From the 12/31/2003 release of VAERS data (an older release, current is 1/15/2021):

This is VAERS ID 46528

Case Details

VAERS ID:	46528 (history)
Form:	Version .0
Age:	94.0
Sex:	Female
Location:	Michigan

Vaccinated:	1992-10-06
Onset:	1992-10-07
Days after vaccination:	1
Submitted:	1992-10-13
Days after onset:	6
Entered:	1992-10-30
Days after submission:	17

Vaccination / Manufacturer	Lot / Dose	Site / Route
FLU: INFLUENZA VACCINE 1992-1993 / WYETH	- / -	- / -

Administered by: Other Purchased by: Unknown
Symptoms: FEVER, FIBRILLAT ATR, HALLUCIN, HERPES ZOSTER, HYPERTENS
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt recvd flu vax the next evening devel a rash & some blisters on breasts & back; dx w/herpes zoster; tx Zovirax & DPH; also exp inc BP & hallucinations; adm to hosp 12OCT92;

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=46528