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This is VAERS ID 43953

Case Details

VAERS ID: 43953 (history)  
Form: Version 1.0  
Age: 62.0  
Sex: Female  
Location: Unknown  
Vaccinated:1991-10-14
Onset:1991-10-25
   Days after vaccination:11
Submitted: 1992-07-08
   Days after onset:257
Entered: 1992-08-06
   Days after submission:29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Cerebrovascular accident
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1991-10-25
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: NA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NA
CDC Split Type: 920262501

Write-up: cerebrovascular accident (lt hemisphere) in pt, 10 days p/vax w/fluvirin; pt was vaxed on 14OCT91 & died 25OCT91; no other clinical info available;


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