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This is VAERS ID 56467

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 56467
VAERS Form:
Age:77.1
Sex:Female
Location:California
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-02
Entered:1993-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1993-1994 / WYETH 4938137 / - LA / IM
PPV: PNU-IMUNE(R)23 / LEDERLE 340938 / 0 RA / -

Administered by: Private      Purchased by: Unknown
Symptoms: APNEA, HEART ARREST

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-01
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: Sinemet; Parlodel, Xanax, Doxepin, Furosemide, ASA, Paxil
Current Illness: parkinsons, skin (contact derm);
Preexisting Conditions: sulfa/motrin advanced parkinsons disease;
Allergies:
Diagnostic Lab Data: last labs 20AUG93 Serum NA 127; serum CA+ 8.5; chlorids 88;
CDC 'Split Type':

Write-up: resp/cardiac arrest;


Changed on 12/8/2009

VAERS ID: 56467 Before After
VAERS Form:
Age:77.1
Sex:Female
Location:California
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-02
Entered:1993-10-13 1993-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA VACCINE 1993-1994 INFLUENZA (SEASONAL) (NO BRAND NAME, 93-94) / WYETH WYETH PHARMACEUTICALS, INC 4938137 / - LA / IM
PPV: PNU-IMUNE(R)23 PNEUMO (PNU-IMUNE) / LEDERLE LEDERLE LABORATORIES 340938 / 0 RA / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Apnoea, Cardiac arrest, APNEA, HEART ARREST

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-01
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: Sinemet; Parlodel, Xanax, Doxepin, Furosemide, ASA, Paxil
Current Illness: parkinsons, skin (contact derm);
Preexisting Conditions: sulfa/motrin advanced parkinsons disease;
Allergies:
Diagnostic Lab Data: last labs 20AUG93 Serum NA 127; serum CA+ 8.5; chlorids 88;
CDC 'Split Type':

Write-up: resp/cardiac arrest;


Changed on 8/31/2010

VAERS ID: 56467 Before After
VAERS Form:
Age:77.1
Sex:Female
Location:California
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-02
Entered:1993-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME, 93-94) INFLUENZA (SEASONAL) (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4938137 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 340938 / 0 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-01
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: Sinemet; Parlodel, Xanax, Doxepin, Furosemide, ASA, Paxil
Current Illness: parkinsons, skin (contact derm);
Preexisting Conditions: sulfa/motrin advanced parkinsons disease;
Allergies:
Diagnostic Lab Data: last labs 20AUG93 Serum NA 127; serum CA+ 8.5; chlorids 88;
CDC 'Split Type':

Write-up: resp/cardiac arrest;


Changed on 7/7/2013

VAERS ID: 56467 Before After
VAERS Form:
Age:77.1
Sex:Female
Location:California
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-02
Entered:1993-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938137 / - LA / IM
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938137 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 340938 / 0 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-01
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: Sinemet; Parlodel, Xanax, Doxepin, Furosemide, ASA, Paxil
Current Illness: parkinsons, skin (contact derm);
Preexisting Conditions: sulfa/motrin advanced parkinsons disease;
Allergies:
Diagnostic Lab Data: last labs 20AUG93 Serum NA 127; serum CA+ 8.5; chlorids 88;
CDC 'Split Type':

Write-up: resp/cardiac arrest;


Changed on 12/14/2016

VAERS ID: 56467 Before After
VAERS Form:
Age:77.1
Sex:Female
Location:California
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-02
Entered:1993-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938137 / - LA / IM
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938137 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 340938 / 0 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-01
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: Sinemet; Parlodel, Xanax, Doxepin, Furosemide, ASA, Paxil
Current Illness: parkinsons, skin (contact derm);
Preexisting Conditions: sulfa/motrin advanced parkinsons disease;
Allergies:
Diagnostic Lab Data: last labs 20AUG93 Serum NA 127; serum CA+ 8.5; chlorids 88;
CDC 'Split Type':

Write-up: resp/cardiac arrest;


Changed on 2/14/2017

VAERS ID: 56467 Before After
VAERS Form:
Age:77.1 77.0
Sex:Female
Location:California
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-02
Entered:1993-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938137 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES 340938 / 0 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-01
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: Sinemet; Parlodel, Xanax, Doxepin, Furosemide, ASA, Paxil
Current Illness: parkinsons, skin (contact derm);
Preexisting Conditions: sulfa/motrin advanced parkinsons disease;
Allergies:
Diagnostic Lab Data: last labs 20AUG93 Serum NA 127; serum CA+ 8.5; chlorids 88;
CDC 'Split Type':

Write-up: resp/cardiac arrest;


