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This is VAERS ID 150596

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

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.


Changed on 12/30/2006

VAERS ID: 150596 Before After
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"" /"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.


Changed on 12/8/2009

VAERS ID: 150596 Before After
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 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.


Changed on 5/14/2017

VAERS ID: 150596 Before After
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: 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.


Changed on 9/14/2017

VAERS ID: 150596 Before After
VAERS Form:(blank) 1
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: 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.


Changed on 2/14/2018

VAERS ID: 150596 Before After
VAERS Form:1
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: 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.


Changed on 6/14/2018

VAERS ID: 150596 Before After
VAERS Form:1
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: 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.


Changed on 8/14/2018

VAERS ID: 150596 Before After
VAERS Form:1
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: 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.


Changed on 9/14/2018

VAERS ID: 150596 Before After
VAERS Form:1
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: 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.


Changed on 10/14/2018

VAERS ID: 150596 Before After
VAERS Form:1
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: 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.

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