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This is VAERS ID 46787

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 46787
VAERS Form:
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-10-08
Entered:1992-11-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1992-1993 / PARKE-DAVIS 01272P / - - / IM

Administered by: Public      Purchased by: Unknown
Symptoms: MALAISE, ECG ABNORM, CARDIOVASC DIS, INFARCT MYOCARD

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: n/s
Current Illness: n/s
Preexisting Conditions: h/o heart disease
Allergies:
Diagnostic Lab Data: n/s
CDC 'Split Type':

Write-up: Death & myocardial infarction are reported in pt who recvd flu vax on 2OCT92; 3OCT92 was not feeling well & went to ER; had MI (full EKG changes); pt had a classical heart attack & died;


Changed on 12/8/2009

VAERS ID: 46787 Before After
VAERS Form:
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-10-08
Entered:1992-11-11 1992-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1992-1993 INFLUENZA (SEASONAL) (FLUOGEN 92-93) / PARKE-DAVIS 01272P / - - / IM

Administered by: Public      Purchased by: Unknown Other
Symptoms: Cardiovascular disorder, Electrocardiogram abnormal, Malaise, Myocardial infarction, MALAISE, ECG ABNORM, CARDIOVASC DIS, INFARCT MYOCARD

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: n/s
Current Illness: n/s
Preexisting Conditions: h/o heart disease
Allergies:
Diagnostic Lab Data: n/s
CDC 'Split Type': (blank) 924092016

Write-up: Death & myocardial infarction are reported in pt who recvd flu vax on 2OCT92; 3OCT92 was not feeling well & went to ER; had MI (full EKG changes); pt had a classical heart attack & died;


Changed on 8/31/2010

VAERS ID: 46787 Before After
VAERS Form:
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-10-08
Entered:1992-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 92-93) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / - - / IM

Administered by: Public      Purchased by: Other
Symptoms: Cardiovascular disorder, Electrocardiogram abnormal, Malaise, Myocardial infarction

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: n/s
Current Illness: n/s
Preexisting Conditions: h/o heart disease
Allergies:
Diagnostic Lab Data: n/s
CDC 'Split Type': 924092016

Write-up: Death & myocardial infarction are reported in pt who recvd flu vax on 2OCT92; 3OCT92 was not feeling well & went to ER; had MI (full EKG changes); pt had a classical heart attack & died;


Changed on 7/7/2013

VAERS ID: 46787 Before After
VAERS Form:
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-10-08
Entered:1992-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / - - / IM
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / - - / IM

Administered by: Public      Purchased by: Other
Symptoms: Cardiovascular disorder, Electrocardiogram abnormal, Malaise, Myocardial infarction

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: n/s
Current Illness: n/s
Preexisting Conditions: h/o heart disease
Allergies:
Diagnostic Lab Data: n/s
CDC 'Split Type': 924092016

Write-up: Death & myocardial infarction are reported in pt who recvd flu vax on 2OCT92; 3OCT92 was not feeling well & went to ER; had MI (full EKG changes); pt had a classical heart attack & died;


Changed on 5/14/2017

VAERS ID: 46787 Before After
VAERS Form:
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-10-08
Entered:1992-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / - - / IM

Administered by: Public      Purchased by: Other
Symptoms: Cardiovascular disorder, Electrocardiogram abnormal, Malaise, Myocardial infarction

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: n/s
Current Illness: n/s
Preexisting Conditions: h/o heart disease
Allergies:
Diagnostic Lab Data: n/s
CDC 'Split Type': 924092016

Write-up: Death & myocardial infarction are reported in pt who recvd flu vax on 2OCT92; 3OCT92 was not feeling well & went to ER; had MI (full EKG changes); pt had a classical heart attack & died;


Changed on 9/14/2017

VAERS ID: 46787 Before After
VAERS Form:(blank) 1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-10-08
Entered:1992-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / - UNK - / IM

Administered by: Public      Purchased by: Other
Symptoms: Cardiovascular disorder, Electrocardiogram abnormal, Malaise, Myocardial infarction

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: n/s
Current Illness: n/s
Preexisting Conditions: h/o heart disease
Allergies:
Diagnostic Lab Data: n/s
CDC 'Split Type': 924092016

Write-up: Death & myocardial infarction are reported in pt who recvd flu vax on 2OCT92; 3OCT92 was not feeling well & went to ER; had MI (full EKG changes); pt had a classical heart attack & died;


Changed on 2/14/2018

VAERS ID: 46787 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-10-08
Entered:1992-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / UNK - / IM

Administered by: Public      Purchased by: Other
Symptoms: Cardiovascular disorder, Electrocardiogram abnormal, Malaise, Myocardial infarction

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: n/s
Current Illness: n/s
Preexisting Conditions: h/o heart disease
Allergies:
Diagnostic Lab Data: n/s
CDC 'Split Type': 924092016

Write-up: Death & myocardial infarction are reported in pt who recvd flu vax on 2OCT92; 3OCT92 was not feeling well & went to ER; had MI (full EKG changes); pt had a classical heart attack & died;


Changed on 6/14/2018

VAERS ID: 46787 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-10-08
Entered:1992-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / UNK - / IM

Administered by: Public      Purchased by: Other
Symptoms: Cardiovascular disorder, Electrocardiogram abnormal, Malaise, Myocardial infarction

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: n/s
Current Illness: n/s
Preexisting Conditions: h/o heart disease
Allergies:
Diagnostic Lab Data: n/s
CDC 'Split Type': 924092016

Write-up: Death & myocardial infarction are reported in pt who recvd flu vax on 2OCT92; 3OCT92 was not feeling well & went to ER; had MI (full EKG changes); pt had a classical heart attack & died;


Changed on 8/14/2018

VAERS ID: 46787 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-10-08
Entered:1992-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / UNK - / IM

Administered by: Public      Purchased by: Other
Symptoms: Cardiovascular disorder, Electrocardiogram abnormal, Malaise, Myocardial infarction

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: n/s
Current Illness: n/s
Preexisting Conditions: h/o heart disease
Allergies:
Diagnostic Lab Data: n/s
CDC 'Split Type': 924092016

Write-up: Death & myocardial infarction are reported in pt who recvd flu vax on 2OCT92; 3OCT92 was not feeling well & went to ER; had MI (full EKG changes); pt had a classical heart attack & died;


Changed on 9/14/2018

VAERS ID: 46787 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-10-08
Entered:1992-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / UNK - / IM

Administered by: Public      Purchased by: Other
Symptoms: Cardiovascular disorder, Electrocardiogram abnormal, Malaise, Myocardial infarction

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: n/s
Current Illness: n/s
Preexisting Conditions: h/o heart disease
Allergies:
Diagnostic Lab Data: n/s
CDC 'Split Type': 924092016

Write-up: Death & myocardial infarction are reported in pt who recvd flu vax on 2OCT92; 3OCT92 was not feeling well & went to ER; had MI (full EKG changes); pt had a classical heart attack & died;


Changed on 10/14/2018

VAERS ID: 46787 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-10-08
Entered:1992-11-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / UNK - / IM

Administered by: Public      Purchased by: Other
Symptoms: Cardiovascular disorder, Electrocardiogram abnormal, Malaise, Myocardial infarction

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: n/s
Current Illness: n/s
Preexisting Conditions: h/o heart disease
Allergies:
Diagnostic Lab Data: n/s
CDC 'Split Type': 924092016

Write-up: Death & myocardial infarction are reported in pt who recvd flu vax on 2OCT92; 3OCT92 was not feeling well & went to ER; had MI (full EKG changes); pt had a classical heart attack & died;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=46787&WAYBACKHISTORY=ON


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