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This is VAERS ID 844315

Case Details

VAERS ID: 844315 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2019-10-05
Onset:2019-10-09
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2019-10-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUA3: INFLUENZA (SEASONAL) (FLUAD) / NOVARTIS VACCINES AND DIAGNOSTICS NO BATCH NUMBER / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Drooling, Hyperhidrosis, Musculoskeletal pain, Nausea, Pain in extremity, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2019-10-09
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: GBSEQIRUS201905599

Write-up: Shoulder pain; Drooling; Pain in arm; Sweating; Nausea; Patient collapsed on way to taxi and died; This is a spontaneous case reported by pharmacist to Regulatory Authority [regulatory reference number: GB-MHRA-EYC 00209913] and initially retrieved on 25-Oct-2019, concerning a female patient of unreported age. The patient''s medical history and concomitant medications were not provided. On 05-Oct-2019, the patient was administered Fluad TIV [influenza vaccine, inactivated influenza virus surface antigen, egg-derived, MF59; dose: 0.5 ml, route of administration: intramuscular, anatomical location: arm, batch number and expiration date: not reported] for influenza immunisation. On an unspecified date in Oct-2019, unknown amount of time after vaccination, the patient experienced nausea, sweating, drooling, pain in arm and shoulder. On 09-Oct-2019, reported as five days after vaccination, the patient contacted Health Service and was advised by a doctor to came to see them. On the way to taxi, the patient collapsed and died. It was unknown if the autopsy was performed. At the time of death, the events of ''nausea'', ''sweating'', ''drooling'', ''shoulder pain'' and ''pain in arm'' were still ongoing. The case was assessed as serious. The reporter did not provide causality assessment. Company Comment: The events of ''circulatory collapse'', ''nausea'', ''sweating'', ''drooling'', ''shoulder pain'' and ''pain in arm'' are considered related to Fluad TIV.; Sender''s Comments: The events of ''circulatory collapse'', ''nausea'', ''sweating'', ''drooling'', ''shoulder pain'' and ''pain in arm'' are considered related to Fluad TIV.; Reported Cause(s) of Death: Circulatory collapse


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