National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 476400

History of Changes from the VAERS Wayback Machine

First Appeared on 12/11/2012

VAERS ID: 476400
VAERS Form:
Age:80.0
Sex:Male
Location:Florida
Vaccinated:2012-11-21
Onset:2012-11-21
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4537AA / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chills, Confusional state, Death, Influenza like illness, Malaise, Nausea, Pain, Vertigo

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-22
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: QUINAPRIL 10 mg tablets, 1 oral dose daily; Simvastatin 10 mg tablets, 1 oral dose daily
Current Illness:
Preexisting Conditions: The patient was a male who smoked, had hyperlipidemia, and hypertension. No known allergies to food or other medications were noted in his medical history.
Allergies:
Diagnostic Lab Data: No autopsy was performed as it appeared at the time to be a natural cause of death due to the patients advanced age.
CDC 'Split Type':

Write-up: Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been given a flu shot early that day. Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been giving a flu shot early that day. At approximately 10:30 pm on 11/21/12 the phone conversation ended with the patient stating that he was going to the bathroom because he did not feel well. The next morning the patient did not respond to phone calls or knocking on the door by relatives. Upon gaining entry to the home, the patient was found dead on the floor between his bedroom and bathroom hallway. The patient was naked and face down on the floor when found. The patient had no history of heart problems and had never experienced a heart attack.


Changed on 7/7/2013

VAERS ID: 476400 Before After
VAERS Form:
Age:80.0
Sex:Male
Location:Florida
Vaccinated:2012-11-21
Onset:2012-11-21
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4537AA / - UN / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4537AA / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chills, Confusional state, Death, Influenza like illness, Malaise, Nausea, Pain, Vertigo

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-22
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: QUINAPRIL 10 mg tablets, 1 oral dose daily; Simvastatin 10 mg tablets, 1 oral dose daily
Current Illness:
Preexisting Conditions: The patient was a male who smoked, had hyperlipidemia, and hypertension. No known allergies to food or other medications were noted in his medical history.
Allergies:
Diagnostic Lab Data: No autopsy was performed as it appeared at the time to be a natural cause of death due to the patients advanced age.
CDC 'Split Type':

Write-up: Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been given a flu shot early that day. Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been giving a flu shot early that day. At approximately 10:30 pm on 11/21/12 the phone conversation ended with the patient stating that he was going to the bathroom because he did not feel well. The next morning the patient did not respond to phone calls or knocking on the door by relatives. Upon gaining entry to the home, the patient was found dead on the floor between his bedroom and bathroom hallway. The patient was naked and face down on the floor when found. The patient had no history of heart problems and had never experienced a heart attack.


Changed on 6/14/2014

VAERS ID: 476400 Before After
VAERS Form:
Age:80.0
Sex:Male
Location:Florida
Vaccinated:2012-11-21
Onset:2012-11-21
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4537AA / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chills, Confusional state, Death, Influenza like illness, Malaise, Nausea, Pain, Vertigo

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-22
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: QUINAPRIL 10 mg tablets, 1 oral dose daily; Simvastatin 10 mg tablets, 1 oral dose daily
Current Illness:
Preexisting Conditions: The patient was a male who smoked, had hyperlipidemia, and hypertension. No known allergies to food or other medications were noted in his medical history.
Allergies:
Diagnostic Lab Data: No autopsy was performed as it appeared at the time to be a natural cause of death due to the patients advanced age.
CDC 'Split Type':

Write-up: Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been given a flu shot early that day. Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been giving a flu shot early that day. At approximately 10:30 pm on 11/21/12 the phone conversation ended with the patient stating that he was going to the bathroom because he did not feel well. The next morning the patient did not respond to phone calls or knocking on the door by relatives. Upon gaining entry to the home, the patient was found dead on the floor between his bedroom and bathroom hallway. The patient was naked and face down on the floor when found. The patient had no history of heart problems and had never experienced a heart attack.


