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This is VAERS ID 470610

Case Details

VAERS ID: 470610 (history)  
Form: Version 1.0  
Age: 59.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2010-09-01
Onset:2010-09-10
   Days after vaccination:9
Submitted: 2012-10-19
   Days after onset:770
Entered: 2012-10-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM

Administered by: Unknown       Purchased by: Other
Symptoms: Chronic fatigue syndrome, Malaise
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2011-03-23
   Days after onset: 194
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Not sure. She had been taking pain meds, psych meds, and laxatives.
Current Illness:
Preexisting Conditions: Hypothyroidism Bipolar disorder Back pain
Allergies:
Diagnostic Lab Data: My mom died from a small bowel obstruction. I believe the vaccine may have precipitated the mechanical obstruction. As a healthcare worker being forced into the flu vaccine, I am extremely afraid of the effect on me or losing my job as a CRNA.
CDC Split Type:

Write-up: Extreme malaise lasting months. Diagnosed with chronic fatigue syndrome from the flu vaccine.


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