National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 57008

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 57008
VAERS Form:
Age:71.6
Sex:Female
Location:Arizona
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-18
Entered:1993-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1993-1994 / CONNAUGHT LABS 3F41007 / 3 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: FEVER, DYSPNEA, COUGH INC, HYPERVENTIL, HYPOCALCEM

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-08
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone; Methotrexate;
Current Illness:
Preexisting Conditions: pulmonary fibrosis, past hx TB, theumatoid arthritis;
Allergies:
Diagnostic Lab Data: family refused autopsy;
CDC 'Split Type':

Write-up: died p/being hospitalized for interstitial pneumonia; day p/vax felt SOB & started to cough; 5OCt admitted;


Changed on 12/8/2009

VAERS ID: 57008 Before After
VAERS Form:
Age:71.6
Sex:Female
Location:Arizona
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-18
Entered:1993-11-10 1993-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1993-1994 INFLUENZA (SEASONAL) (FLUZONE 93-94) / CONNAUGHT LABS CONNAUGHT LABORATORIES 3F41007 / 3 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Dyspnoea, Hyperventilation, Hypocalcaemia, Leukocytosis, Pneumonia, Pyrexia, Tachycardia, FEVER, DYSPNEA, COUGH INC, HYPERVENTIL, HYPOCALCEM

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-08
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone; Methotrexate;
Current Illness:
Preexisting Conditions: pulmonary fibrosis, past hx TB, theumatoid arthritis;
Allergies:
Diagnostic Lab Data: family refused autopsy;
CDC 'Split Type': (blank) CO5040

Write-up: died p/being hospitalized for interstitial pneumonia; day p/vax felt SOB & started to cough; 5OCt admitted;


Changed on 8/31/2010

VAERS ID: 57008 Before After
VAERS Form:
Age:71.6
Sex:Female
Location:Arizona
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-18
Entered:1993-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 93-94) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3F41007 / 3 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Dyspnoea, Hyperventilation, Hypocalcaemia, Leukocytosis, Pneumonia, Pyrexia, Tachycardia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-08
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone; Methotrexate;
Current Illness:
Preexisting Conditions: pulmonary fibrosis, past hx TB, theumatoid arthritis;
Allergies:
Diagnostic Lab Data: family refused autopsy;
CDC 'Split Type': CO5040

Write-up: died p/being hospitalized for interstitial pneumonia; day p/vax felt SOB & started to cough; 5OCt admitted;


Changed on 7/7/2013

VAERS ID: 57008 Before After
VAERS Form:
Age:71.6
Sex:Female
Location:Arizona
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-18
Entered:1993-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3F41007 / 3 - / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3F41007 / 3 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Dyspnoea, Hyperventilation, Hypocalcaemia, Leukocytosis, Pneumonia, Pyrexia, Tachycardia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-08
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone; Methotrexate;
Current Illness:
Preexisting Conditions: pulmonary fibrosis, past hx TB, theumatoid arthritis;
Allergies:
Diagnostic Lab Data: family refused autopsy;
CDC 'Split Type': CO5040

Write-up: died p/being hospitalized for interstitial pneumonia; day p/vax felt SOB & started to cough; 5OCt admitted;


Changed on 2/14/2017

VAERS ID: 57008 Before After
VAERS Form:
Age:71.6 71.0
Sex:Female
Location:Arizona
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-18
Entered:1993-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3F41007 / 3 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Dyspnoea, Hyperventilation, Hypocalcaemia, Leukocytosis, Pneumonia, Pyrexia, Tachycardia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-08
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prednisone; Methotrexate;
Current Illness:
Preexisting Conditions: pulmonary fibrosis, past hx TB, theumatoid arthritis;
Allergies:
Diagnostic Lab Data: family refused autopsy;
CDC 'Split Type': CO5040

Write-up: died p/being hospitalized for interstitial pneumonia; day p/vax felt SOB & started to cough; 5OCt admitted;


Changed on 5/14/2017

VAERS ID: 57008 Before After
VAERS Form:
Age:71.0
Sex:Female
Location:Arizona
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-18
Entered:1993-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3F41007 / 3 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Dyspnoea, Hyperventilation, Hypocalcaemia, Leukocytosis, Pneumonia, Pyrexia, Tachycardia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-08
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prednisone; Methotrexate;
Current Illness:
Preexisting Conditions: pulmonary fibrosis, past hx TB, theumatoid arthritis;
Allergies:
Diagnostic Lab Data: family refused autopsy;
CDC 'Split Type': CO5040

