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This is VAERS ID 486413

Case Details

VAERS ID: 486413 (history)  
Form: Version 1.0  
Age: 49.0  
Sex: Female  
Location: Georgia  
Vaccinated:2012-09-14
Onset:2012-09-15
   Days after vaccination:1
Submitted: 2013-03-07
   Days after onset:173
Entered: 2013-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / NOVARTIS VACCINES AND DIAGNOSTICS 1204601 / UNK LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Abasia, Diarrhoea, Dysstasia, Hypersomnia, Hypokinesia, Intensive care, Lethargy, Malaise, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2012-10-01
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: couldnt move without assistance~ ()~~0.00~Patient|couldnt stand~ ()~~0.00~Patient|weakness~ ()~UN~12.75~Patient|~Influenza (Seas
Other Medications: Duonebs, Abilify, Azactam, Carvedilol, Diflucan, Diflucan, Levanquin, Solu-Cortef, Synthroid, Vancomycin. Allergies: Sulfa, Penicillin, Benadryl
Current Illness: After an hour of vaccine, patient was nausea, vomiting, diarrhea and couldn''t move or stand to go to bathroom.
Preexisting Conditions: Received vaccine at dialysis center. Dialysis of kidney, full-blown AIDS, but very active and lively before incident.
Allergies:
Diagnostic Lab Data: Yes. ER & ICU & CCU
CDC Split Type:

Write-up: Stated she wasnt feeling well. I thought it was from dialysis treatment. She went to sleep, slept longer than normal, tried to eat, vomiting, couldn''t move or stand without assistance. Refused to go to hospital, diarrhea on herself, sleeping, couldn''t move off couch to bed, could walk, kept saying she was sick wanted. Very lethargic, no fever, got help from two sons to help move to wash off diarrhea & vomit.


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