National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 4/8/2021 release of VAERS data:

This is VAERS ID 61772



Case Details

VAERS ID: 61772 (history)  
Form: Version 1.0  
Age: 68.0  
Sex: Male  
Location: Florida  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 1994-01-03
Entered: 1994-04-12
   Days after submission:98
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4938088 / UNK - / -
PPV: PNEUMO (PNU-IMUNE) / PFIZER/WYETH 324906 / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Pneumonia
SMQs:, Acute central respiratory depression (narrow), Eosinophilic pneumonia (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-12-18
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lasix, Coumaden, Potassium, Lanoxin;
Current Illness:
Preexisting Conditions: hx heart disease-MI 1SEP93; OCT93 congestive heart failure; SEP93 bypass surgery;
Allergies:
Diagnostic Lab Data: Chest XR; lung biopsy;
CDC Split Type:

Write-up: following flu vax & pneumonia devel resp failure; lung biopsy-usual interstital pneumonitis; died 18DEC93;


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=61772


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166