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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 46249 |
VAERS Form: | |
Age: | |
Sex: | Unknown |
Location: | Michigan |
Vaccinated: | 1988-11-15 |
Onset: | 1989-01-17 |
Submitted: | 1992-10-07 |
Entered: | 1992-12-04 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: FLUOGEN 1988-1989 / PARKE-DAVIS | 1108P / - | - / IM |
Administered by: Other Purchased by: Unknown
Symptoms: INFECT, NO DRUG EFFECT, FLU SYND
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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 recvd flu vax & was 1 of 5 who devel influenza & died;
Vaccinated: | 1988-11-15 |
Onset: | 1989-01-17 |
Submitted: | 1992-10-07 |
Entered: | 1992-12-04 1992-10-19 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: FLUOGEN 1988-1989 INFLUENZA (SEASONAL) (FLUOGEN 88-89) / PARKE-DAVIS | 1108P / - | - / IM |
Administered by: Other Purchased by: Unknown Other
Symptoms: Drug ineffective, Infection, Influenza, INFECT, NO DRUG EFFECT, FLU SYND
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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) 924090028
Write-up: pt recvd flu vax & was 1 of 5 who devel influenza & died;
Vaccinated: | 1988-11-15 |
Onset: | 1989-01-17 |
Submitted: | 1992-10-07 |
Entered: | 1992-10-19 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (SEASONAL) (FLUOGEN 88-89) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 1108P / - | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090028
Write-up: pt recvd flu vax & was 1 of 5 who devel influenza & died;
Vaccinated: | 1988-11-15 |
Onset: | 1989-01-17 |
Submitted: | 1992-10-07 |
Entered: | 1992-10-19 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 1108P / - | - / IM |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 1108P / - | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090028
Write-up: pt recvd flu vax & was 1 of 5 who devel influenza & died;
Vaccinated: | 1988-11-15 |
Onset: | 1989-01-17 |
Submitted: | 1992-10-07 |
Entered: | 1992-10-19 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 1108P / - | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090028
Write-up: pt recvd flu vax & was 1 of 5 who devel influenza & died;
Vaccinated: | 1988-11-15 |
Onset: | 1989-01-17 |
Submitted: | 1992-10-07 |
Entered: | 1992-10-19 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 1108P / - UNK | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090028
Write-up: pt recvd flu vax & was 1 of 5 who devel influenza & died;
Vaccinated: | 1988-11-15 |
Onset: | 1989-01-17 |
Submitted: | 1992-10-07 |
Entered: | 1992-10-19 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 1108P / UNK | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090028
Write-up: pt recvd flu vax & was 1 of 5 who devel influenza & died;
Vaccinated: | 1988-11-15 |
Onset: | 1989-01-17 |
Submitted: | 1992-10-07 |
Entered: | 1992-10-19 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 1108P / UNK | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090028
Write-up: pt recvd flu vax & was 1 of 5 who devel influenza & died;
Vaccinated: | 1988-11-15 |
Onset: | 1989-01-17 |
Submitted: | 1992-10-07 |
Entered: | 1992-10-19 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 1108P / UNK | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090028
Write-up: pt recvd flu vax & was 1 of 5 who devel influenza & died;
Vaccinated: | 1988-11-15 |
Onset: | 1989-01-17 |
Submitted: | 1992-10-07 |
Entered: | 1992-10-19 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 1108P / UNK | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090028
Write-up: pt recvd flu vax & was 1 of 5 who devel influenza & died;
Vaccinated: | 1988-11-15 |
Onset: | 1989-01-17 |
Submitted: | 1992-10-07 |
Entered: | 1992-10-19 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 1108P / UNK | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090028
Write-up: pt recvd flu vax & was 1 of 5 who devel influenza & died;
Vaccinated: | 1988-11-15 |
Onset: | 1989-01-17 |
Submitted: | 1992-10-07 |
Entered: | 1992-10-19 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 1108P / UNK | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090028
Write-up: pt recvd flu vax & was 1 of 5 who devel influenza & died;
Vaccinated: | 1988-11-15 |
Onset: | 1989-01-17 |
Submitted: | 1992-10-07 |
Entered: | 1992-10-19 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS | 1108P / UNK | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090028
Write-up: pt recvd flu vax & was 1 of 5 who devel influenza & died;
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=46249&WAYBACKHISTORY=ON
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