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This is VAERS ID 887995

History of Changes from the VAERS Wayback Machine

First Appeared on 10/14/2020

VAERS ID: 887995
VAERS Form:2
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2020-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Underdose

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': USGLAXOSMITHKLINEUS2020AM

Write-up: died; Underdose; This case was reported by a consumer via interactive digital media and described the occurrence of unknown cause of death in a female patient who received Flu unspecified (Flu vaccine) for prophylaxis. On an unknown date, the patient received the 1st dose of Flu vaccine. On an unknown date, unknown after receiving Flu vaccine, the patient experienced unknown cause of death (serious criteria death and GSK medically significant) and underdose. On an unknown date, the outcome of the unknown cause of death was fatal and the outcome of the underdose was unknown. The reported cause of death was unknown cause of death. It was unknown if the reporter considered the unknown cause of death to be related to Flu vaccine. Additional case details were reported as follows: The reporter was patient''s grandchild. The age at vaccination was not reported. The patient received her first half flu shot, which led to underdose. On an unknown date patient was died. This was a medication error with harm. The follow up was not required.; Reported Cause(s) of Death: Unknown cause of death


Changed on 12/24/2020

VAERS ID: 887995 Before After
VAERS Form:2
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2020-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Underdose

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': USGLAXOSMITHKLINEUS2020AM

Write-up: died; Underdose; This case was reported by a consumer via interactive digital media and described the occurrence of unknown cause of death in a female patient who received Flu unspecified (Flu vaccine) for prophylaxis. On an unknown date, the patient received the 1st dose of Flu vaccine. On an unknown date, unknown after receiving Flu vaccine, the patient experienced unknown cause of death (serious criteria death and GSK medically significant) and underdose. On an unknown date, the outcome of the unknown cause of death was fatal and the outcome of the underdose was unknown. The reported cause of death was unknown cause of death. It was unknown if the reporter considered the unknown cause of death to be related to Flu vaccine. Additional case details were reported as follows: The reporter was patient''s grandchild. The age at vaccination was not reported. The patient received her first half flu shot, which led to underdose. On an unknown date patient was died. This was a medication error with harm. The follow up was not required.; Reported Cause(s) of Death: Unknown cause of death


Changed on 12/30/2020

VAERS ID: 887995 Before After
VAERS Form:2
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2020-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Underdose

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': USGLAXOSMITHKLINEUS2020AM

Write-up: died; Underdose; This case was reported by a consumer via interactive digital media and described the occurrence of unknown cause of death in a female patient who received Flu unspecified (Flu vaccine) for prophylaxis. On an unknown date, the patient received the 1st dose of Flu vaccine. On an unknown date, unknown after receiving Flu vaccine, the patient experienced unknown cause of death (serious criteria death and GSK medically significant) and underdose. On an unknown date, the outcome of the unknown cause of death was fatal and the outcome of the underdose was unknown. The reported cause of death was unknown cause of death. It was unknown if the reporter considered the unknown cause of death to be related to Flu vaccine. Additional case details were reported as follows: The reporter was patient''s grandchild. The age at vaccination was not reported. The patient received her first half flu shot, which led to underdose. On an unknown date patient was died. This was a medication error with harm. The follow up was not required.; Reported Cause(s) of Death: Unknown cause of death


Changed on 5/7/2021

VAERS ID: 887995 Before After
VAERS Form:2
Age:
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2020-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Underdose

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': USGLAXOSMITHKLINEUS2020AM

Write-up: died; Underdose; This case was reported by a consumer via interactive digital media and described the occurrence of unknown cause of death in a female patient who received Flu unspecified (Flu vaccine) for prophylaxis. On an unknown date, the patient received the 1st dose of Flu vaccine. On an unknown date, unknown after receiving Flu vaccine, the patient experienced unknown cause of death (serious criteria death and GSK medically significant) and underdose. On an unknown date, the outcome of the unknown cause of death was fatal and the outcome of the underdose was unknown. The reported cause of death was unknown cause of death. It was unknown if the reporter considered the unknown cause of death to be related to Flu vaccine. Additional case details were reported as follows: The reporter was patient''s grandchild. The age at vaccination was not reported. The patient received her first half flu shot, which led to underdose. On an unknown date patient was died. This was a medication error with harm. The follow up was not required.; Reported Cause(s) of Death: Unknown cause of death

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