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This is VAERS ID 472279

(NOTE: This result is from the 9/14/2018 version of the VAERS database)

Case Details

VAERS ID: 472279 (history)  
Form: Version 1.0  
Age: 62.0  
Sex: Male  
Location: New Hampshire  
Vaccinated:2012-10-11
Onset:2012-10-13
   Days after vaccination:2
Submitted: 2012-10-26
   Days after onset:13
Entered: 2012-10-31
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (AFLURIA) / CSL LIMITED P58306 / UNK UN / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-10-13
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Recent massive heart attack; Narcolepsy
Allergies:
Diagnostic Lab Data:
CDC Split Type: 2012033702

Write-up: This medically confirmed spontaneous report (initial receipt: 18-Oct-2012) concerns a 62-year-old male patient, who had a medical history of recent massive heart attack and narcolepsy. He had no known drug allergy. He was taking ''a lot of medications'' (type unspecified). On 11-Oct-2012 the patient received AFLURIA (batch number: P58306) injection at a dose of 0.5 mL intramuscularly. On the day of vaccination, the patient did not complain of any symptoms and went home without any adverse events. On 13-Oct-2012 the patient was found dead. The cause of death was still being investigated. According to the pharmacist (reporter), the patient had many health problems including a recent massive heart attack (date unspecified).


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