National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 41862

Case Details

VAERS ID: 41862 (history)  
Form: Version 1.0  
Age: 68.0  
Sex: Male  
Location: Nebraska  
Vaccinated:1991-12-12
Onset:1991-12-22
   Days after vaccination:10
Submitted: 1992-04-30
   Days after onset:129
Entered: 1992-05-11
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 1F21216 / 7+ LA / IM

Administered by: Public       Purchased by: Private
Symptoms: Anaemia, Asthenia, Malaise, Myelofibrosis, Oedema peripheral, Otitis media
SMQs:, Cardiac failure (broad), Angioedema (broad), Haematopoietic cytopenias affecting more than one type of blood cell (broad), Haematopoietic erythropenia (broad), Blood premalignant disorders (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type: NE9212

Write-up: 10 days p/flu vax felt poorly-tired; MD tests done found to be very anemic; dx rare acute myleofibrosis of the bone; gets blood transfusions every 2 wks; has also had ear infects & now swelling of the feet is very weak;


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=41862


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166