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This is VAERS ID 108923

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 108923
VAERS Form:
Age:73.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-10-06
Onset:1997-10-22
Submitted:1997-11-12
Entered:1998-03-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1997-1998 / WYETH 4978172 / 1 RA / -
PPV: PNU-IMUNE(R)23 / LEDERLE 444071 / 0 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: ARTHRALGIA, DYSPNEA, ASTHENIA, CONSTIP, CHILLS FEVER

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-water pill
Current Illness: NONE
Preexisting Conditions: HTN, dizziness;
Allergies:
Diagnostic Lab Data: 2wk later on 22OCT97 felt resp diff breathing merthiolate, thimerosal rxn;
CDC 'Split Type':

Write-up: extreme fatigue, muscles/joint pain, h/a, gastrointestinal upset, constipation, diarrhea, chills-feeling cold, dry cough, fever;22OCT97 exp extreme diff breathing & dizziness;pt felt had the flu;


Changed on 12/8/2009

VAERS ID: 108923 Before After
VAERS Form:
Age:73.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-10-06
Onset:1997-10-22
Submitted:1997-11-12
Entered:1998-03-31 1998-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUSHIELD 1997-1998 INFLUENZA (SEASONAL) (FLUSHIELD 97-98) / WYETH WYETH PHARMACEUTICALS, INC 4978172 / 1 RA / -
PPV: PNU-IMUNE(R)23 PNEUMO (PNU-IMUNE) / LEDERLE WYETH PHARMACEUTICALS, INC 444071 / 0 LA / -

Administered by: Public Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Chills, Condition aggravated, Constipation, Cough, Diarrhoea, Dizziness, Dyspepsia, Dyspnoea, Fatigue, Feeling cold, Headache, Influenza, Influenza like illness, Myalgia, Nausea, Pyrexia, ARTHRALGIA, DYSPNEA, ASTHENIA, CONSTIP, CHILLS FEVER

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-water pill
Current Illness: NONE
Preexisting Conditions: HTN, dizziness;
Allergies:
Diagnostic Lab Data: 2wk later on 22OCT97 felt resp diff breathing merthiolate, thimerosal rxn;
CDC 'Split Type':

Write-up: extreme fatigue, muscles/joint pain, h/a, gastrointestinal upset, constipation, diarrhea, chills-feeling cold, dry cough, fever;22OCT97 exp extreme diff breathing & dizziness;pt felt had the flu; flu;. All these symptoms started on Oct 6, 1997 when the influenza, pneumococcal vaccines were administered. Her health continued to deteriorate and on Oct 22, 1997 in the evening she experienced extreme difficulty breathing and then later dizziness. At this point she was taken to the Emergency room of hospital. Felt nauseated at home- threw up at hospital. Asthenia, headache, diarrhea, no dyspnea, myalgia, dyspepsia, chills fever, flu symd, arthralgia, constipation, cough inc, reaction aggrav.


Changed on 8/31/2010

VAERS ID: 108923 Before After
VAERS Form:
Age:73.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-10-06
Onset:1997-10-22
Submitted:1997-11-12
Entered:1998-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD 97-98) INFLUENZA (SEASONAL) (FLUSHIELD) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4978172 / 1 RA / -
PPV: PNEUMO (PNU-IMUNE) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 444071 / 0 LA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Chills, Condition aggravated, Constipation, Cough, Diarrhoea, Dizziness, Dyspepsia, Dyspnoea, Fatigue, Feeling cold, Headache, Influenza, Influenza like illness, Myalgia, Nausea, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-water pill
Current Illness: NONE
Preexisting Conditions: HTN, dizziness;
Allergies:
Diagnostic Lab Data: 2wk later on 22OCT97 felt resp diff breathing merthiolate, thimerosal rxn;
CDC 'Split Type':

Write-up: extreme fatigue, muscles/joint pain, h/a, gastrointestinal upset, constipation, diarrhea, chills-feeling cold, dry cough, fever;22OCT97 exp extreme diff breathing & dizziness;pt felt had the flu;. All these symptoms started on Oct 6, 1997 when the influenza, pneumococcal vaccines were administered. Her health continued to deteriorate and on Oct 22, 1997 in the evening she experienced extreme difficulty breathing and then later dizziness. At this point she was taken to the Emergency room of hospital. Felt nauseated at home- threw up at hospital. Asthenia, headache, diarrhea, no dyspnea, myalgia, dyspepsia, chills fever, flu symd, arthralgia, constipation, cough inc, reaction aggrav.


