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This is VAERS ID 846472

History of Changes from the VAERS Wayback Machine

First Appeared on 11/14/2019

VAERS ID: 846472
VAERS Form:2
Age:43.0
Sex:Male
Location:Kansas
Vaccinated:2019-11-04
Onset:2019-11-05
Submitted:0000-00-00
Entered:2019-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUR4: INFLUENZA (SEASONAL) (FLUBLOK QUADRIVALENT) / PROTEIN SCIENCES CORPORATION QFAA1920 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2019-11-05
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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Family reported death from unknown cause. Coroners report did not identify cause of death. Patient died driving on the way to work 8 hours after receiving vaccination.


Changed on 12/24/2020

VAERS ID: 846472 Before After
VAERS Form:2
Age:43.0
Sex:Male
Location:Kansas
Vaccinated:2019-11-04
Onset:2019-11-05
Submitted:0000-00-00
Entered:2019-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUR4: INFLUENZA (SEASONAL) (FLUBLOK QUADRIVALENT) / PROTEIN SCIENCES CORPORATION QFAA1920 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2019-11-05
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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Family reported death from unknown cause. Coroners report did not identify cause of death. Patient died driving on the way to work 8 hours after receiving vaccination.


Changed on 12/30/2020

VAERS ID: 846472 Before After
VAERS Form:2
Age:43.0
Sex:Male
Location:Kansas
Vaccinated:2019-11-04
Onset:2019-11-05
Submitted:0000-00-00
Entered:2019-11-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUR4: INFLUENZA (SEASONAL) (FLUBLOK QUADRIVALENT) / PROTEIN SCIENCES CORPORATION QFAA1920 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Death, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2019-11-05
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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Family reported death from unknown cause. Coroners report did not identify cause of death. Patient died driving on the way to work 8 hours after receiving vaccination.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=846472&WAYBACKHISTORY=ON


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