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This is VAERS ID 483818

Case Details

VAERS ID: 483818 (history)  
Form: Version 1.0  
Age: 56.0  
Sex: Male  
Location: Texas  
Vaccinated:2013-02-01
Onset:2013-02-02
   Days after vaccination:1
Submitted: 2013-02-04
   Days after onset:2
Entered: 2013-02-08
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UH712AA / 1 AR / IM

Administered by: Public       Purchased by: Public
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2013-02-02
   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: VISTARIL; Temazepam; SEROQUEL; RISPERDAL
Current Illness: None
Preexisting Conditions: Hypertension; Schizophrenia
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Reported by family that he was found dead on 2/2/13.


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