Changed on 5/14/2017

VAERS ID: 56467 Before After
VAERS Form:
Age:77.0
Sex:Female
Location:California
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-02
Entered:1993-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938137 / - LA / IM
PPV: PNEUMO (PNU-IMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 340938 / 0 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-01
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: ~ ()~~~In patient
Other Medications: Sinemet; Parlodel, Xanax, Doxepin, Furosemide, ASA, Paxil
Current Illness: parkinsons, skin (contact derm);
Preexisting Conditions: sulfa/motrin advanced parkinsons disease;
Allergies:
Diagnostic Lab Data: last labs 20AUG93 Serum NA 127; serum CA+ 8.5; chlorids 88;
CDC 'Split Type':

Write-up: resp/cardiac arrest;


Changed on 9/14/2017

VAERS ID: 56467 Before After
VAERS Form:(blank) 1
Age:77.0
Sex:Female
Location:California
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-02
Entered:1993-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938137 / - UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 340938 / 0 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-01
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: ~ ()~~~In patient
Other Medications: Sinemet; Parlodel, Xanax, Doxepin, Furosemide, ASA, Paxil
Current Illness: parkinsons, skin (contact derm);
Preexisting Conditions: sulfa/motrin advanced parkinsons disease;
Allergies:
Diagnostic Lab Data: last labs 20AUG93 Serum NA 127; serum CA+ 8.5; chlorids 88;
CDC 'Split Type':

Write-up: resp/cardiac arrest;


Changed on 2/14/2018

VAERS ID: 56467 Before After
VAERS Form:1
Age:77.0
Sex:Female
Location:California
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-02
Entered:1993-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938137 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 340938 / 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-01
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: ~ ()~~~In patient
Other Medications: Sinemet; Parlodel, Xanax, Doxepin, Furosemide, ASA, Paxil
Current Illness: parkinsons, skin (contact derm);
Preexisting Conditions: sulfa/motrin advanced parkinsons disease;
Allergies:
Diagnostic Lab Data: last labs 20AUG93 Serum NA 127; serum CA+ 8.5; chlorids 88;
CDC 'Split Type':

Write-up: resp/cardiac arrest;


Changed on 6/14/2018

VAERS ID: 56467 Before After
VAERS Form:1
Age:77.0
Sex:Female
Location:California
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-02
Entered:1993-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938137 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 340938 / 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-01
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: ~ ()~~~In patient
Other Medications: Sinemet; Parlodel, Xanax, Doxepin, Furosemide, ASA, Paxil
Current Illness: parkinsons, skin (contact derm);
Preexisting Conditions: sulfa/motrin advanced parkinsons disease;
Allergies:
Diagnostic Lab Data: last labs 20AUG93 Serum NA 127; serum CA+ 8.5; chlorids 88;
CDC 'Split Type':

Write-up: resp/cardiac arrest;


Changed on 8/14/2018

VAERS ID: 56467 Before After
VAERS Form:1
Age:77.0
Sex:Female
Location:California
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-02
Entered:1993-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938137 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 340938 / 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-01
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: ~ ()~~~In patient
Other Medications: Sinemet; Parlodel, Xanax, Doxepin, Furosemide, ASA, Paxil
Current Illness: parkinsons, skin (contact derm);
Preexisting Conditions: sulfa/motrin advanced parkinsons disease;
Allergies:
Diagnostic Lab Data: last labs 20AUG93 Serum NA 127; serum CA+ 8.5; chlorids 88;
CDC 'Split Type':

Write-up: resp/cardiac arrest;


Changed on 9/14/2018

VAERS ID: 56467 Before After
VAERS Form:1
Age:77.0
Sex:Female
Location:California
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-02
Entered:1993-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938137 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 340938 / 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-01
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: ~ ()~~~In patient
Other Medications: Sinemet; Parlodel, Xanax, Doxepin, Furosemide, ASA, Paxil
Current Illness: parkinsons, skin (contact derm);
Preexisting Conditions: sulfa/motrin advanced parkinsons disease;
Allergies:
Diagnostic Lab Data: last labs 20AUG93 Serum NA 127; serum CA+ 8.5; chlorids 88;
CDC 'Split Type':

Write-up: resp/cardiac arrest;


Changed on 10/14/2018

VAERS ID: 56467 Before After
VAERS Form:1
Age:77.0
Sex:Female
Location:California
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-02
Entered:1993-10-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938137 / UNK LA / IM
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 340938 / 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-01
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: ~ ()~~~In patient
Other Medications: Sinemet; Parlodel, Xanax, Doxepin, Furosemide, ASA, Paxil
Current Illness: parkinsons, skin (contact derm);
Preexisting Conditions: sulfa/motrin advanced parkinsons disease;
Allergies:
Diagnostic Lab Data: last labs 20AUG93 Serum NA 127; serum CA+ 8.5; chlorids 88;
CDC 'Split Type':

Write-up: resp/cardiac arrest;

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