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This is VAERS ID 46247

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 46247
VAERS Form:
Age:
Sex:Unknown
Location:Michigan
Vaccinated:1988-11-15
Onset:1989-01-17
Submitted:1992-10-07
Entered:1992-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1988-1989 / PARKE-DAVIS 1108P / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: INFECT, NO DRUG EFFECT, FLU SYND

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd flu vax & pt was 1 of 5 who devel influenza & died;


Changed on 12/8/2009

VAERS ID: 46247 Before After
VAERS Form:
Age:
Sex:Unknown
Location:Michigan
Vaccinated:1988-11-15
Onset:1989-01-17
Submitted:1992-10-07
Entered:1992-12-04 1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1988-1989 INFLUENZA (SEASONAL) (FLUOGEN 88-89) / PARKE-DAVIS 1108P / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Drug ineffective, Infection, Influenza, INFECT, NO DRUG EFFECT, FLU SYND

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 924090030

Write-up: pt recvd flu vax & pt was 1 of 5 who devel influenza & died;


Changed on 8/31/2010

VAERS ID: 46247 Before After
VAERS Form:
Age:
Sex:Unknown
Location:Michigan
Vaccinated:1988-11-15
Onset:1989-01-17
Submitted:1992-10-07
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 88-89) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 1108P / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090030

Write-up: pt recvd flu vax & pt was 1 of 5 who devel influenza & died;


Changed on 7/7/2013

VAERS ID: 46247 Before After
VAERS Form:
Age:
Sex:Unknown
Location:Michigan
Vaccinated:1988-11-15
Onset:1989-01-17
Submitted:1992-10-07
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 1108P / - - / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 1108P / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090030

Write-up: pt recvd flu vax & pt was 1 of 5 who devel influenza & died;


Changed on 5/14/2017

VAERS ID: 46247 Before After
VAERS Form:
Age:
Sex:Unknown
Location:Michigan
Vaccinated:1988-11-15
Onset:1989-01-17
Submitted:1992-10-07
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 1108P / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090030

Write-up: pt recvd flu vax & pt was 1 of 5 who devel influenza & died;


Changed on 9/14/2017

VAERS ID: 46247 Before After
VAERS Form:(blank) 1
Age:
Sex:Unknown
Location:Michigan
Vaccinated:1988-11-15
Onset:1989-01-17
Submitted:1992-10-07
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 1108P / - UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090030

Write-up: pt recvd flu vax & pt was 1 of 5 who devel influenza & died;


Changed on 2/14/2018

VAERS ID: 46247 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Michigan
Vaccinated:1988-11-15
Onset:1989-01-17
Submitted:1992-10-07
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 1108P / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090030

Write-up: pt recvd flu vax & pt was 1 of 5 who devel influenza & died;


Changed on 6/14/2018

VAERS ID: 46247 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Michigan
Vaccinated:1988-11-15
Onset:1989-01-17
Submitted:1992-10-07
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 1108P / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090030

Write-up: pt recvd flu vax & pt was 1 of 5 who devel influenza & died;


Changed on 8/14/2018

VAERS ID: 46247 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Michigan
Vaccinated:1988-11-15
Onset:1989-01-17
Submitted:1992-10-07
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 1108P / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090030

Write-up: pt recvd flu vax & pt was 1 of 5 who devel influenza & died;


Changed on 9/14/2018

VAERS ID: 46247 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Michigan
Vaccinated:1988-11-15
Onset:1989-01-17
Submitted:1992-10-07
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 1108P / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090030

Write-up: pt recvd flu vax & pt was 1 of 5 who devel influenza & died;


Changed on 10/14/2018

VAERS ID: 46247 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Michigan
Vaccinated:1988-11-15
Onset:1989-01-17
Submitted:1992-10-07
Entered:1992-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 1108P / UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective, Infection, Influenza

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 924090030

Write-up: pt recvd flu vax & pt was 1 of 5 who devel influenza & died;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=46247&WAYBACKHISTORY=ON


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