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This is VAERS ID 848765

History of Changes from the VAERS Wayback Machine

First Appeared on 12/14/2019

VAERS ID: 848765
VAERS Form:2
Age:73.0
Sex:Female
Location:New York
Vaccinated:2019-11-07
Onset:2019-11-08
Submitted:0000-00-00
Entered:2019-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS 2LL97 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2019-11-08
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: metformin, enalapril, amlodipine, lipitor, vitamin d, hydroxyzine, januvia
Current Illness: DM, HTN, obesity, chronic urticaria, urinary frequency
Preexisting Conditions: as above
Allergies: mold, pollen,
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Pt was reported to be found dead the morning after vaccination. There is no clear association between vaccination and death, considering patient age and comorbidities. Medical examiner office informed clinic the next day


Changed on 12/24/2020

VAERS ID: 848765 Before After
VAERS Form:2
Age:73.0
Sex:Female
Location:New York
Vaccinated:2019-11-07
Onset:2019-11-08
Submitted:0000-00-00
Entered:2019-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS 2LL97 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2019-11-08
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: metformin, enalapril, amlodipine, lipitor, vitamin d, hydroxyzine, januvia
Current Illness: DM, HTN, obesity, chronic urticaria, urinary frequency
Preexisting Conditions: as above
Allergies: mold, pollen, pollen,
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Pt was reported to be found dead the morning after vaccination. There is no clear association between vaccination and death, considering patient age and comorbidities. Medical examiner office informed clinic the next day


Changed on 12/30/2020

VAERS ID: 848765 Before After
VAERS Form:2
Age:73.0
Sex:Female
Location:New York
Vaccinated:2019-11-07
Onset:2019-11-08
Submitted:0000-00-00
Entered:2019-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS 2LL97 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2019-11-08
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: metformin, enalapril, amlodipine, lipitor, vitamin d, hydroxyzine, januvia
Current Illness: DM, HTN, obesity, chronic urticaria, urinary frequency
Preexisting Conditions: as above
Allergies: mold, pollen, pollen,
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Pt was reported to be found dead the morning after vaccination. There is no clear association between vaccination and death, considering patient age and comorbidities. Medical examiner office informed clinic the next day


Changed on 5/7/2021

VAERS ID: 848765 Before After
VAERS Form:2
Age:73.0
Sex:Female
Location:New York
Vaccinated:2019-11-07
Onset:2019-11-08
Submitted:0000-00-00
Entered:2019-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS 2LL97 / 1 LA / IM

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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2019-11-08
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: metformin, enalapril, amlodipine, lipitor, vitamin d, hydroxyzine, januvia
Current Illness: DM, HTN, obesity, chronic urticaria, urinary frequency
Preexisting Conditions: as above
Allergies: mold, pollen, pollen,
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Pt was reported to be found dead the morning after vaccination. There is no clear association between vaccination and death, considering patient age and comorbidities. Medical examiner office informed clinic the next day

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