |
Administered by: Private Purchased by: Unknown
Symptoms: CEREBROVASC ACCID, MYELOMA
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Pt with a history of multiple myeloma received injections of Pnu-Imune 23, Act-HIB (Aventis Pasteur SA) and Menomune-a/c/y/w 135 (Aventis Pasteur Inc) vaccines on 9-FEB-2000. Later that day he experienced ""stroke-like symptoms"" and was brought to emerge"ncy room. After extensive testing it was determined he had an embolic stroke and the reporter did not feel it was related to the vaccines.
Vaccinated: | 2000-02-09 |
Onset: | 2000-02-09 |
Submitted: | 2000-03-28 |
Entered: | 2000-03-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HIBV: UNK. HAEMOPHILUS B / UNCLASSIFIED | - / 0 | - / IM |
MEN: UNK. MENINGOCOCCAL POLYSACCHARIDE / UNCLASSIFIED | - / 0 | - / SC |
PPV: PNU-IMUNE(R)23 / LEDERLE | 463727 / 0 | - / - |
Administered by: Private Purchased by: Unknown
Symptoms: CEREBROVASC ACCID, MYELOMA
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: Pt with a history of multiple myeloma received injections of Pnu-Imune 23, Act-HIB (Aventis Pasteur SA) and Menomune-a/c/y/w 135 (Aventis Pasteur Inc) vaccines on 9-FEB-2000. Later that day he experienced ""stroke-like symptoms"" /"stroke-like symptoms/" and was brought to emerge"ncy room. After extensive testing it was determined he had an embolic stroke and the reporter did not feel it was related to the vaccines.
Vaccinated: | 2000-02-09 |
Onset: | 2000-02-09 |
Submitted: | 2000-03-28 |
Entered: | 2000-03-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HIBV: UNK. HAEMOPHILUS B HIB (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER | - / 0 | - / IM |
MEN: UNK. MENINGOCOCCAL POLYSACCHARIDE MENINGOCOCCAL (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER | - / 0 | - / SC |
PPV: PNU-IMUNE(R)23 PNEUMO (PNU-IMUNE) / LEDERLE LEDERLE LABORATORIES | 463727 / 0 | - / - |
Administered by: Private Purchased by: Unknown Other
Symptoms: Cerebrovascular accident, Multiple myeloma, CEREBROVASC ACCID, MYELOMA
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) HQ1812624MAR2000
Write-up: Pt with a history of multiple myeloma received injections of Pnu-Imune 23, Act-HIB (Aventis Pasteur SA) and Menomune-a/c/y/w 135 (Aventis Pasteur Inc) vaccines on 9-FEB-2000. Later that day he experienced /"stroke-like symptoms/" "stroke-like symptoms" and was brought to emerge"ncy emergency room. After extensive testing it was determined he had an embolic stroke and the reporter did not feel it was related to the vaccines.
Vaccinated: | 2000-02-09 |
Onset: | 2000-02-09 |
Submitted: | 2000-03-28 |
Entered: | 2000-03-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 0 | - / IM |
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 0 | - / SC |
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES PFIZER/WYETH | 463727 / 0 | - / - |
Administered by: Private Purchased by: Other
Symptoms: Cerebrovascular accident, Multiple myeloma
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': HQ1812624MAR2000
Write-up: Pt with a history of multiple myeloma received injections of Pnu-Imune 23, Act-HIB (Aventis Pasteur SA) and Menomune-a/c/y/w 135 (Aventis Pasteur Inc) vaccines on 9-FEB-2000. Later that day he experienced "stroke-like symptoms" and was brought to emergency room. After extensive testing it was determined he had an embolic stroke and the reporter did not feel it was related to the vaccines.
Vaccinated: | 2000-02-09 |
Onset: | 2000-02-09 |
Submitted: | 2000-03-28 |
Entered: | 2000-03-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 0 1 | - / IM |
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 0 1 | - / SC |
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH | 463727 / 0 1 | - / - |
Administered by: Private Purchased by: Other
Symptoms: Cerebrovascular accident
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': HQ1812624MAR2000
Write-up: Pt with a history of multiple myeloma received injections of Pnu-Imune 23, Act-HIB (Aventis Pasteur SA) and Menomune-a/c/y/w 135 (Aventis Pasteur Inc) vaccines on 9-FEB-2000. Later that day he experienced "stroke-like symptoms" and was brought to emergency room. After extensive testing it was determined he had an embolic stroke and the reporter did not feel it was related to the vaccines.
Vaccinated: | 2000-02-09 |
Onset: | 2000-02-09 |
Submitted: | 2000-03-28 |
Entered: | 2000-03-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 1 | - / IM |
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 1 | - / SC |
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH | 463727 / 1 | - / - |
Administered by: Private Purchased by: Other
Symptoms: Cerebrovascular accident
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': HQ1812624MAR2000
Write-up: Pt with a history of multiple myeloma received injections of Pnu-Imune 23, Act-HIB (Aventis Pasteur SA) and Menomune-a/c/y/w 135 (Aventis Pasteur Inc) vaccines on 9-FEB-2000. Later that day he experienced "stroke-like symptoms" and was brought to emergency room. After extensive testing it was determined he had an embolic stroke and the reporter did not feel it was related to the vaccines.