Changed on 7/7/2013

VAERS ID: 108923 Before After
VAERS Form:
Age:73.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-10-06
Onset:1997-10-22
Submitted:1997-11-12
Entered:1998-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978172 / 1 RA / -
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978172 / 1 RA / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 444071 / 0 LA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Chills, Condition aggravated, Constipation, Cough, Diarrhoea, Dizziness, Dyspepsia, Dyspnoea, Fatigue, Feeling cold, Headache, Influenza, Influenza like illness, Myalgia, Nausea, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-water pill
Current Illness: NONE
Preexisting Conditions: HTN, dizziness;
Allergies:
Diagnostic Lab Data: 2wk later on 22OCT97 felt resp diff breathing merthiolate, thimerosal rxn;
CDC 'Split Type':

Write-up: extreme fatigue, muscles/joint pain, h/a, gastrointestinal upset, constipation, diarrhea, chills-feeling cold, dry cough, fever;22OCT97 exp extreme diff breathing & dizziness;pt felt had the flu;. All these symptoms started on Oct 6, 1997 when the influenza, pneumococcal vaccines were administered. Her health continued to deteriorate and on Oct 22, 1997 in the evening she experienced extreme difficulty breathing and then later dizziness. At this point she was taken to the Emergency room of hospital. Felt nauseated at home- threw up at hospital. Asthenia, headache, diarrhea, no dyspnea, myalgia, dyspepsia, chills fever, flu symd, arthralgia, constipation, cough inc, reaction aggrav.


Changed on 6/14/2014

VAERS ID: 108923 Before After
VAERS Form:
Age:73.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-10-06
Onset:1997-10-22
Submitted:1997-11-12
Entered:1998-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978172 / 1 RA / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 444071 / 0 LA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Chills, Condition aggravated, Constipation, Cough, Diarrhoea, Dizziness, Dyspepsia, Dyspnoea, Fatigue, Feeling cold, Headache, Influenza, Influenza like illness, Myalgia, Nausea, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-water pill
Current Illness: NONE
Preexisting Conditions: HTN, dizziness;
Allergies:
Diagnostic Lab Data: 2wk later on 22OCT97 felt resp diff breathing merthiolate, thimerosal rxn;
CDC 'Split Type':

Write-up: extreme fatigue, muscles/joint pain, h/a, gastrointestinal upset, constipation, diarrhea, chills-feeling cold, dry cough, fever;22OCT97 exp extreme diff breathing & dizziness;pt felt had the flu;. All these symptoms started on Oct 6, 1997 when the influenza, pneumococcal vaccines were administered. Her health continued to deteriorate and on Oct 22, 1997 in the evening she experienced extreme difficulty breathing and then later dizziness. At this point she was taken to the Emergency room of hospital. Felt nauseated at home- threw up at hospital. Asthenia, headache, diarrhea, no dyspnea, myalgia, dyspepsia, chills fever, flu symd, arthralgia, constipation, cough inc, reaction aggrav.


Changed on 5/14/2017

VAERS ID: 108923 Before After
VAERS Form:
Age:73.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-10-06
Onset:1997-10-22
Submitted:1997-11-12
Entered:1998-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978172 / 1 RA / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 444071 / 0 LA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Chills, Condition aggravated, Constipation, Cough, Diarrhoea, Dizziness, Dyspepsia, Dyspnoea, Fatigue, Feeling cold, Headache, Influenza, Influenza like illness, Myalgia, Nausea, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-water pill
Current Illness: NONE
Preexisting Conditions: HTN, dizziness;
Allergies:
Diagnostic Lab Data: 2wk later on 22OCT97 felt resp diff breathing merthiolate, thimerosal rxn;
CDC 'Split Type':

Write-up: extreme fatigue, muscles/joint pain, h/a, gastrointestinal upset, constipation, diarrhea, chills-feeling cold, dry cough, fever;22OCT97 exp extreme diff breathing & dizziness;pt felt had the flu;. All these symptoms started on Oct 6, 1997 when the influenza, pneumococcal vaccines were administered. Her health continued to deteriorate and on Oct 22, 1997 in the evening she experienced extreme difficulty breathing and then later dizziness. At this point she was taken to the Emergency room of hospital. Felt nauseated at home- threw up at hospital. Asthenia, headache, diarrhea, no dyspnea, myalgia, dyspepsia, chills fever, flu symd, arthralgia, constipation, cough inc, reaction aggrav.


