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This is VAERS ID 483215

Case Details

VAERS ID: 483215 (history)  
Form: Version 1.0  
Age: 2.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2013-01-16
Onset:2013-01-17
   Days after vaccination:1
Submitted: 2013-02-01
   Days after onset:15
Entered: 2013-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN3: INFLUENZA (SEASONAL) (FLUMIST) / MEDIMMUNE VACCINES, INC. AL2156 / 4 NS / IN

Administered by: Private       Purchased by: Private
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2013-01-17
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient deceased.


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