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From the 2/18/2021 release of VAERS data:

This is VAERS ID 115260

Case Details

VAERS ID: 115260 (history)  
Form: Version 1.0  
Age: 77.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:1998-10-21
Onset:1998-10-22
   Days after vaccination:1
Submitted: 1998-10-23
   Days after onset:1
Entered: 1998-10-26
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0975790 / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-10-22
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: ESRD, HTN
Allergies:
Diagnostic Lab Data: T102.4;
CDC Split Type:

Write-up: c/o vague sx of not feeling well;T102.4;


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=115260


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