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This is VAERS ID 29150

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 29150
VAERS Form:
Age:87.9
Sex:Female
Location:Minnesota
Vaccinated:1990-10-24
Onset:1990-10-26
Submitted:1990-11-20
Entered:1991-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT / CONNAUGHT LABS 0F11200 / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: HEART FAIL, INFARCT MYOCARD

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-26
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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


Changed on 12/8/2009

VAERS ID: 29150 Before After
VAERS Form:
Age:87.9
Sex:Female
Location:Minnesota
Vaccinated:1990-10-24
Onset:1990-10-26
Submitted:1990-11-20
Entered:1991-03-19 1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1990-1991 CONNAUGHT INFLUENZA (SEASONAL) (FLUZONE 90-91) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0F11200 / 1 LA / -

Administered by: Public      Purchased by: Unknown Public
Symptoms: Cardiac failure, Myocardial infarction, HEART FAIL, INFARCT MYOCARD

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-26
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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) MN90002

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


Changed on 8/31/2010

VAERS ID: 29150 Before After
VAERS Form:
Age:87.9
Sex:Female
Location:Minnesota
Vaccinated:1990-10-24
Onset:1990-10-26
Submitted:1990-11-20
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 90-91) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Cardiac failure, Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-26
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: 1     Extended hospital stay? No
Previous Vaccinations:
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.


Changed on 7/7/2013

VAERS ID: 29150 Before After
VAERS Form:
Age:87.9
Sex:Female
Location:Minnesota
Vaccinated:1990-10-24
Onset:1990-10-26
Submitted:1990-11-20
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / 1 LA / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Cardiac failure, Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-26
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: 1     Extended hospital stay? No
Previous Vaccinations:
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.


Changed on 2/14/2017

VAERS ID: 29150 Before After
VAERS Form:
Age:87.9 87.0
Sex:Female
Location:Minnesota
Vaccinated:1990-10-24
Onset:1990-10-26
Submitted:1990-11-20
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Cardiac failure, Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-26
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: 1     Extended hospital stay? No
Previous Vaccinations:
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.


Changed on 5/14/2017

VAERS ID: 29150 Before After
VAERS Form:
Age:87.0
Sex:Female
Location:Minnesota
Vaccinated:1990-10-24
Onset:1990-10-26
Submitted:1990-11-20
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / 1 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Cardiac failure, Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-26
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: 1     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.


Changed on 9/14/2017

VAERS ID: 29150 Before After
VAERS Form:(blank) 1
Age:87.0
Sex:Female
Location:Minnesota
Vaccinated:1990-10-24
Onset:1990-10-26
Submitted:1990-11-20
Entered:1991-03-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11200 / 1 2 LA / -

Administered by: Public      Purchased by: Public
Symptoms: Cardiac failure, Myocardial infarction

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-26
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: 1     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.


Changed on 2/14/2018

VAERS ID: 29150 Before After
VAERS Form:1
Age:87.0
Sex:Female
Location:Minnesota
Vaccinated:1990-10-24
Onset:1990-10-26
Submitted:1990-11-20
Entered:1991-03-15
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-26
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: 1     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.


Changed on 6/14/2018

VAERS ID: 29150 Before After
VAERS Form:1
Age:87.0
Sex:Female
Location:Minnesota
Vaccinated:1990-10-24
Onset:1990-10-26
Submitted:1990-11-20
Entered:1991-03-15
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-26
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: 1     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.


Changed on 8/14/2018

VAERS ID: 29150 Before After
VAERS Form:1
Age:87.0
Sex:Female
Location:Minnesota
Vaccinated:1990-10-24
Onset:1990-10-26
Submitted:1990-11-20
Entered:1991-03-15
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-26
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: 1     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.


Changed on 9/14/2018

VAERS ID: 29150 Before After
VAERS Form:1
Age:87.0
Sex:Female
Location:Minnesota
Vaccinated:1990-10-24
Onset:1990-10-26
Submitted:1990-11-20
Entered:1991-03-15
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-26
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: 1     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.


Changed on 10/14/2018

VAERS ID: 29150 Before After
VAERS Form:1
Age:87.0
Sex:Female
Location:Minnesota
Vaccinated:1990-10-24
Onset:1990-10-26
Submitted:1990-11-20
Entered:1991-03-15
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-10-26
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: 1     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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