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This is VAERS ID 58384

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 58384
VAERS Form:
Age:25.3
Sex:Female
Location:North Dakota
Vaccinated:1993-10-13
Onset:1993-11-29
Submitted:0000-00-00
Entered:1993-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1993-1994 / CONNAUGHT LABS 3J41148 / - - / IM

Administered by: Military      Purchased by: Unknown
Symptoms: INFECT, HEM, LEUKOPENIA, HEMATEMESIS, ENDOCARD

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-11-29
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:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: waiting on drug screen
CDC 'Split Type':

Write-up: found dead in apartment, no suspicious circumstances. Autopsy results: lymphoma; no known cause of death.


Changed on 12/8/2009

VAERS ID: 58384 Before After
VAERS Form:
Age:25.3
Sex:Female
Location:North Dakota
Vaccinated:1993-10-13
Onset:1993-11-29
Submitted:0000-00-00
Entered:1993-12-29 1993-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUZONE 1993-1994 INFLUENZA (SEASONAL) (FLUZONE 93-94) / CONNAUGHT LABS CONNAUGHT LABORATORIES 3J41148 / - - / IM

Administered by: Military      Purchased by: Unknown Military
Symptoms: Endocarditis, Haematemesis, Infection, Leukopenia, Lymphadenopathy, Necrosis, Pneumonia, Haemorrhage, INFECT, HEM, LEUKOPENIA, HEMATEMESIS, ENDOCARD

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-11-29
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:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: waiting on drug screen
CDC 'Split Type': (blank) CO5196

Write-up: found dead in apartment, no suspicious circumstances. Autopsy results: lymphoma; no known cause of death.


Changed on 1/5/2010

VAERS ID: 58384 Before After
VAERS Form:
Age:25.3 25.0
Sex:Female
Location:North Dakota
Vaccinated:1993-10-13
Onset:1993-11-29
Submitted:0000-00-00
Entered:1993-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 93-94) / CONNAUGHT LABORATORIES 3J41148 / - - / IM

Administered by: Military      Purchased by: Military
Symptoms: Endocarditis, Haematemesis, Infection, Leukopenia, Lymphadenopathy, Necrosis, Pneumonia, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-11-29
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: ~ ()~ ~~In patient
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: waiting on drug screen
CDC 'Split Type': CO5196

Write-up: found dead in apartment, no suspicious circumstances. Autopsy results: lymphoma; no known cause of death.


Changed on 8/31/2010

VAERS ID: 58384 Before After
VAERS Form:
Age:25.0
Sex:Female
Location:North Dakota
Vaccinated:1993-10-13
Onset:1993-11-29
Submitted:0000-00-00
Entered:1993-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE 93-94) INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3J41148 / - - / IM

Administered by: Military      Purchased by: Military
Symptoms: Endocarditis, Haematemesis, Infection, Leukopenia, Lymphadenopathy, Necrosis, Pneumonia, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-11-29
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: ~ ()~ ~~In patient
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: waiting on drug screen
CDC 'Split Type': CO5196

Write-up: found dead in apartment, no suspicious circumstances. Autopsy results: lymphoma; no known cause of death.


Changed on 7/7/2013

VAERS ID: 58384 Before After
VAERS Form:
Age:25.0
Sex:Female
Location:North Dakota
Vaccinated:1993-10-13
Onset:1993-11-29
Submitted:0000-00-00
Entered:1993-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3J41148 / - - / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3J41148 / - - / IM

Administered by: Military      Purchased by: Military
Symptoms: Endocarditis, Haematemesis, Infection, Leukopenia, Lymphadenopathy, Necrosis, Pneumonia, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-11-29
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: ~ ()~ ~~In patient
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: waiting on drug screen
CDC 'Split Type': CO5196

Write-up: found dead in apartment, no suspicious circumstances. Autopsy results: lymphoma; no known cause of death.


Changed on 6/14/2014

VAERS ID: 58384 Before After
VAERS Form:
Age:25.0
Sex:Female
Location:North Dakota
Vaccinated:1993-10-13
Onset:1993-11-29
Submitted:0000-00-00
Entered:1993-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3J41148 / - - / IM

Administered by: Military      Purchased by: Military
Symptoms: Endocarditis, Haematemesis, Infection, Leukopenia, Lymphadenopathy, Necrosis, Pneumonia, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-11-29
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: ~ ()~ ~~In patient
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: waiting on drug screen
CDC 'Split Type': CO5196

Write-up: found dead in apartment, no suspicious circumstances. Autopsy results: lymphoma; no known cause of death.


Changed on 2/14/2017

VAERS ID: 58384 Before After
VAERS Form:
Age:25.0
Sex:Female
Location:North Dakota
Vaccinated:1993-10-13
Onset:1993-11-29
Submitted:0000-00-00
Entered:1993-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3J41148 / - - / IM

Administered by: Military      Purchased by: Military
Symptoms: Endocarditis, Haematemesis, Infection, Leukopenia, Lymphadenopathy, Necrosis, Pneumonia, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-11-29
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: ~ ()~ ~~In patient
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: waiting on drug screen
CDC 'Split Type': CO5196

Write-up: found dead in apartment, no suspicious circumstances. Autopsy results: lymphoma; no known cause of death.


