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This is VAERS ID 58384

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Case Details

VAERS ID: 58384 (history)  
Form: Version .0  
Age: 25.3  
Sex: Female  
Location: North Dakota  
Vaccinated:1993-10-13
Onset:1993-11-29
   Days after vaccination:47
Submitted: 0000-00-00
Entered: 1993-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 93-94) / CONNAUGHT LABORATORIES 3J41148 / - - / IM

Administered by: Military       Purchased by: Military
Symptoms: Endocarditis, Haematemesis, Haemorrhage, Infection, Leukopenia, Lymphadenopathy, Necrosis, Pneumonia
SMQs:, Haematopoietic leukopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Gastrointestinal haemorrhage (narrow), Eosinophilic pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-11-29
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: waiting on drug screen
CDC Split Type: CO5196

Write-up: found dead in apartment, no suspicious circumstances. Autopsy results: lymphoma; no known cause of death.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=58384


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