Vaccinated: | 2000-02-09 |
Onset: | 2000-02-09 |
Submitted: | 2000-03-28 |
Entered: | 2000-03-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 1 | - / IM |
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 1 | - / SC |
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH | 463727 / 1 | - / - |
Administered by: Private Purchased by: Other
Symptoms: Cerebrovascular accident
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': HQ1812624MAR2000
Write-up: Pt with a history of multiple myeloma received injections of Pnu-Imune 23, Act-HIB (Aventis Pasteur SA) and Menomune-a/c/y/w 135 (Aventis Pasteur Inc) vaccines on 9-FEB-2000. Later that day he experienced "stroke-like symptoms" and was brought to emergency room. After extensive testing it was determined he had an embolic stroke and the reporter did not feel it was related to the vaccines.
Vaccinated: | 2000-02-09 |
Onset: | 2000-02-09 |
Submitted: | 2000-03-28 |
Entered: | 2000-03-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 1 | - / IM |
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 1 | - / SC |
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH | 463727 / 1 | - / - |
Administered by: Private Purchased by: Other
Symptoms: Cerebrovascular accident
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': HQ1812624MAR2000
Write-up: Pt with a history of multiple myeloma received injections of Pnu-Imune 23, Act-HIB (Aventis Pasteur SA) and Menomune-a/c/y/w 135 (Aventis Pasteur Inc) vaccines on 9-FEB-2000. Later that day he experienced "stroke-like symptoms" and was brought to emergency room. After extensive testing it was determined he had an embolic stroke and the reporter did not feel it was related to the vaccines.
Vaccinated: | 2000-02-09 |
Onset: | 2000-02-09 |
Submitted: | 2000-03-28 |
Entered: | 2000-03-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 1 | - / IM |
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 1 | - / SC |
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH | 463727 / 1 | - / - |
Administered by: Private Purchased by: Other
Symptoms: Cerebrovascular accident
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': HQ1812624MAR2000
Write-up: Pt with a history of multiple myeloma received injections of Pnu-Imune 23, Act-HIB (Aventis Pasteur SA) and Menomune-a/c/y/w 135 (Aventis Pasteur Inc) vaccines on 9-FEB-2000. Later that day he experienced "stroke-like symptoms" and was brought to emergency room. After extensive testing it was determined he had an embolic stroke and the reporter did not feel it was related to the vaccines.
Vaccinated: | 2000-02-09 |
Onset: | 2000-02-09 |
Submitted: | 2000-03-28 |
Entered: | 2000-03-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 1 | - / IM |
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 1 | - / SC |
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH | 463727 / 1 | - / - |
Administered by: Private Purchased by: Other
Symptoms: Cerebrovascular accident
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': HQ1812624MAR2000
Write-up: Pt with a history of multiple myeloma received injections of Pnu-Imune 23, Act-HIB (Aventis Pasteur SA) and Menomune-a/c/y/w 135 (Aventis Pasteur Inc) vaccines on 9-FEB-2000. Later that day he experienced "stroke-like symptoms" and was brought to emergency room. After extensive testing it was determined he had an embolic stroke and the reporter did not feel it was related to the vaccines.
Vaccinated: | 2000-02-09 |
Onset: | 2000-02-09 |
Submitted: | 2000-03-28 |
Entered: | 2000-03-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 1 | - / IM |
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 1 | - / SC |
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH | 463727 / 1 | - / - |
Administered by: Private Purchased by: Other
Symptoms: Cerebrovascular accident
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': HQ1812624MAR2000
Write-up: Pt with a history of multiple myeloma received injections of Pnu-Imune 23, Act-HIB (Aventis Pasteur SA) and Menomune-a/c/y/w 135 (Aventis Pasteur Inc) vaccines on 9-FEB-2000. Later that day he experienced "stroke-like symptoms" and was brought to emergency room. After extensive testing it was determined he had an embolic stroke and the reporter did not feel it was related to the vaccines.
Vaccinated: | 2000-02-09 |
Onset: | 2000-02-09 |
Submitted: | 2000-03-28 |
Entered: | 2000-03-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 1 | - / IM |
MEN: MENINGOCOCCAL (NO BRAND NAME) / UNKNOWN MANUFACTURER | - / 1 | - / SC |
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH | 463727 / 1 | - / - |
Administered by: Private Purchased by: Other
Symptoms: Cerebrovascular accident
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2000-02-15
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': HQ1812624MAR2000
Write-up: Pt with a history of multiple myeloma received injections of Pnu-Imune 23, Act-HIB (Aventis Pasteur SA) and Menomune-a/c/y/w 135 (Aventis Pasteur Inc) vaccines on 9-FEB-2000. Later that day he experienced "stroke-like symptoms" and was brought to emergency room. After extensive testing it was determined he had an embolic stroke and the reporter did not feel it was related to the vaccines.
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=150596&WAYBACKHISTORY=ON
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