National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 379507

History of Changes from the VAERS Wayback Machine

First Appeared on 2/5/2010

VAERS ID: 379507
VAERS Form:
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (INFLUENZA A (H1N1) 2009 MONOVALENT) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / - - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Death, Eating disorder, Hypotonia, Lethargy, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro tab 10 mg Amitiza Caps 24mcg Nasonex Scent Free Ns Spr 17g 50mcg Omeprazole Caps 20mg Requip Tabs 0.25mg Xalatan Opth Soln 2.5ml 0.005% Carbidopa/levodopa Tabs 25/100mg Megestrol Oral Susp 40mg/ml
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.


Changed on 6/2/2010

VAERS ID: 379507 Before After
VAERS Form:
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (INFLUENZA A (H1N1) 2009 MONOVALENT) INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / - - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Death, Eating disorder, Hypotonia, Lethargy, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro tab 10 mg Amitiza Caps 24mcg Nasonex Scent Free Ns Spr 17g 50mcg Omeprazole Caps 20mg Requip Tabs 0.25mg Xalatan Opth Soln 2.5ml 0.005% Carbidopa/levodopa Tabs 25/100mg Megestrol Oral Susp 40mg/ml
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.


Changed on 4/13/2011

VAERS ID: 379507 Before After
VAERS Form:
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / - - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Anaemia of chronic disease, Condition aggravated, Death, Eating disorder, Hypotonia, Lethargy, Prostatitis, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro tab 10 mg Amitiza Caps 24mcg Nasonex Scent Free Ns Spr 17g 50mcg Omeprazole Caps 20mg Requip Tabs 0.25mg Xalatan Opth Soln 2.5ml 0.005% Carbidopa/levodopa Tabs 25/100mg Megestrol Oral Susp 40mg/ml
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.


Changed on 5/13/2011

VAERS ID: 379507 Before After
VAERS Form:
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / - - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Anaemia of chronic disease, Condition aggravated, Death, Eating disorder, Hypotonia, Lethargy, Prostatitis, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro tab 10 mg Amitiza Caps 24mcg Nasonex Scent Free Ns Spr 17g 50mcg Omeprazole Caps 20mg Requip Tabs 0.25mg Xalatan Opth Soln 2.5ml 0.005% Carbidopa/levodopa Tabs 25/100mg Megestrol Oral Susp 40mg/ml
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.


Changed on 6/11/2011

VAERS ID: 379507 Before After
VAERS Form:
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / - - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Anaemia of chronic disease, Condition aggravated, Death, Eating disorder, Hypotonia, Lethargy, Prostatitis, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro tab 10 mg Amitiza Caps 24mcg Nasonex Scent Free Ns Spr 17g 50mcg Omeprazole Caps 20mg Requip Tabs 0.25mg Xalatan Opth Soln 2.5ml 0.005% Carbidopa/levodopa Tabs 25/100mg Megestrol Oral Susp 40mg/ml
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.


Changed on 7/12/2011

VAERS ID: 379507 Before After
VAERS Form:
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)) INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / - - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Anaemia of chronic disease, Condition aggravated, Death, Eating disorder, Hypotonia, Lethargy, Prostatitis, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro tab 10 mg Amitiza Caps 24mcg Nasonex Scent Free Ns Spr 17g 50mcg Omeprazole Caps 20mg Requip Tabs 0.25mg Xalatan Opth Soln 2.5ml 0.005% Carbidopa/levodopa Tabs 25/100mg Megestrol Oral Susp 40mg/ml
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.


Changed on 6/14/2014

VAERS ID: 379507 Before After
VAERS Form:
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / - - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Anaemia of chronic disease, Condition aggravated, Death, Eating disorder, Hypotonia, Lethargy, Prostatitis, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro tab 10 mg Amitiza Caps 24mcg Nasonex Scent Free Ns Spr 17g 50mcg Omeprazole Caps 20mg Requip Tabs 0.25mg Xalatan Opth Soln 2.5ml 0.005% Carbidopa/levodopa Tabs 25/100mg Megestrol Oral Susp 40mg/ml
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.


Changed on 3/14/2015

VAERS ID: 379507 Before After
VAERS Form:
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / - - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Anaemia of chronic disease, Condition aggravated, Death, Eating disorder, Hypotonia, Lethargy, Prostatitis, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.


Changed on 2/14/2017

VAERS ID: 379507 Before After
VAERS Form:
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS) INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / - - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Death, Eating disorder, Hypotonia, Lethargy, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro tab 10 mg Amitiza Caps 24mcg Nasonex Scent Free Ns Spr 17g 50mcg Omeprazole Caps 20mg Requip Tabs 0.25mg Xalatan Opth Soln 2.5ml 0.005% Carbidopa/levodopa Tabs 25/100mg Megestrol Oral Susp 40mg/ml
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.


