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This is VAERS ID 47474

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 47474
VAERS Form:
Age:24.0
Sex:Female
Location:Maine
Vaccinated:1992-11-05
Onset:0000-00-00
Submitted:1992-11-09
Entered:1992-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1992-1993 / WYETH 4928115 / - A / IM

Administered by: Other      Purchased by: Unknown
Symptoms: FLU SYND, SHOCK, ENDOCARD

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: hodgkins disease/asplenic
Preexisting Conditions: pt had hodgkins disease & is asplenic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd flu vax & devel flu-like sx; the following morning pt collapsed & was adm to the hosp; pt is on a respirator & is critically ill;


Changed on 12/8/2009

VAERS ID: 47474 Before After
VAERS Form:
Age:24.0
Sex:Female
Location:Maine
Vaccinated:1992-11-05
Onset:0000-00-00
Submitted:1992-11-09
Entered:1992-12-03 1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1992-1993 INFLUENZA (SEASONAL) (NO BRAND NAME, 92-93) / WYETH WYETH PHARMACEUTICALS, INC 4928115 / - A / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Endocarditis, Influenza, Shock, FLU SYND, SHOCK, ENDOCARD

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: hodgkins disease/asplenic
Preexisting Conditions: pt had hodgkins disease & is asplenic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 892315007E

Write-up: pt recvd flu vax & devel flu-like sx; the following morning pt collapsed & was adm to the hosp; pt is on a respirator & is critically ill;


Changed on 8/31/2010

VAERS ID: 47474 Before After
VAERS Form:
Age:24.0
Sex:Female
Location:Maine
Vaccinated:1992-11-05
Onset:0000-00-00
Submitted:1992-11-09
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 92-93) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4928115 / - A / IM

Administered by: Other      Purchased by: Other
Symptoms: Endocarditis, Influenza, Shock

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: hodgkins disease/asplenic
Preexisting Conditions: pt had hodgkins disease & is asplenic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892315007E

Write-up: pt recvd flu vax & devel flu-like sx; the following morning pt collapsed & was adm to the hosp; pt is on a respirator & is critically ill;


Changed on 7/7/2013

VAERS ID: 47474 Before After
VAERS Form:
Age:24.0
Sex:Female
Location:Maine
Vaccinated:1992-11-05
Onset:0000-00-00
Submitted:1992-11-09
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928115 / - A / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928115 / - A / IM

Administered by: Other      Purchased by: Other
Symptoms: Endocarditis, Influenza, Shock

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: hodgkins disease/asplenic
Preexisting Conditions: pt had hodgkins disease & is asplenic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892315007E

Write-up: pt recvd flu vax & devel flu-like sx; the following morning pt collapsed & was adm to the hosp; pt is on a respirator & is critically ill;


Changed on 12/14/2016

VAERS ID: 47474 Before After
VAERS Form:
Age:24.0
Sex:Female
Location:Maine
Vaccinated:1992-11-05
Onset:0000-00-00
Submitted:1992-11-09
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928115 / - A / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928115 / - A / IM

Administered by: Other      Purchased by: Other
Symptoms: Endocarditis, Influenza, Shock

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: hodgkins disease/asplenic
Preexisting Conditions: pt had hodgkins disease & is asplenic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892315007E

Write-up: pt recvd flu vax & devel flu-like sx; the following morning pt collapsed & was adm to the hosp; pt is on a respirator & is critically ill;


Changed on 5/14/2017

VAERS ID: 47474 Before After
VAERS Form:
Age:24.0
Sex:Female
Location:Maine
Vaccinated:1992-11-05
Onset:0000-00-00
Submitted:1992-11-09
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928115 / - A - / IM IM A

Administered by: Other      Purchased by: Other
Symptoms: Endocarditis, Influenza, Shock

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: hodgkins disease/asplenic
Preexisting Conditions: pt had hodgkins disease & is asplenic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892315007E

Write-up: pt recvd flu vax & devel flu-like sx; the following morning pt collapsed & was adm to the hosp; pt is on a respirator & is critically ill;


Changed on 9/14/2017

VAERS ID: 47474 Before After
VAERS Form:(blank) 1
Age:24.0
Sex:Female
Location:Maine
Vaccinated:1992-11-05
Onset:0000-00-00
Submitted:1992-11-09
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928115 / - UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Endocarditis, Influenza, Shock

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: hodgkins disease/asplenic
Preexisting Conditions: pt had hodgkins disease & is asplenic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892315007E

Write-up: pt recvd flu vax & devel flu-like sx; the following morning pt collapsed & was adm to the hosp; pt is on a respirator & is critically ill;


Changed on 2/14/2018

VAERS ID: 47474 Before After
VAERS Form:1
Age:24.0
Sex:Female
Location:Maine
Vaccinated:1992-11-05
Onset:0000-00-00
Submitted:1992-11-09
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928115 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Endocarditis, Influenza, Shock

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: hodgkins disease/asplenic
Preexisting Conditions: pt had hodgkins disease & is asplenic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892315007E

Write-up: pt recvd flu vax & devel flu-like sx; the following morning pt collapsed & was adm to the hosp; pt is on a respirator & is critically ill;


Changed on 6/14/2018

VAERS ID: 47474 Before After
VAERS Form:1
Age:24.0
Sex:Female
Location:Maine
Vaccinated:1992-11-05
Onset:0000-00-00
Submitted:1992-11-09
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928115 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Endocarditis, Influenza, Shock

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: hodgkins disease/asplenic
Preexisting Conditions: pt had hodgkins disease & is asplenic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892315007E

Write-up: pt recvd flu vax & devel flu-like sx; the following morning pt collapsed & was adm to the hosp; pt is on a respirator & is critically ill;


Changed on 8/14/2018

VAERS ID: 47474 Before After
VAERS Form:1
Age:24.0
Sex:Female
Location:Maine
Vaccinated:1992-11-05
Onset:0000-00-00
Submitted:1992-11-09
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928115 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Endocarditis, Influenza, Shock

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: hodgkins disease/asplenic
Preexisting Conditions: pt had hodgkins disease & is asplenic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892315007E

Write-up: pt recvd flu vax & devel flu-like sx; the following morning pt collapsed & was adm to the hosp; pt is on a respirator & is critically ill;


Changed on 9/14/2018

VAERS ID: 47474 Before After
VAERS Form:1
Age:24.0
Sex:Female
Location:Maine
Vaccinated:1992-11-05
Onset:0000-00-00
Submitted:1992-11-09
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928115 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Endocarditis, Influenza, Shock

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: hodgkins disease/asplenic
Preexisting Conditions: pt had hodgkins disease & is asplenic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892315007E

Write-up: pt recvd flu vax & devel flu-like sx; the following morning pt collapsed & was adm to the hosp; pt is on a respirator & is critically ill;


Changed on 10/14/2018

VAERS ID: 47474 Before After
VAERS Form:1
Age:24.0
Sex:Female
Location:Maine
Vaccinated:1992-11-05
Onset:0000-00-00
Submitted:1992-11-09
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928115 / UNK - / IM A

Administered by: Other      Purchased by: Other
Symptoms: Endocarditis, Influenza, Shock

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: hodgkins disease/asplenic
Preexisting Conditions: pt had hodgkins disease & is asplenic;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 892315007E

Write-up: pt recvd flu vax & devel flu-like sx; the following morning pt collapsed & was adm to the hosp; pt is on a respirator & is critically ill;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=47474&WAYBACKHISTORY=ON


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