Write-up: died p/being hospitalized for interstitial pneumonia; day p/vax felt SOB & started to cough; 5OCt admitted;


Changed on 9/14/2017

VAERS ID: 57008 Before After
VAERS Form:(blank) 1
Age:71.0
Sex:Female
Location:Arizona
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-18
Entered:1993-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3F41007 / 3 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Dyspnoea, Hyperventilation, Hypocalcaemia, Leukocytosis, Pneumonia, Pyrexia, Tachycardia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-08
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prednisone; Methotrexate;
Current Illness:
Preexisting Conditions: pulmonary fibrosis, past hx TB, theumatoid arthritis;
Allergies:
Diagnostic Lab Data: family refused autopsy;
CDC 'Split Type': CO5040

Write-up: died p/being hospitalized for interstitial pneumonia; day p/vax felt SOB & started to cough; 5OCt admitted;


Changed on 2/14/2018

VAERS ID: 57008 Before After
VAERS Form:1
Age:71.0
Sex:Female
Location:Arizona
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-18
Entered:1993-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3F41007 / 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Dyspnoea, Hyperventilation, Hypocalcaemia, Leukocytosis, Pneumonia, Pyrexia, Tachycardia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-08
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prednisone; Methotrexate;
Current Illness:
Preexisting Conditions: pulmonary fibrosis, past hx TB, theumatoid arthritis;
Allergies:
Diagnostic Lab Data: family refused autopsy;
CDC 'Split Type': CO5040

Write-up: died p/being hospitalized for interstitial pneumonia; day p/vax felt SOB & started to cough; 5OCt admitted;


Changed on 6/14/2018

VAERS ID: 57008 Before After
VAERS Form:1
Age:71.0
Sex:Female
Location:Arizona
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-18
Entered:1993-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3F41007 / 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Dyspnoea, Hyperventilation, Hypocalcaemia, Leukocytosis, Pneumonia, Pyrexia, Tachycardia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-08
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prednisone; Methotrexate;
Current Illness:
Preexisting Conditions: pulmonary fibrosis, past hx TB, theumatoid arthritis;
Allergies:
Diagnostic Lab Data: family refused autopsy;
CDC 'Split Type': CO5040

Write-up: died p/being hospitalized for interstitial pneumonia; day p/vax felt SOB & started to cough; 5OCt admitted;


Changed on 8/14/2018

VAERS ID: 57008 Before After
VAERS Form:1
Age:71.0
Sex:Female
Location:Arizona
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-18
Entered:1993-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3F41007 / 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Dyspnoea, Hyperventilation, Hypocalcaemia, Leukocytosis, Pneumonia, Pyrexia, Tachycardia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-08
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prednisone; Methotrexate;
Current Illness:
Preexisting Conditions: pulmonary fibrosis, past hx TB, theumatoid arthritis;
Allergies:
Diagnostic Lab Data: family refused autopsy;
CDC 'Split Type': CO5040

Write-up: died p/being hospitalized for interstitial pneumonia; day p/vax felt SOB & started to cough; 5OCt admitted;


Changed on 9/14/2018

VAERS ID: 57008 Before After
VAERS Form:1
Age:71.0
Sex:Female
Location:Arizona
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-18
Entered:1993-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3F41007 / 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Dyspnoea, Hyperventilation, Hypocalcaemia, Leukocytosis, Pneumonia, Pyrexia, Tachycardia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-08
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prednisone; Methotrexate;
Current Illness:
Preexisting Conditions: pulmonary fibrosis, past hx TB, theumatoid arthritis;
Allergies:
Diagnostic Lab Data: family refused autopsy;
CDC 'Split Type': CO5040

Write-up: died p/being hospitalized for interstitial pneumonia; day p/vax felt SOB & started to cough; 5OCt admitted;


Changed on 10/14/2018

VAERS ID: 57008 Before After
VAERS Form:1
Age:71.0
Sex:Female
Location:Arizona
Vaccinated:1993-09-30
Onset:1993-10-01
Submitted:1993-10-18
Entered:1993-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3F41007 / 4 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cough, Dyspnoea, Hyperventilation, Hypocalcaemia, Leukocytosis, Pneumonia, Pyrexia, Tachycardia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-10-08
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Prednisone; Methotrexate;
Current Illness:
Preexisting Conditions: pulmonary fibrosis, past hx TB, theumatoid arthritis;
Allergies:
Diagnostic Lab Data: family refused autopsy;
CDC 'Split Type': CO5040

Write-up: died p/being hospitalized for interstitial pneumonia; day p/vax felt SOB & started to cough; 5OCt admitted;

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=57008&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166