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This is VAERS ID 46705

Case Details

VAERS ID: 46705 (history)  
Form: Version 1.0  
Age: 64.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:1992-10-02
Onset:1992-10-05
   Days after vaccination:3
Submitted: 1992-10-08
   Days after onset:3
Entered: 1992-11-05
   Days after submission:28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / UNK - / IM

Administered by: Public       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: 1992-10-05
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: n/s
Current Illness: n/s
Preexisting Conditions: surgery on facial sinus; brain stem infarct
Allergies:
Diagnostic Lab Data: n/s
CDC Split Type: 924092015

Write-up: death is reported in a pt who recvd flu vax on 2OCT; pt died on 5OCT92 w/no final cause of death given; an autopsy was performed; coroner believed that pt died of CVA; pt had undergone facial sinus surgery 2 wks prior to death;


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