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This is VAERS ID 472279

History of Changes from the VAERS Wayback Machine

First Appeared on 11/13/2012

VAERS ID: 472279
VAERS Form:
Age:62.0
Sex:Male
Location:New Hampshire
Vaccinated:2012-10-11
Onset:2012-10-13
Submitted:2012-10-26
Entered:2012-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (AFLURIA) / CSL LIMITED P58306 / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-10-13
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: Recent massive heart attack; Narcolepsy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2012033702

Write-up: This medically confirmed spontaneous report (initial receipt: 18-Oct-2012) concerns a 62-year-old male patient, who had a medical history of recent massive heart attack and narcolepsy. He had no known drug allergy. He was taking ''a lot of medications'' (type unspecified). On 11-Oct-2012 the patient received AFLURIA (batch number: P58306) injection at a dose of 0.5 mL intramuscularly. On the day of vaccination, the patient did not complain of any symptoms and went home without any adverse events. On 13-Oct-2012 the patient was found dead. The cause of death was still being investigated. According to the pharmacist (reporter), the patient had many health problems including a recent massive heart attack (date unspecified).


Changed on 7/7/2013

VAERS ID: 472279 Before After
VAERS Form:
Age:62.0
Sex:Male
Location:New Hampshire
Vaccinated:2012-10-11
Onset:2012-10-13
Submitted:2012-10-26
Entered:2012-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (AFLURIA) / CSL LIMITED P58306 / - UN / IM
FLU3: INFLUENZA (SEASONAL) (AFLURIA) / CSL LIMITED P58306 / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-10-13
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: Recent massive heart attack; Narcolepsy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2012033702

Write-up: This medically confirmed spontaneous report (initial receipt: 18-Oct-2012) concerns a 62-year-old male patient, who had a medical history of recent massive heart attack and narcolepsy. He had no known drug allergy. He was taking ''a lot of medications'' (type unspecified). On 11-Oct-2012 the patient received AFLURIA (batch number: P58306) injection at a dose of 0.5 mL intramuscularly. On the day of vaccination, the patient did not complain of any symptoms and went home without any adverse events. On 13-Oct-2012 the patient was found dead. The cause of death was still being investigated. According to the pharmacist (reporter), the patient had many health problems including a recent massive heart attack (date unspecified).


Changed on 9/14/2017

VAERS ID: 472279 Before After
VAERS Form:(blank) 1
Age:62.0
Sex:Male
Location:New Hampshire
Vaccinated:2012-10-11
Onset:2012-10-13
Submitted:2012-10-26
Entered:2012-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (AFLURIA) / CSL LIMITED P58306 / - UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-10-13
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: Recent massive heart attack; Narcolepsy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2012033702

Write-up: This medically confirmed spontaneous report (initial receipt: 18-Oct-2012) concerns a 62-year-old male patient, who had a medical history of recent massive heart attack and narcolepsy. He had no known drug allergy. He was taking ''a lot of medications'' (type unspecified). On 11-Oct-2012 the patient received AFLURIA (batch number: P58306) injection at a dose of 0.5 mL intramuscularly. On the day of vaccination, the patient did not complain of any symptoms and went home without any adverse events. On 13-Oct-2012 the patient was found dead. The cause of death was still being investigated. According to the pharmacist (reporter), the patient had many health problems including a recent massive heart attack (date unspecified).


Changed on 2/14/2018

VAERS ID: 472279 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:New Hampshire
Vaccinated:2012-10-11
Onset:2012-10-13
Submitted:2012-10-26
Entered:2012-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (AFLURIA) / CSL LIMITED P58306 / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-10-13
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: Recent massive heart attack; Narcolepsy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2012033702

Write-up: This medically confirmed spontaneous report (initial receipt: 18-Oct-2012) concerns a 62-year-old male patient, who had a medical history of recent massive heart attack and narcolepsy. He had no known drug allergy. He was taking ''a lot of medications'' (type unspecified). On 11-Oct-2012 the patient received AFLURIA (batch number: P58306) injection at a dose of 0.5 mL intramuscularly. On the day of vaccination, the patient did not complain of any symptoms and went home without any adverse events. On 13-Oct-2012 the patient was found dead. The cause of death was still being investigated. According to the pharmacist (reporter), the patient had many health problems including a recent massive heart attack (date unspecified).