Changed on 9/14/2017

VAERS ID: 108923 Before After
VAERS Form:(blank) 1
Age:73.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-10-06
Onset:1997-10-22
Submitted:1997-11-12
Entered:1998-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978172 / 1 2 RA / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 444071 / 0 1 LA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Chills, Condition aggravated, Constipation, Cough, Diarrhoea, Dizziness, Dyspepsia, Dyspnoea, Fatigue, Feeling cold, Headache, Influenza, Influenza like illness, Myalgia, Nausea, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-water pill
Current Illness: NONE
Preexisting Conditions: HTN, dizziness;
Allergies:
Diagnostic Lab Data: 2wk later on 22OCT97 felt resp diff breathing merthiolate, thimerosal rxn;
CDC 'Split Type':

Write-up: extreme fatigue, muscles/joint pain, h/a, gastrointestinal upset, constipation, diarrhea, chills-feeling cold, dry cough, fever;22OCT97 exp extreme diff breathing & dizziness;pt felt had the flu;. All these symptoms started on Oct 6, 1997 when the influenza, pneumococcal vaccines were administered. Her health continued to deteriorate and on Oct 22, 1997 in the evening she experienced extreme difficulty breathing and then later dizziness. At this point she was taken to the Emergency room of hospital. Felt nauseated at home- threw up at hospital. Asthenia, headache, diarrhea, no dyspnea, myalgia, dyspepsia, chills fever, flu symd, arthralgia, constipation, cough inc, reaction aggrav.


Changed on 2/14/2018

VAERS ID: 108923 Before After
VAERS Form:1
Age:73.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-10-06
Onset:1997-10-22
Submitted:1997-11-12
Entered:1998-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978172 / 2 RA / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 444071 / 1 LA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Chills, Condition aggravated, Constipation, Cough, Diarrhoea, Dizziness, Dyspepsia, Dyspnoea, Fatigue, Feeling cold, Headache, Influenza, Influenza like illness, Myalgia, Nausea, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-water pill
Current Illness: NONE
Preexisting Conditions: HTN, dizziness;
Allergies:
Diagnostic Lab Data: 2wk later on 22OCT97 felt resp diff breathing merthiolate, thimerosal rxn;
CDC 'Split Type':

Write-up: extreme fatigue, muscles/joint pain, h/a, gastrointestinal upset, constipation, diarrhea, chills-feeling cold, dry cough, fever;22OCT97 exp extreme diff breathing & dizziness;pt felt had the flu;. All these symptoms started on Oct 6, 1997 when the influenza, pneumococcal vaccines were administered. Her health continued to deteriorate and on Oct 22, 1997 in the evening she experienced extreme difficulty breathing and then later dizziness. At this point she was taken to the Emergency room of hospital. Felt nauseated at home- threw up at hospital. Asthenia, headache, diarrhea, no dyspnea, myalgia, dyspepsia, chills fever, flu symd, arthralgia, constipation, cough inc, reaction aggrav.


Changed on 6/14/2018

VAERS ID: 108923 Before After
VAERS Form:1
Age:73.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-10-06
Onset:1997-10-22
Submitted:1997-11-12
Entered:1998-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978172 / 2 RA / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 444071 / 1 LA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Chills, Condition aggravated, Constipation, Cough, Diarrhoea, Dizziness, Dyspepsia, Dyspnoea, Fatigue, Feeling cold, Headache, Influenza, Influenza like illness, Myalgia, Nausea, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-water pill
Current Illness: NONE
Preexisting Conditions: HTN, dizziness;
Allergies:
Diagnostic Lab Data: 2wk later on 22OCT97 felt resp diff breathing merthiolate, thimerosal rxn;
CDC 'Split Type':

Write-up: extreme fatigue, muscles/joint pain, h/a, gastrointestinal upset, constipation, diarrhea, chills-feeling cold, dry cough, fever;22OCT97 exp extreme diff breathing & dizziness;pt felt had the flu;. All these symptoms started on Oct 6, 1997 when the influenza, pneumococcal vaccines were administered. Her health continued to deteriorate and on Oct 22, 1997 in the evening she experienced extreme difficulty breathing and then later dizziness. At this point she was taken to the Emergency room of hospital. Felt nauseated at home- threw up at hospital. Asthenia, headache, diarrhea, no dyspnea, myalgia, dyspepsia, chills fever, flu symd, arthralgia, constipation, cough inc, reaction aggrav.