Changed on 5/14/2017

VAERS ID: 58384 Before After
VAERS Form:
Age:25.0
Sex:Female
Location:North Dakota
Vaccinated:1993-10-13
Onset:1993-11-29
Submitted:0000-00-00
Entered:1993-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3J41148 / - - / IM

Administered by: Military      Purchased by: Military
Symptoms: Endocarditis, Haematemesis, Infection, Leukopenia, Lymphadenopathy, Necrosis, Pneumonia, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-11-29
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: ~ ()~ ~~In ()~~~In patient
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: waiting on drug screen
CDC 'Split Type': CO5196

Write-up: found dead in apartment, no suspicious circumstances. Autopsy results: lymphoma; no known cause of death.


Changed on 9/14/2017

VAERS ID: 58384 Before After
VAERS Form:(blank) 1
Age:25.0
Sex:Female
Location:North Dakota
Vaccinated:1993-10-13
Onset:1993-11-29
Submitted:0000-00-00
Entered:1993-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3J41148 / - UNK - / IM

Administered by: Military      Purchased by: Military
Symptoms: Endocarditis, Haematemesis, Infection, Leukopenia, Lymphadenopathy, Necrosis, Pneumonia, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-11-29
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: ~ ()~~~In patient
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: waiting on drug screen
CDC 'Split Type': CO5196

Write-up: found dead in apartment, no suspicious circumstances. Autopsy results: lymphoma; no known cause of death.


Changed on 2/14/2018

VAERS ID: 58384 Before After
VAERS Form:1
Age:25.0
Sex:Female
Location:North Dakota
Vaccinated:1993-10-13
Onset:1993-11-29
Submitted:0000-00-00
Entered:1993-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3J41148 / UNK - / IM

Administered by: Military      Purchased by: Military
Symptoms: Endocarditis, Haematemesis, Infection, Leukopenia, Lymphadenopathy, Necrosis, Pneumonia, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-11-29
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: ~ ()~~~In patient
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: waiting on drug screen
CDC 'Split Type': CO5196

Write-up: found dead in apartment, no suspicious circumstances. Autopsy results: lymphoma; no known cause of death.


Changed on 6/14/2018

VAERS ID: 58384 Before After
VAERS Form:1
Age:25.0
Sex:Female
Location:North Dakota
Vaccinated:1993-10-13
Onset:1993-11-29
Submitted:0000-00-00
Entered:1993-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3J41148 / UNK - / IM

Administered by: Military      Purchased by: Military
Symptoms: Endocarditis, Haematemesis, Infection, Leukopenia, Lymphadenopathy, Necrosis, Pneumonia, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-11-29
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: ~ ()~~~In patient
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: waiting on drug screen
CDC 'Split Type': CO5196

Write-up: found dead in apartment, no suspicious circumstances. Autopsy results: lymphoma; no known cause of death.


Changed on 8/14/2018

VAERS ID: 58384 Before After
VAERS Form:1
Age:25.0
Sex:Female
Location:North Dakota
Vaccinated:1993-10-13
Onset:1993-11-29
Submitted:0000-00-00
Entered:1993-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3J41148 / UNK - / IM

Administered by: Military      Purchased by: Military
Symptoms: Endocarditis, Haematemesis, Infection, Leukopenia, Lymphadenopathy, Necrosis, Pneumonia, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-11-29
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: ~ ()~~~In patient
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: waiting on drug screen
CDC 'Split Type': CO5196

Write-up: found dead in apartment, no suspicious circumstances. Autopsy results: lymphoma; no known cause of death.


Changed on 9/14/2018

VAERS ID: 58384 Before After
VAERS Form:1
Age:25.0
Sex:Female
Location:North Dakota
Vaccinated:1993-10-13
Onset:1993-11-29
Submitted:0000-00-00
Entered:1993-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3J41148 / UNK - / IM

Administered by: Military      Purchased by: Military
Symptoms: Endocarditis, Haematemesis, Infection, Leukopenia, Lymphadenopathy, Necrosis, Pneumonia, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-11-29
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: ~ ()~~~In patient
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: waiting on drug screen
CDC 'Split Type': CO5196

Write-up: found dead in apartment, no suspicious circumstances. Autopsy results: lymphoma; no known cause of death.


Changed on 10/14/2018

VAERS ID: 58384 Before After
VAERS Form:1
Age:25.0
Sex:Female
Location:North Dakota
Vaccinated:1993-10-13
Onset:1993-11-29
Submitted:0000-00-00
Entered:1993-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / CONNAUGHT LABORATORIES 3J41148 / UNK - / IM

Administered by: Military      Purchased by: Military
Symptoms: Endocarditis, Haematemesis, Infection, Leukopenia, Lymphadenopathy, Necrosis, Pneumonia, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-11-29
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: ~ ()~~~In patient
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: waiting on drug screen
CDC 'Split Type': CO5196

Write-up: found dead in apartment, no suspicious circumstances. Autopsy results: lymphoma; no known cause of death.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=58384&WAYBACKHISTORY=ON


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