A report was received from a health care professional on 11/19/03 concerning a male vaccinee more than 65 years old who experienced sniffles, cough, fever, sore throat, and was hospitalized and died 8 days after receiving Fluvirin on 11/9/03. On an unspecified date, 2 to 3 days after vaccination, the vaccinee experienced sniffles, cough, fever, and sore throat. The vaccinee was treated with antibiotics on commencing on 11/13/03. The vaccinee was transferred to hospital on 11/15/03 and subsequently intubated. The vaccinee died on 11/17/03. The cause of death was not reported. There was insufficient information to determine the reporter's causality assessment. Follow up pending.  Follow up on 12/10/2003: "Update 1, 11/26/03: A follow up report was received from a health care professional indicating that an 84 year old male vaccinee experienced respiratory failure 8 days after, with mild cough, vomiting, fever of 100 degrees F, occurring 4 days after receiving Fluvirin, and diarrhea occuring an unspecified length of time after vaccination.  The vaccinee has a history of respiratory distress, Alzheimer's disease, congestive heart failure, hypertension, alcohol abuse and dementia with psychosis since 12/31/1998.  The vaccinee also has a history of MI, arteriosclerotic heart disease, anxiety and insomnia from an unspecified date.  Concomitant medication taken included lorazepam, trazodone, quetiapine, atenolol, furosemide, and ranitidine hydrochloride.  On 11/13/03 the vaccinee experienced a mild cough with congestion, vomiting and a fever of 100 degrees F.  The vaccinee also experienced diarrhea on an unspecified date.  The vaccinee was treated with levofloxacin on 11/31/03.  At this point the vaccinee's respiration was rapid.  The vaccinee was admitted to hospital on 11/15/03 and on an unknown date was placed on a ventilator.  On 11/17/03 the vaccinee died due to respiratory failure.  A post mortem report is not available.  "Update 2, 18February2004": A follow up report was received from a healthcare professional indicating that the vaccinee had received Fluvirin on 10 November 2003 and not on 9 November 2003 as previously reported. The vaccinee received Influenza vaccine (brand unspecified) previously on 25 November 2002. Additional concomitant medication included terazosin hydrochloride and lisinopril. The reporter indicated that the vaccinee had a history of respiratory distress, congestive heart failure, hypertension, myocardial infarction, moderate pulmonary hypertension and bi-ventricular failure prior to 31 December 1998. In addition to the events reported previously the reporter indicated that the vaccinee was also feeling week and lethargic on 13 November 2003. The reporter also indicated that the vaccinee died from respiratory collapse on 18 November 2003 and not on 17 November 2003 as previously reported. "Update 3, 27 April 2004": A follow up report was received from a health care professional indicating that the vaccinee had received Fluvirin on 9 November 2003 as initially reported. The vaccinee had received a prior influenza vaccination on an unspecified date in November 2002. Additional concomitant medications reported included acetylonlicylic acid, valproic acid and levodopa in combination with carbidopa. The vaccinee also has a history of severe tricupsid regurgitation before 31 December 1998, and Parkinson's disease. The reporter indicated that the vaccinee was treated with levofloxacin and quoifenesin after 3 days with no improvement. The vaccinee was also treated with paracetonol for fever. The vaccinee's level of consciousness began to decrease and the vaccinee was experiencing shortness of breath. The vaccinee was treated with oxygen. The vaccinee was admitted to the hospital on 15 November 2003, where he was on a ventilator which was removed 2 days later. The vaccinee died on 18 November 1003. No follow up pending, all information received. Cross reference with: PJP-2003-01118, PJP-2003-01119, PJP-2003-01120, PJP-2003-01121, PJP-2003-01122, PJP-2003-01123, PJP-2003-01124, PJP-2003-01125, PJP-2003-01126, PJP-2003-01127, PJP-2003-01128, PJP-2003-01117."