This is VAERS ID 29150

Case Details

VAERS ID:	29150 (history)
Form:	Version 1.0
Age:	87.0
Sex:	Female
Location:	Minnesota

Vaccinated:	1990-10-24
Onset:	1990-10-26
Days after vaccination:	2
Submitted:	1990-11-20
Days after onset:	25
Entered:	1991-03-15
Days after submission:	115

Vaccination / Manufacturer	Lot / Dose	Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES	0F11200 / 2	LA / -

Administered by: Public Purchased by: Public
Symptoms: Cardiac failure, Myocardial infarction
SMQs:, Cardiac failure (narrow), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1990-10-26
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: MN90002

Write-up: Admitted to hosp on 26OCT90 died on 26OCT90; MI w/cardiac arrest.

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