Changed on 9/14/2017

VAERS ID: 379507 Before After
VAERS Form:(blank) 1
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / - UNK - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Death, Eating disorder, Hypotonia, Lethargy, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro tab 10 mg Amitiza Caps 24mcg Nasonex Scent Free Ns Spr 17g 50mcg Omeprazole Caps 20mg Requip Tabs 0.25mg Xalatan Opth Soln 2.5ml 0.005% Carbidopa/levodopa Tabs 25/100mg Megestrol Oral Susp 40mg/ml
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.


Changed on 2/14/2018

VAERS ID: 379507 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / UNK - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Death, Eating disorder, Hypotonia, Lethargy, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro tab 10 mg Amitiza Caps 24mcg Nasonex Scent Free Ns Spr 17g 50mcg Omeprazole Caps 20mg Requip Tabs 0.25mg Xalatan Opth Soln 2.5ml 0.005% Carbidopa/levodopa Tabs 25/100mg Megestrol Oral Susp 40mg/ml
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.


Changed on 6/14/2018

VAERS ID: 379507 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / UNK - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Death, Eating disorder, Hypotonia, Lethargy, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro tab 10 mg Amitiza Caps 24mcg Nasonex Scent Free Ns Spr 17g 50mcg Omeprazole Caps 20mg Requip Tabs 0.25mg Xalatan Opth Soln 2.5ml 0.005% Carbidopa/levodopa Tabs 25/100mg Megestrol Oral Susp 40mg/ml
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.


Changed on 8/14/2018

VAERS ID: 379507 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / UNK - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Death, Eating disorder, Hypotonia, Lethargy, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro tab 10 mg Amitiza Caps 24mcg Nasonex Scent Free Ns Spr 17g 50mcg Omeprazole Caps 20mg Requip Tabs 0.25mg Xalatan Opth Soln 2.5ml 0.005% Carbidopa/levodopa Tabs 25/100mg Megestrol Oral Susp 40mg/ml
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.


Changed on 9/14/2018

VAERS ID: 379507 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / UNK - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Death, Eating disorder, Hypotonia, Lethargy, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro tab 10 mg Amitiza Caps 24mcg Nasonex Scent Free Ns Spr 17g 50mcg Omeprazole Caps 20mg Requip Tabs 0.25mg Xalatan Opth Soln 2.5ml 0.005% Carbidopa/levodopa Tabs 25/100mg Megestrol Oral Susp 40mg/ml
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.


Changed on 10/14/2018

VAERS ID: 379507 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / UNK - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Death, Eating disorder, Hypotonia, Lethargy, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro tab 10 mg Amitiza Caps 24mcg Nasonex Scent Free Ns Spr 17g 50mcg Omeprazole Caps 20mg Requip Tabs 0.25mg Xalatan Opth Soln 2.5ml 0.005% Carbidopa/levodopa Tabs 25/100mg Megestrol Oral Susp 40mg/ml
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.


Changed on 12/24/2020

VAERS ID: 379507 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / UNK - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Death, Eating disorder, Hypotonia, Lethargy, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro tab 10 mg Amitiza Caps 24mcg Nasonex Scent Free Ns Spr 17g 50mcg Omeprazole Caps 20mg Requip Tabs 0.25mg Xalatan Opth Soln 2.5ml 0.005% Carbidopa/levodopa Tabs 25/100mg Megestrol Oral Susp 40mg/ml
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.


Changed on 12/30/2020

VAERS ID: 379507 Before After
VAERS Form:1
Age:85.0
Sex:Male
Location:Indiana
Vaccinated:2010-01-21
Onset:2010-01-21
Submitted:2010-02-04
Entered:2010-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)) / NOVARTIS VACCINES AND DIAGNOSTICS 102135P1 / UNK - / IJ

Administered by: Other      Purchased by: Public
Symptoms: Death, Eating disorder, Hypotonia, Lethargy, Parkinson's disease

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-01-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro tab 10 mg Amitiza Caps 24mcg Nasonex Scent Free Ns Spr 17g 50mcg Omeprazole Caps 20mg Requip Tabs 0.25mg Xalatan Opth Soln 2.5ml 0.005% Carbidopa/levodopa Tabs 25/100mg Megestrol Oral Susp 40mg/ml
Current Illness: Parkinson''s Disease
Preexisting Conditions: Parkinson''s Disease
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Lethargic, stopped drinking, stopped eating on the 21st. On the 22nd his arms layed limp at his sides when previously they were rigid and locked from the Parkinson''s. He would not eat or drink on the 22nd.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=379507&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166