Changed on 6/14/2018

VAERS ID: 472279 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:New Hampshire
Vaccinated:2012-10-11
Onset:2012-10-13
Submitted:2012-10-26
Entered:2012-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (AFLURIA) / CSL LIMITED P58306 / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-10-13
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: Recent massive heart attack; Narcolepsy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2012033702

Write-up: This medically confirmed spontaneous report (initial receipt: 18-Oct-2012) concerns a 62-year-old male patient, who had a medical history of recent massive heart attack and narcolepsy. He had no known drug allergy. He was taking ''a lot of medications'' (type unspecified). On 11-Oct-2012 the patient received AFLURIA (batch number: P58306) injection at a dose of 0.5 mL intramuscularly. On the day of vaccination, the patient did not complain of any symptoms and went home without any adverse events. On 13-Oct-2012 the patient was found dead. The cause of death was still being investigated. According to the pharmacist (reporter), the patient had many health problems including a recent massive heart attack (date unspecified).


Changed on 8/14/2018

VAERS ID: 472279 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:New Hampshire
Vaccinated:2012-10-11
Onset:2012-10-13
Submitted:2012-10-26
Entered:2012-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (AFLURIA) / CSL LIMITED P58306 / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-10-13
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: Recent massive heart attack; Narcolepsy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2012033702

Write-up: This medically confirmed spontaneous report (initial receipt: 18-Oct-2012) concerns a 62-year-old male patient, who had a medical history of recent massive heart attack and narcolepsy. He had no known drug allergy. He was taking ''a lot of medications'' (type unspecified). On 11-Oct-2012 the patient received AFLURIA (batch number: P58306) injection at a dose of 0.5 mL intramuscularly. On the day of vaccination, the patient did not complain of any symptoms and went home without any adverse events. On 13-Oct-2012 the patient was found dead. The cause of death was still being investigated. According to the pharmacist (reporter), the patient had many health problems including a recent massive heart attack (date unspecified).


Changed on 9/14/2018

VAERS ID: 472279 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:New Hampshire
Vaccinated:2012-10-11
Onset:2012-10-13
Submitted:2012-10-26
Entered:2012-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (AFLURIA) / CSL LIMITED P58306 / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-10-13
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: Recent massive heart attack; Narcolepsy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2012033702

Write-up: This medically confirmed spontaneous report (initial receipt: 18-Oct-2012) concerns a 62-year-old male patient, who had a medical history of recent massive heart attack and narcolepsy. He had no known drug allergy. He was taking ''a lot of medications'' (type unspecified). On 11-Oct-2012 the patient received AFLURIA (batch number: P58306) injection at a dose of 0.5 mL intramuscularly. On the day of vaccination, the patient did not complain of any symptoms and went home without any adverse events. On 13-Oct-2012 the patient was found dead. The cause of death was still being investigated. According to the pharmacist (reporter), the patient had many health problems including a recent massive heart attack (date unspecified).


Changed on 10/14/2018

VAERS ID: 472279 Before After
VAERS Form:1
Age:62.0
Sex:Male
Location:New Hampshire
Vaccinated:2012-10-11
Onset:2012-10-13
Submitted:2012-10-26
Entered:2012-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (AFLURIA) / CSL LIMITED P58306 / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-10-13
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: Recent massive heart attack; Narcolepsy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2012033702

Write-up: This medically confirmed spontaneous report (initial receipt: 18-Oct-2012) concerns a 62-year-old male patient, who had a medical history of recent massive heart attack and narcolepsy. He had no known drug allergy. He was taking ''a lot of medications'' (type unspecified). On 11-Oct-2012 the patient received AFLURIA (batch number: P58306) injection at a dose of 0.5 mL intramuscularly. On the day of vaccination, the patient did not complain of any symptoms and went home without any adverse events. On 13-Oct-2012 the patient was found dead. The cause of death was still being investigated. According to the pharmacist (reporter), the patient had many health problems including a recent massive heart attack (date unspecified).

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