Changed on 4/14/2017

VAERS ID: 476400 Before After
VAERS Form:
Age:80.0
Sex:Male
Location:Florida
Vaccinated:2012-11-21
Onset:2012-11-21
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4537AA / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chills, Confusional state, Death, Influenza like illness, Malaise, Nausea, Pain, Vertigo

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-22
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: QUINAPRIL 10 mg tablets, 1 oral dose daily; Simvastatin 10 mg tablets, 1 oral dose daily
Current Illness:
Preexisting Conditions: The patient was a male who smoked, had hyperlipidemia, and hypertension. No known allergies to food or other medications were noted in his medical history.
Allergies:
Diagnostic Lab Data: No autopsy was performed as it appeared at the time to be a natural cause of death due to the patients advanced age.
CDC 'Split Type':

Write-up: Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been given a flu shot early that day. Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been giving a flu shot early that day. At approximately 10:30 pm on 11/21/12 the phone conversation ended with the patient stating that he was going to the bathroom because he did not feel well. The next morning the patient did not respond to phone calls or knocking on the door by relatives. Upon gaining entry to the home, the patient was found dead on the floor between his bedroom and bathroom hallway. The patient was naked and face down on the floor when found. The patient had no history of heart problems and had never experienced a heart attack.


Changed on 9/14/2017

VAERS ID: 476400 Before After
VAERS Form:(blank) 1
Age:80.0
Sex:Male
Location:Florida
Vaccinated:2012-11-21
Onset:2012-11-21
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4537AA / - UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chills, Confusional state, Death, Influenza like illness, Malaise, Nausea, Pain, Vertigo

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-22
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: QUINAPRIL 10 mg tablets, 1 oral dose daily; Simvastatin 10 mg tablets, 1 oral dose daily
Current Illness:
Preexisting Conditions: The patient was a male who smoked, had hyperlipidemia, and hypertension. No known allergies to food or other medications were noted in his medical history.
Allergies:
Diagnostic Lab Data: No autopsy was performed as it appeared at the time to be a natural cause of death due to the patients advanced age.
CDC 'Split Type':

Write-up: Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been given a flu shot early that day. Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been giving a flu shot early that day. At approximately 10:30 pm on 11/21/12 the phone conversation ended with the patient stating that he was going to the bathroom because he did not feel well. The next morning the patient did not respond to phone calls or knocking on the door by relatives. Upon gaining entry to the home, the patient was found dead on the floor between his bedroom and bathroom hallway. The patient was naked and face down on the floor when found. The patient had no history of heart problems and had never experienced a heart attack.


Changed on 2/14/2018

VAERS ID: 476400 Before After
VAERS Form:1
Age:80.0
Sex:Male
Location:Florida
Vaccinated:2012-11-21
Onset:2012-11-21
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4537AA / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chills, Confusional state, Death, Influenza like illness, Malaise, Nausea, Pain, Vertigo

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-22
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: QUINAPRIL 10 mg tablets, 1 oral dose daily; Simvastatin 10 mg tablets, 1 oral dose daily
Current Illness:
Preexisting Conditions: The patient was a male who smoked, had hyperlipidemia, and hypertension. No known allergies to food or other medications were noted in his medical history.
Allergies:
Diagnostic Lab Data: No autopsy was performed as it appeared at the time to be a natural cause of death due to the patients advanced age.
CDC 'Split Type':

Write-up: Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been given a flu shot early that day. Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been giving a flu shot early that day. At approximately 10:30 pm on 11/21/12 the phone conversation ended with the patient stating that he was going to the bathroom because he did not feel well. The next morning the patient did not respond to phone calls or knocking on the door by relatives. Upon gaining entry to the home, the patient was found dead on the floor between his bedroom and bathroom hallway. The patient was naked and face down on the floor when found. The patient had no history of heart problems and had never experienced a heart attack.


Changed on 6/14/2018

VAERS ID: 476400 Before After
VAERS Form:1
Age:80.0
Sex:Male
Location:Florida
Vaccinated:2012-11-21
Onset:2012-11-21
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4537AA / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chills, Confusional state, Death, Influenza like illness, Malaise, Nausea, Pain, Vertigo

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-22
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: QUINAPRIL 10 mg tablets, 1 oral dose daily; Simvastatin 10 mg tablets, 1 oral dose daily
Current Illness:
Preexisting Conditions: The patient was a male who smoked, had hyperlipidemia, and hypertension. No known allergies to food or other medications were noted in his medical history.
Allergies:
Diagnostic Lab Data: No autopsy was performed as it appeared at the time to be a natural cause of death due to the patients advanced age.
CDC 'Split Type':

Write-up: Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been given a flu shot early that day. Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been giving a flu shot early that day. At approximately 10:30 pm on 11/21/12 the phone conversation ended with the patient stating that he was going to the bathroom because he did not feel well. The next morning the patient did not respond to phone calls or knocking on the door by relatives. Upon gaining entry to the home, the patient was found dead on the floor between his bedroom and bathroom hallway. The patient was naked and face down on the floor when found. The patient had no history of heart problems and had never experienced a heart attack.