Changed on 8/14/2018

VAERS ID: 108923 Before After
VAERS Form:1
Age:73.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-10-06
Onset:1997-10-22
Submitted:1997-11-12
Entered:1998-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978172 / 2 RA / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 444071 / 1 LA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Chills, Condition aggravated, Constipation, Cough, Diarrhoea, Dizziness, Dyspepsia, Dyspnoea, Fatigue, Feeling cold, Headache, Influenza, Influenza like illness, Myalgia, Nausea, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-water pill
Current Illness: NONE
Preexisting Conditions: HTN, dizziness;
Allergies:
Diagnostic Lab Data: 2wk later on 22OCT97 felt resp diff breathing merthiolate, thimerosal rxn;
CDC 'Split Type':

Write-up: extreme fatigue, muscles/joint pain, h/a, gastrointestinal upset, constipation, diarrhea, chills-feeling cold, dry cough, fever;22OCT97 exp extreme diff breathing & dizziness;pt felt had the flu;. All these symptoms started on Oct 6, 1997 when the influenza, pneumococcal vaccines were administered. Her health continued to deteriorate and on Oct 22, 1997 in the evening she experienced extreme difficulty breathing and then later dizziness. At this point she was taken to the Emergency room of hospital. Felt nauseated at home- threw up at hospital. Asthenia, headache, diarrhea, no dyspnea, myalgia, dyspepsia, chills fever, flu symd, arthralgia, constipation, cough inc, reaction aggrav.


Changed on 9/14/2018

VAERS ID: 108923 Before After
VAERS Form:1
Age:73.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-10-06
Onset:1997-10-22
Submitted:1997-11-12
Entered:1998-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978172 / 2 RA / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 444071 / 1 LA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Chills, Condition aggravated, Constipation, Cough, Diarrhoea, Dizziness, Dyspepsia, Dyspnoea, Fatigue, Feeling cold, Headache, Influenza, Influenza like illness, Myalgia, Nausea, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-water pill
Current Illness: NONE
Preexisting Conditions: HTN, dizziness;
Allergies:
Diagnostic Lab Data: 2wk later on 22OCT97 felt resp diff breathing merthiolate, thimerosal rxn;
CDC 'Split Type':

Write-up: extreme fatigue, muscles/joint pain, h/a, gastrointestinal upset, constipation, diarrhea, chills-feeling cold, dry cough, fever;22OCT97 exp extreme diff breathing & dizziness;pt felt had the flu;. All these symptoms started on Oct 6, 1997 when the influenza, pneumococcal vaccines were administered. Her health continued to deteriorate and on Oct 22, 1997 in the evening she experienced extreme difficulty breathing and then later dizziness. At this point she was taken to the Emergency room of hospital. Felt nauseated at home- threw up at hospital. Asthenia, headache, diarrhea, no dyspnea, myalgia, dyspepsia, chills fever, flu symd, arthralgia, constipation, cough inc, reaction aggrav.


Changed on 10/14/2018

VAERS ID: 108923 Before After
VAERS Form:1
Age:73.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-10-06
Onset:1997-10-22
Submitted:1997-11-12
Entered:1998-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD) / PFIZER/WYETH 4978172 / 2 RA / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 444071 / 1 LA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Chills, Condition aggravated, Constipation, Cough, Diarrhoea, Dizziness, Dyspepsia, Dyspnoea, Fatigue, Feeling cold, Headache, Influenza, Influenza like illness, Myalgia, Nausea, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-31
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Dyazide-water pill
Current Illness: NONE
Preexisting Conditions: HTN, dizziness;
Allergies:
Diagnostic Lab Data: 2wk later on 22OCT97 felt resp diff breathing merthiolate, thimerosal rxn;
CDC 'Split Type':

Write-up: extreme fatigue, muscles/joint pain, h/a, gastrointestinal upset, constipation, diarrhea, chills-feeling cold, dry cough, fever;22OCT97 exp extreme diff breathing & dizziness;pt felt had the flu;. All these symptoms started on Oct 6, 1997 when the influenza, pneumococcal vaccines were administered. Her health continued to deteriorate and on Oct 22, 1997 in the evening she experienced extreme difficulty breathing and then later dizziness. At this point she was taken to the Emergency room of hospital. Felt nauseated at home- threw up at hospital. Asthenia, headache, diarrhea, no dyspnea, myalgia, dyspepsia, chills fever, flu symd, arthralgia, constipation, cough inc, reaction aggrav.

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