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This is VAERS ID 31684

Case Details

VAERS ID: 31684 (history)  
Form: Version 1.0  
Age: 34.0  
Sex: Male  
Location: Iowa  
Vaccinated:1990-11-01
Onset:1990-11-18
   Days after vaccination:17
Submitted: 1991-06-03
   Days after onset:196
Entered: 1991-06-24
   Days after submission:21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 0F11211 / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Vascular occlusion
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1990-12-10
   Days after onset: 22
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: No medications
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy report
CDC Split Type: IA910018

Write-up: Cervical spine cord infarction & subsequent death;


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