Changed on 8/14/2018

VAERS ID: 476400 Before After
VAERS Form:1
Age:80.0
Sex:Male
Location:Florida
Vaccinated:2012-11-21
Onset:2012-11-21
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4537AA / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chills, Confusional state, Death, Influenza like illness, Malaise, Nausea, Pain, Vertigo

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-22
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: QUINAPRIL 10 mg tablets, 1 oral dose daily; Simvastatin 10 mg tablets, 1 oral dose daily
Current Illness:
Preexisting Conditions: The patient was a male who smoked, had hyperlipidemia, and hypertension. No known allergies to food or other medications were noted in his medical history.
Allergies:
Diagnostic Lab Data: No autopsy was performed as it appeared at the time to be a natural cause of death due to the patients advanced age.
CDC 'Split Type':

Write-up: Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been given a flu shot early that day. Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been giving a flu shot early that day. At approximately 10:30 pm on 11/21/12 the phone conversation ended with the patient stating that he was going to the bathroom because he did not feel well. The next morning the patient did not respond to phone calls or knocking on the door by relatives. Upon gaining entry to the home, the patient was found dead on the floor between his bedroom and bathroom hallway. The patient was naked and face down on the floor when found. The patient had no history of heart problems and had never experienced a heart attack.


Changed on 9/14/2018

VAERS ID: 476400 Before After
VAERS Form:1
Age:80.0
Sex:Male
Location:Florida
Vaccinated:2012-11-21
Onset:2012-11-21
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4537AA / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chills, Confusional state, Death, Influenza like illness, Malaise, Nausea, Pain, Vertigo

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-22
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: QUINAPRIL 10 mg tablets, 1 oral dose daily; Simvastatin 10 mg tablets, 1 oral dose daily
Current Illness:
Preexisting Conditions: The patient was a male who smoked, had hyperlipidemia, and hypertension. No known allergies to food or other medications were noted in his medical history.
Allergies:
Diagnostic Lab Data: No autopsy was performed as it appeared at the time to be a natural cause of death due to the patients advanced age.
CDC 'Split Type':

Write-up: Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been given a flu shot early that day. Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been giving a flu shot early that day. At approximately 10:30 pm on 11/21/12 the phone conversation ended with the patient stating that he was going to the bathroom because he did not feel well. The next morning the patient did not respond to phone calls or knocking on the door by relatives. Upon gaining entry to the home, the patient was found dead on the floor between his bedroom and bathroom hallway. The patient was naked and face down on the floor when found. The patient had no history of heart problems and had never experienced a heart attack.


Changed on 10/14/2018

VAERS ID: 476400 Before After
VAERS Form:1
Age:80.0
Sex:Male
Location:Florida
Vaccinated:2012-11-21
Onset:2012-11-21
Submitted:2012-12-04
Entered:2012-12-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4537AA / UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chills, Confusional state, Death, Influenza like illness, Malaise, Nausea, Pain, Vertigo

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2012-11-22
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: QUINAPRIL 10 mg tablets, 1 oral dose daily; Simvastatin 10 mg tablets, 1 oral dose daily
Current Illness:
Preexisting Conditions: The patient was a male who smoked, had hyperlipidemia, and hypertension. No known allergies to food or other medications were noted in his medical history.
Allergies:
Diagnostic Lab Data: No autopsy was performed as it appeared at the time to be a natural cause of death due to the patients advanced age.
CDC 'Split Type':

Write-up: Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been given a flu shot early that day. Patient died after receiving a HIGH DOSE flu shot on the morning of 11/21/12. The shot was administered at pharmacy. The shot was given to the patient at approximately 11:00 am on November 21, 2012. By late afternoon the patient was experiencing flu-like symptoms; chills, body aches, vertigo, nausea and confusion. The patient spoke with his eldest son late that evening by phone and told his son of his symptoms and the fact that he had been giving a flu shot early that day. At approximately 10:30 pm on 11/21/12 the phone conversation ended with the patient stating that he was going to the bathroom because he did not feel well. The next morning the patient did not respond to phone calls or knocking on the door by relatives. Upon gaining entry to the home, the patient was found dead on the floor between his bedroom and bathroom hallway. The patient was naked and face down on the floor when found. The patient had no history of heart problems and had never experienced a heart attack.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=476400&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166