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This is VAERS ID 46526

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 46526
VAERS Form:
Age:56.2
Sex:Male
Location:California
Vaccinated:1992-10-12
Onset:1992-10-14
Submitted:1992-10-16
Entered:1992-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1992-1993 / WYETH 4928234 / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: HYPOTENS, APNEA, CONFUS, EDEMA LUNG, CARDIOMEGALY

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1992-10-16
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: following Hemodialysis
Preexisting Conditions: pt had chronic renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd flu vax & devel sudden onset of hypotension, hypoglycemia & chills; pt suffered a cardiac arrest & was hospitalized & died;


Changed on 12/8/2009

VAERS ID: 46526 Before After
VAERS Form:
Age:56.2
Sex:Male
Location:California
Vaccinated:1992-10-12
Onset:1992-10-14
Submitted:1992-10-16
Entered:1992-10-30 1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1992-1993 INFLUENZA (SEASONAL) (NO BRAND NAME, 92-93) / WYETH WYETH PHARMACEUTICALS, INC 4928234 / - - / -

Administered by: Private      Purchased by: Unknown Other
Symptoms: Apnoea, Cardiomegaly, Confusional state, Hypotension, Leukocytosis, Myocardial infarction, Pulmonary oedema, Vascular occlusion, HYPOTENS, APNEA, CONFUS, EDEMA LUNG, CARDIOMEGALY

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1992-10-16
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: following Hemodialysis
Preexisting Conditions: pt had chronic renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 892293001E

Write-up: pt recvd flu vax & devel sudden onset of hypotension, hypoglycemia & chills; pt suffered a cardiac arrest & was hospitalized & died;


Changed on 8/31/2010

VAERS ID: 46526 Before After
VAERS Form:
Age:56.2
Sex:Male
Location:California
Vaccinated:1992-10-12
Onset:1992-10-14
Submitted:1992-10-16
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 92-93) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4928234 / - - / -

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Cardiomegaly, Confusional state, Hypotension, Leukocytosis, Myocardial infarction, Pulmonary oedema, Vascular occlusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1992-10-16
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: following Hemodialysis
Preexisting Conditions: pt had chronic renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892293001E

Write-up: pt recvd flu vax & devel sudden onset of hypotension, hypoglycemia & chills; pt suffered a cardiac arrest & was hospitalized & died;


Changed on 7/7/2013

VAERS ID: 46526 Before After
VAERS Form:
Age:56.2
Sex:Male
Location:California
Vaccinated:1992-10-12
Onset:1992-10-14
Submitted:1992-10-16
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928234 / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928234 / - - / -

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Cardiomegaly, Confusional state, Hypotension, Leukocytosis, Myocardial infarction, Pulmonary oedema, Vascular occlusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1992-10-16
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: following Hemodialysis
Preexisting Conditions: pt had chronic renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892293001E

Write-up: pt recvd flu vax & devel sudden onset of hypotension, hypoglycemia & chills; pt suffered a cardiac arrest & was hospitalized & died;


Changed on 12/14/2016

VAERS ID: 46526 Before After
VAERS Form:
Age:56.2
Sex:Male
Location:California
Vaccinated:1992-10-12
Onset:1992-10-14
Submitted:1992-10-16
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928234 / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928234 / - - / -

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Cardiomegaly, Confusional state, Hypotension, Leukocytosis, Myocardial infarction, Pulmonary oedema, Vascular occlusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1992-10-16
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: following Hemodialysis
Preexisting Conditions: pt had chronic renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892293001E

Write-up: pt recvd flu vax & devel sudden onset of hypotension, hypoglycemia & chills; pt suffered a cardiac arrest & was hospitalized & died;


Changed on 2/14/2017

VAERS ID: 46526 Before After
VAERS Form:
Age:56.2 56.0
Sex:Male
Location:California
Vaccinated:1992-10-12
Onset:1992-10-14
Submitted:1992-10-16
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928234 / - - / -

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Cardiomegaly, Confusional state, Hypotension, Leukocytosis, Myocardial infarction, Pulmonary oedema, Vascular occlusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1992-10-16
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: following Hemodialysis
Preexisting Conditions: pt had chronic renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892293001E

Write-up: pt recvd flu vax & devel sudden onset of hypotension, hypoglycemia & chills; pt suffered a cardiac arrest & was hospitalized & died;


