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This is VAERS ID 480899

History of Changes from the VAERS Wayback Machine

First Appeared on 2/13/2013

VAERS ID: 480899
VAERS Form:
Age:89.0
Sex:Male
Location:Florida
Vaccinated:2013-01-07
Onset:2013-01-07
Submitted:2013-01-10
Entered:2013-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4542AA / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Death, Diarrhoea, Viral infection, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-01-07
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: Latanoprost eye drops, tamsulosin, possibly other, patient uses other pharmacies also
Current Illness: None reported at time of vaccination
Preexisting Conditions: High blood pressure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Neighbor reported that the patient died 1-7-13. Inital cause has been diagnosed as vomiting and diarrhea probably caused by a virus. Due to its close approximation to vaccination I am reporting this incident.


Changed on 7/7/2013

VAERS ID: 480899 Before After
VAERS Form:
Age:89.0
Sex:Male
Location:Florida
Vaccinated:2013-01-07
Onset:2013-01-07
Submitted:2013-01-10
Entered:2013-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4542AA / 1 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4542AA / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Death, Diarrhoea, Viral infection, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-01-07
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: Latanoprost eye drops, tamsulosin, possibly other, patient uses other pharmacies also
Current Illness: None reported at time of vaccination
Preexisting Conditions: High blood pressure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Neighbor reported that the patient died 1-7-13. Inital cause has been diagnosed as vomiting and diarrhea probably caused by a virus. Due to its close approximation to vaccination I am reporting this incident.


Changed on 6/14/2014

VAERS ID: 480899 Before After
VAERS Form:
Age:89.0
Sex:Male
Location:Florida
Vaccinated:2013-01-07
Onset:2013-01-07
Submitted:2013-01-10
Entered:2013-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4542AA / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Death, Diarrhoea, Viral infection, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-01-07
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: Latanoprost eye drops, tamsulosin, possibly other, patient uses other pharmacies also
Current Illness: None reported at time of vaccination
Preexisting Conditions: High blood pressure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Neighbor reported that the patient died 1-7-13. Inital cause has been diagnosed as vomiting and diarrhea probably caused by a virus. Due to its close approximation to vaccination I am reporting this incident.


Changed on 3/14/2015

VAERS ID: 480899 Before After
VAERS Form:
Age:89.0
Sex:Male
Location:Florida
Vaccinated:2013-01-07
Onset:2013-01-07
Submitted:2013-01-10
Entered:2013-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4542AA / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Death, Diarrhoea, Viral infection, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-01-07
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: Latanoprost eye drops, tamsulosin, possibly other, patient uses other pharmacies also
Current Illness: None reported at time of vaccination
Preexisting Conditions: High blood pressure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Neighbor reported that the patient died 1-7-13. Inital cause has been diagnosed as vomiting and diarrhea probably caused by a virus. Due to its close approximation to vaccination I am reporting this incident.


Changed on 9/14/2017

VAERS ID: 480899 Before After
VAERS Form:(blank) 1
Age:89.0
Sex:Male
Location:Florida
Vaccinated:2013-01-07
Onset:2013-01-07
Submitted:2013-01-10
Entered:2013-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4542AA / 1 2 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Death, Diarrhoea, Viral infection, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-01-07
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: Latanoprost eye drops, tamsulosin, possibly other, patient uses other pharmacies also
Current Illness: None reported at time of vaccination
Preexisting Conditions: High blood pressure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Neighbor reported that the patient died 1-7-13. Inital cause has been diagnosed as vomiting and diarrhea probably caused by a virus. Due to its close approximation to vaccination I am reporting this incident.


Changed on 2/14/2018

VAERS ID: 480899 Before After
VAERS Form:1
Age:89.0
Sex:Male
Location:Florida
Vaccinated:2013-01-07
Onset:2013-01-07
Submitted:2013-01-10
Entered:2013-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4542AA / 2 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Death, Diarrhoea, Viral infection, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-01-07
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: Latanoprost eye drops, tamsulosin, possibly other, patient uses other pharmacies also
Current Illness: None reported at time of vaccination
Preexisting Conditions: High blood pressure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Neighbor reported that the patient died 1-7-13. Inital cause has been diagnosed as vomiting and diarrhea probably caused by a virus. Due to its close approximation to vaccination I am reporting this incident.


Changed on 6/14/2018

VAERS ID: 480899 Before After
VAERS Form:1
Age:89.0
Sex:Male
Location:Florida
Vaccinated:2013-01-07
Onset:2013-01-07
Submitted:2013-01-10
Entered:2013-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4542AA / 2 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Death, Diarrhoea, Viral infection, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-01-07
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: Latanoprost eye drops, tamsulosin, possibly other, patient uses other pharmacies also
Current Illness: None reported at time of vaccination
Preexisting Conditions: High blood pressure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Neighbor reported that the patient died 1-7-13. Inital cause has been diagnosed as vomiting and diarrhea probably caused by a virus. Due to its close approximation to vaccination I am reporting this incident.


Changed on 8/14/2018

VAERS ID: 480899 Before After
VAERS Form:1
Age:89.0
Sex:Male
Location:Florida
Vaccinated:2013-01-07
Onset:2013-01-07
Submitted:2013-01-10
Entered:2013-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4542AA / 2 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Death, Diarrhoea, Viral infection, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-01-07
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: Latanoprost eye drops, tamsulosin, possibly other, patient uses other pharmacies also
Current Illness: None reported at time of vaccination
Preexisting Conditions: High blood pressure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Neighbor reported that the patient died 1-7-13. Inital cause has been diagnosed as vomiting and diarrhea probably caused by a virus. Due to its close approximation to vaccination I am reporting this incident.


Changed on 9/14/2018

VAERS ID: 480899 Before After
VAERS Form:1
Age:89.0
Sex:Male
Location:Florida
Vaccinated:2013-01-07
Onset:2013-01-07
Submitted:2013-01-10
Entered:2013-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4542AA / 2 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Death, Diarrhoea, Viral infection, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-01-07
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: Latanoprost eye drops, tamsulosin, possibly other, patient uses other pharmacies also
Current Illness: None reported at time of vaccination
Preexisting Conditions: High blood pressure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Neighbor reported that the patient died 1-7-13. Inital cause has been diagnosed as vomiting and diarrhea probably caused by a virus. Due to its close approximation to vaccination I am reporting this incident.


Changed on 10/14/2018

VAERS ID: 480899 Before After
VAERS Form:1
Age:89.0
Sex:Male
Location:Florida
Vaccinated:2013-01-07
Onset:2013-01-07
Submitted:2013-01-10
Entered:2013-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR U4542AA / 2 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Death, Diarrhoea, Viral infection, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-01-07
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: Latanoprost eye drops, tamsulosin, possibly other, patient uses other pharmacies also
Current Illness: None reported at time of vaccination
Preexisting Conditions: High blood pressure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Neighbor reported that the patient died 1-7-13. Inital cause has been diagnosed as vomiting and diarrhea probably caused by a virus. Due to its close approximation to vaccination I am reporting this incident.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=480899&WAYBACKHISTORY=ON


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