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This is VAERS ID 489874

History of Changes from the VAERS Wayback Machine

First Appeared on 5/13/2013

VAERS ID: 489874
VAERS Form:
Age:29.0
Sex:Female
Location:California
Vaccinated:2012-04-01
Onset:2013-04-02
Submitted:2013-04-23
Entered:2013-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / IM

Administered by: Public      Purchased by: Private
Symptoms: Ultrasound scan, Foetal death, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-04-02
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: NO
Preexisting Conditions: PREGNANCY
Allergies:
Diagnostic Lab Data: ULTRASOUND, DELIVERY
CDC 'Split Type':

Write-up: FETAL DEATH.


Changed on 7/7/2013

VAERS ID: 489874 Before After
VAERS Form:
Age:29.0
Sex:Female
Location:California
Vaccinated:2012-04-01
Onset:2013-04-02
Submitted:2013-04-23
Entered:2013-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / IM

Administered by: Public      Purchased by: Private
Symptoms: Ultrasound scan, Foetal death, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-04-02
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: NO
Preexisting Conditions: PREGNANCY
Allergies:
Diagnostic Lab Data: ULTRASOUND, DELIVERY
CDC 'Split Type':

Write-up: FETAL DEATH.


Changed on 12/14/2016

VAERS ID: 489874 Before After
VAERS Form:
Age:29.0
Sex:Female
Location:California
Vaccinated:2012-04-01
Onset:2013-04-02
Submitted:2013-04-23
Entered:2013-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / IM

Administered by: Public      Purchased by: Private
Symptoms: Ultrasound scan, Foetal death, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-04-02
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: NO
Preexisting Conditions: PREGNANCY
Allergies:
Diagnostic Lab Data: ULTRASOUND, DELIVERY
CDC 'Split Type':

Write-up: FETAL DEATH.


Changed on 9/14/2017

VAERS ID: 489874 Before After
VAERS Form:(blank) 1
Age:29.0
Sex:Female
Location:California
Vaccinated:2012-04-01
Onset:2013-04-02
Submitted:2013-04-23
Entered:2013-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 2 - / IM

Administered by: Public      Purchased by: Private
Symptoms: Ultrasound scan, Foetal death, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-04-02
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: NO
Preexisting Conditions: PREGNANCY
Allergies:
Diagnostic Lab Data: ULTRASOUND, DELIVERY
CDC 'Split Type':

Write-up: FETAL DEATH.


Changed on 2/14/2018

VAERS ID: 489874 Before After
VAERS Form:1
Age:29.0
Sex:Female
Location:California
Vaccinated:2012-04-01
Onset:2013-04-02
Submitted:2013-04-23
Entered:2013-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / IM

Administered by: Public      Purchased by: Private
Symptoms: Ultrasound scan, Foetal death, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-04-02
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: NO
Preexisting Conditions: PREGNANCY
Allergies:
Diagnostic Lab Data: ULTRASOUND, DELIVERY
CDC 'Split Type':

Write-up: FETAL DEATH.


Changed on 6/14/2018

VAERS ID: 489874 Before After
VAERS Form:1
Age:29.0
Sex:Female
Location:California
Vaccinated:2012-04-01
Onset:2013-04-02
Submitted:2013-04-23
Entered:2013-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / IM

Administered by: Public      Purchased by: Private
Symptoms: Ultrasound scan, Foetal death, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-04-02
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: NO
Preexisting Conditions: PREGNANCY
Allergies:
Diagnostic Lab Data: ULTRASOUND, DELIVERY
CDC 'Split Type':

Write-up: FETAL DEATH.


Changed on 8/14/2018

VAERS ID: 489874 Before After
VAERS Form:1
Age:29.0
Sex:Female
Location:California
Vaccinated:2012-04-01
Onset:2013-04-02
Submitted:2013-04-23
Entered:2013-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / IM

Administered by: Public      Purchased by: Private
Symptoms: Ultrasound scan, Foetal death, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-04-02
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: NO
Preexisting Conditions: PREGNANCY
Allergies:
Diagnostic Lab Data: ULTRASOUND, DELIVERY
CDC 'Split Type':

Write-up: FETAL DEATH.


Changed on 9/14/2018

VAERS ID: 489874 Before After
VAERS Form:1
Age:29.0
Sex:Female
Location:California
Vaccinated:2012-04-01
Onset:2013-04-02
Submitted:2013-04-23
Entered:2013-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / IM

Administered by: Public      Purchased by: Private
Symptoms: Ultrasound scan, Foetal death, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-04-02
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: NO
Preexisting Conditions: PREGNANCY
Allergies:
Diagnostic Lab Data: ULTRASOUND, DELIVERY
CDC 'Split Type':

Write-up: FETAL DEATH.


Changed on 10/14/2018

VAERS ID: 489874 Before After
VAERS Form:1
Age:29.0
Sex:Female
Location:California
Vaccinated:2012-04-01
Onset:2013-04-02
Submitted:2013-04-23
Entered:2013-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / IM

Administered by: Public      Purchased by: Private
Symptoms: Ultrasound scan, Foetal death, Exposure during pregnancy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-04-02
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: NO
Preexisting Conditions: PREGNANCY
Allergies:
Diagnostic Lab Data: ULTRASOUND, DELIVERY
CDC 'Split Type':

Write-up: FETAL DEATH.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=489874&WAYBACKHISTORY=ON


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