Changed on 5/14/2017

VAERS ID: 46526 Before After
VAERS Form:
Age:56.0
Sex:Male
Location:California
Vaccinated:1992-10-12
Onset:1992-10-14
Submitted:1992-10-16
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928234 / - - / -

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Cardiomegaly, Confusional state, Hypotension, Leukocytosis, Myocardial infarction, Pulmonary oedema, Vascular occlusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1992-10-16
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: following Hemodialysis
Preexisting Conditions: pt had chronic renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892293001E

Write-up: pt recvd flu vax & devel sudden onset of hypotension, hypoglycemia & chills; pt suffered a cardiac arrest & was hospitalized & died;


Changed on 9/14/2017

VAERS ID: 46526 Before After
VAERS Form:(blank) 1
Age:56.0
Sex:Male
Location:California
Vaccinated:1992-10-12
Onset:1992-10-14
Submitted:1992-10-16
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928234 / - UNK - / -

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Cardiomegaly, Confusional state, Hypotension, Leukocytosis, Myocardial infarction, Pulmonary oedema, Vascular occlusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1992-10-16
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: following Hemodialysis
Preexisting Conditions: pt had chronic renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892293001E

Write-up: pt recvd flu vax & devel sudden onset of hypotension, hypoglycemia & chills; pt suffered a cardiac arrest & was hospitalized & died;


Changed on 2/14/2018

VAERS ID: 46526 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:California
Vaccinated:1992-10-12
Onset:1992-10-14
Submitted:1992-10-16
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928234 / UNK - / -

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Cardiomegaly, Confusional state, Hypotension, Leukocytosis, Myocardial infarction, Pulmonary oedema, Vascular occlusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1992-10-16
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: following Hemodialysis
Preexisting Conditions: pt had chronic renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892293001E

Write-up: pt recvd flu vax & devel sudden onset of hypotension, hypoglycemia & chills; pt suffered a cardiac arrest & was hospitalized & died;


Changed on 6/14/2018

VAERS ID: 46526 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:California
Vaccinated:1992-10-12
Onset:1992-10-14
Submitted:1992-10-16
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928234 / UNK - / -

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Cardiomegaly, Confusional state, Hypotension, Leukocytosis, Myocardial infarction, Pulmonary oedema, Vascular occlusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1992-10-16
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: following Hemodialysis
Preexisting Conditions: pt had chronic renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892293001E

Write-up: pt recvd flu vax & devel sudden onset of hypotension, hypoglycemia & chills; pt suffered a cardiac arrest & was hospitalized & died;


Changed on 8/14/2018

VAERS ID: 46526 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:California
Vaccinated:1992-10-12
Onset:1992-10-14
Submitted:1992-10-16
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928234 / UNK - / -

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Cardiomegaly, Confusional state, Hypotension, Leukocytosis, Myocardial infarction, Pulmonary oedema, Vascular occlusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1992-10-16
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: following Hemodialysis
Preexisting Conditions: pt had chronic renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892293001E

Write-up: pt recvd flu vax & devel sudden onset of hypotension, hypoglycemia & chills; pt suffered a cardiac arrest & was hospitalized & died;


Changed on 9/14/2018

VAERS ID: 46526 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:California
Vaccinated:1992-10-12
Onset:1992-10-14
Submitted:1992-10-16
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928234 / UNK - / -

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Cardiomegaly, Confusional state, Hypotension, Leukocytosis, Myocardial infarction, Pulmonary oedema, Vascular occlusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1992-10-16
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: following Hemodialysis
Preexisting Conditions: pt had chronic renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892293001E

Write-up: pt recvd flu vax & devel sudden onset of hypotension, hypoglycemia & chills; pt suffered a cardiac arrest & was hospitalized & died;


Changed on 10/14/2018

VAERS ID: 46526 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:California
Vaccinated:1992-10-12
Onset:1992-10-14
Submitted:1992-10-16
Entered:1992-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928234 / UNK - / -

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Cardiomegaly, Confusional state, Hypotension, Leukocytosis, Myocardial infarction, Pulmonary oedema, Vascular occlusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1992-10-16
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: following Hemodialysis
Preexisting Conditions: pt had chronic renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892293001E

Write-up: pt recvd flu vax & devel sudden onset of hypotension, hypoglycemia & chills; pt suffered a cardiac arrest & was hospitalized & died;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=46526&WAYBACKHISTORY=ON


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