National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 797713

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2019

VAERS ID: 797713
VAERS Form:2
Age:73.0
Sex:Female
Location:New York
Vaccinated:2018-12-08
Onset:2018-12-08
Submitted:0000-00-00
Entered:2019-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR UJ043AB / N/A RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Dysphagia, Resuscitation, Unresponsive to stimuli, Breath sounds abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2018-12-08
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? No
Previous Vaccinations:
Other Medications: risperidone; omeprazole; DEPAKOTE; calcium +D; ENSURE
Current Illness: Dysphagia; Bronchiectasis; Latent Tuberculosis; Pulmonary nodule; Mild dementia; Breast cancer; Bipolar disorder; Low weight
Preexisting Conditions: As above
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The following is history obtained from family after the event: The patient left the office, went for breakfast, developed difficulty swallowing in the restaurant and was making sounds in her chest when breathing, was driven home by family, was not answering her family verbally, then EMS was called and they could not revive her, she was sent to the ER.


Changed on 12/24/2020

VAERS ID: 797713 Before After
VAERS Form:2
Age:73.0
Sex:Female
Location:New York
Vaccinated:2018-12-08
Onset:2018-12-08
Submitted:0000-00-00
Entered:2019-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR UJ043AB / N/A RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Dysphagia, Resuscitation, Unresponsive to stimuli, Breath sounds abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2018-12-08
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? No
Previous Vaccinations:
Other Medications: risperidone; omeprazole; DEPAKOTE; calcium +D; ENSURE
Current Illness: Dysphagia; Bronchiectasis; Latent Tuberculosis; Pulmonary nodule; Mild dementia; Breast cancer; Bipolar disorder; Low weight
Preexisting Conditions: As above
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The following is history obtained from family after the event: The patient left the office, went for breakfast, developed difficulty swallowing in the restaurant and was making sounds in her chest when breathing, was driven home by family, was not answering her family verbally, then EMS was called and they could not revive her, she was sent to the ER.


Changed on 12/30/2020

VAERS ID: 797713 Before After
VAERS Form:2
Age:73.0
Sex:Female
Location:New York
Vaccinated:2018-12-08
Onset:2018-12-08
Submitted:0000-00-00
Entered:2019-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE) / SANOFI PASTEUR UJ043AB / N/A RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Dysphagia, Resuscitation, Unresponsive to stimuli, Breath sounds abnormal

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2018-12-08
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? No
Previous Vaccinations:
Other Medications: risperidone; omeprazole; DEPAKOTE; calcium +D; ENSURE
Current Illness: Dysphagia; Bronchiectasis; Latent Tuberculosis; Pulmonary nodule; Mild dementia; Breast cancer; Bipolar disorder; Low weight
Preexisting Conditions: As above
Allergies: None None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The following is history obtained from family after the event: The patient left the office, went for breakfast, developed difficulty swallowing in the restaurant and was making sounds in her chest when breathing, was driven home by family, was not answering her family verbally, then EMS was called and they could not revive her, she was sent to the ER.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=797713&WAYBACKHISTORY=ON


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