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This is VAERS ID 47493

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 47493
VAERS Form:
Age:74.8
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-11-12
Entered:1992-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1992-1993 / PARKE-DAVIS 01272P / - LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-03
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': UNK

Write-up: pt seen in ER where died 3OCT92;


Changed on 12/8/2009

VAERS ID: 47493 Before After
VAERS Form:
Age:74.8
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-11-12
Entered:1992-12-03 1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1992-1993 INFLUENZA (SEASONAL) (FLUOGEN 92-93) / PARKE-DAVIS 01272P / - LA / -

Administered by: Public      Purchased by: Unknown Private
Symptoms: Unevaluable event, REACT UNEVAL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-03
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': UNK PA92328

Write-up: pt seen in ER where died 3OCT92;


Changed on 8/31/2010

VAERS ID: 47493 Before After
VAERS Form:
Age:74.8
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-11-12
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN 92-93) INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / - LA / -

Administered by: Public      Purchased by: Private
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-03
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': PA92328

Write-up: pt seen in ER where died 3OCT92;


Changed on 7/7/2013

VAERS ID: 47493 Before After
VAERS Form:
Age:74.8
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-11-12
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / - LA / -
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / - LA / -

Administered by: Public      Purchased by: Private
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-03
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': PA92328

Write-up: pt seen in ER where died 3OCT92;


Changed on 2/14/2017

VAERS ID: 47493 Before After
VAERS Form:
Age:74.8 74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-11-12
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / - LA / -

Administered by: Public      Purchased by: Private
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-03
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: UNK
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': PA92328

Write-up: pt seen in ER where died 3OCT92;


Changed on 5/14/2017

VAERS ID: 47493 Before After
VAERS Form:
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-11-12
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / - LA / -

Administered by: Public      Purchased by: Private
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-03
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: UNK UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': PA92328

Write-up: pt seen in ER where died 3OCT92;


Changed on 9/14/2017

VAERS ID: 47493 Before After
VAERS Form:(blank) 1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-11-12
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / - UNK LA / -

Administered by: Public      Purchased by: Private
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-03
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': PA92328

Write-up: pt seen in ER where died 3OCT92;


Changed on 2/14/2018

VAERS ID: 47493 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-11-12
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / UNK LA / -

Administered by: Public      Purchased by: Private
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-03
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': PA92328

Write-up: pt seen in ER where died 3OCT92;


Changed on 6/14/2018

VAERS ID: 47493 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-11-12
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / UNK LA / -

Administered by: Public      Purchased by: Private
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-03
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': PA92328

Write-up: pt seen in ER where died 3OCT92;


Changed on 8/14/2018

VAERS ID: 47493 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-11-12
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / UNK LA / -

Administered by: Public      Purchased by: Private
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-03
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': PA92328

Write-up: pt seen in ER where died 3OCT92;


Changed on 9/14/2018

VAERS ID: 47493 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-11-12
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / UNK LA / -

Administered by: Public      Purchased by: Private
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-03
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': PA92328

Write-up: pt seen in ER where died 3OCT92;


Changed on 10/14/2018

VAERS ID: 47493 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-10-02
Onset:1992-10-03
Submitted:1992-11-12
Entered:1992-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 01272P / UNK LA / -

Administered by: Public      Purchased by: Private
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-10-03
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': PA92328

Write-up: pt seen in ER where died 3OCT92;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=47493&WAYBACKHISTORY=ON


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