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This is VAERS ID 860822

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2020

VAERS ID: 860822
VAERS Form:2
Age:44.0
Sex:Female
Location:Unknown
Vaccinated:2019-11-08
Onset:2020-02-06
Submitted:0000-00-00
Entered:2020-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS 2LL97 / N/A RA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Influenza, Respiratory distress, Influenza A virus test positive, Lung assist device therapy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-02-09
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Influenza A positive
CDC 'Split Type':

Write-up: Patient was diagnosed with Influenza A and had severe respiratory distress. Was placed on ECMO


Changed on 12/24/2020

VAERS ID: 860822 Before After
VAERS Form:2
Age:44.0
Sex:Female
Location:Unknown
Vaccinated:2019-11-08
Onset:2020-02-06
Submitted:0000-00-00
Entered:2020-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS 2LL97 / N/A RA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Influenza, Respiratory distress, Influenza A virus test positive, Lung assist device therapy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-02-09
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Influenza A positive
CDC 'Split Type':

Write-up: Patient was diagnosed with Influenza A and had severe respiratory distress. Was placed on ECMO


Changed on 12/30/2020

VAERS ID: 860822 Before After
VAERS Form:2
Age:44.0
Sex:Female
Location:Unknown
Vaccinated:2019-11-08
Onset:2020-02-06
Submitted:0000-00-00
Entered:2020-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS 2LL97 / N/A RA / IM

Administered by: Unknown      Purchased by: ??
Symptoms: Influenza, Respiratory distress, Influenza A virus test positive, Lung assist device therapy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2020-02-09
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Influenza A positive
CDC 'Split Type':

Write-up: Patient was diagnosed with Influenza A and had severe respiratory distress. Was placed on ECMO

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=860822&WAYBACKHISTORY=ON


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