National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 117106

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 117106
VAERS Form:
Age:23.6
Sex:Male
Location:Unknown
Vaccinated:1998-11-19
Onset:1998-11-19
Submitted:1998-11-22
Entered:1998-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX ADSORBED / MICHIGAN DPH FAV030 / 1 A / SC

Administered by: Military      Purchased by: Unknown
Symptoms: EDEMA, ANGIOEDEMA, POS RECHAL, PREV REACT

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: pt exp mild lt jaw swelling w/dose 1 anthrax;
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': NONE

Write-up: devel mild lt jaw swelling p/vax;treated as dental infect;devel marked lt jaw swelling p/#2 vax treated an angioedema;observed overnight in ward & treated w/antihistamines/parenteral;steroids;


Changed on 12/8/2009

VAERS ID: 117106 Before After
VAERS Form:
Age:23.6
Sex:Male
Location:Unknown
Vaccinated:1998-11-19
Onset:1998-11-19
Submitted:1998-11-22
Entered:1998-12-08 1998-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX ADSORBED ANTHRAX (NO BRAND NAME) / MICHIGAN DPH MICHIGAN DEPT PUB HLTH FAV030 / 1 A / SC

Administered by: Military      Purchased by: Unknown Military
Symptoms: Angioneurotic oedema, Oedema, Adverse drug reaction, Similar reaction on previous exposure to drug, EDEMA, ANGIOEDEMA, POS RECHAL, PREV REACT

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: pt exp mild lt jaw swelling w/dose 1 anthrax;
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': NONE (blank)

Write-up: devel mild lt jaw swelling p/vax;treated as dental infect;devel marked lt jaw swelling p/#2 vax treated an angioedema;observed overnight in ward & treated w/antihistamines/parenteral;steroids;


Changed on 11/14/2011

VAERS ID: 117106 Before After
VAERS Form:
Age:23.6 23.0
Sex:Male
Location:Unknown
Vaccinated:1998-11-19
Onset:1998-11-19
Submitted:1998-11-22
Entered:1998-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV030 / 1 A AR / SC

Administered by: Military      Purchased by: Military
Symptoms: Angioneurotic oedema, Oedema, Adverse drug reaction, Similar reaction on previous exposure to drug

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: pt exp mild lt jaw swelling w/dose 1 anthrax; anthrax;~ ()~~0.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: devel mild lt jaw swelling p/vax;treated as dental infect;devel marked lt jaw swelling p/#2 vax treated an angioedema;observed overnight in ward & treated w/antihistamines/parenteral;steroids;


Changed on 3/12/2013

VAERS ID: 117106 Before After
VAERS Form:
Age:23.0
Sex:Male
Location:Unknown
Vaccinated:1998-11-19
Onset:1998-11-19
Submitted:1998-11-22
Entered:1998-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) ANTHRAX (BIOTHRAX) / MICHIGAN DEPT PUB HLTH EMERGENT BIOSOLUTIONS FAV030 / 1 AR / SC

Administered by: Military      Purchased by: Military
Symptoms: Angioneurotic oedema, Condition aggravated, Eyelid oedema, Lip swelling, Oedema, Swelling face, Vaccination complication

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: pt exp mild lt jaw swelling w/dose 1 anthrax;~ ()~~0.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: devel mild lt Developed mild, Lt jaw swelling p/vax;treated after anthrax vacc #1, treated as dental infect;devel infection. Developed marked lt (L) jaw swelling p/#2 vax after anthrax vacc #2, treated an angioedema;observed angioedema - observed overnight in ward & treated w/antihistamines/parenteral;steroids; w/antihistamines/parenteral steroids.


Changed on 6/14/2014

VAERS ID: 117106 Before After
VAERS Form:
Age:23.0
Sex:Male
Location:Unknown
Vaccinated:1998-11-19
Onset:1998-11-19
Submitted:1998-11-22
Entered:1998-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS FAV030 / 1 AR / SC

Administered by: Military      Purchased by: Military
Symptoms: Angioneurotic oedema, Condition aggravated, Eyelid oedema, Lip swelling, Oedema, Swelling face, Vaccination complication

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: pt exp mild lt jaw swelling w/dose 1 anthrax;~ ()~~0.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Developed mild, Lt jaw swelling after anthrax vacc #1, treated as dental infection. Developed marked (L) jaw swelling after anthrax vacc #2, treated an angioedema - observed overnight in ward & treated w/antihistamines/parenteral steroids.


Changed on 3/14/2015

VAERS ID: 117106 Before After
VAERS Form:
Age:23.0
Sex:Male
Location:Unknown
Vaccinated:1998-11-19
Onset:1998-11-19
Submitted:1998-11-22
Entered:1998-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS FAV030 / 1 AR / SC

Administered by: Military      Purchased by: Military
Symptoms: Angioneurotic oedema, Condition aggravated, Eyelid oedema, Lip swelling, Oedema, Swelling face, Vaccination complication

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: pt exp mild lt jaw swelling w/dose 1 anthrax;~ ()~~0.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Developed mild, Lt jaw swelling after anthrax vacc #1, treated as dental infection. Developed marked (L) jaw swelling after anthrax vacc #2, treated an angioedema - observed overnight in ward & treated w/antihistamines/parenteral steroids.


Changed on 5/14/2017

VAERS ID: 117106 Before After
VAERS Form:
Age:23.0
Sex:Male
Location:Unknown
Vaccinated:1998-11-19
Onset:1998-11-19
Submitted:1998-11-22
Entered:1998-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS FAV030 / 1 AR / SC

Administered by: Military      Purchased by: Military
Symptoms: Angioneurotic oedema, Condition aggravated, Eyelid oedema, Lip swelling, Oedema, Swelling face, Vaccination complication

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: pt exp mild lt jaw swelling w/dose 1 anthrax;~ ()~~0.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Developed mild, Lt jaw swelling after anthrax vacc #1, treated as dental infection. Developed marked (L) jaw swelling after anthrax vacc #2, treated an angioedema - observed overnight in ward & treated w/antihistamines/parenteral steroids.


Changed on 9/14/2017

VAERS ID: 117106 Before After
VAERS Form:(blank) 1
Age:23.0
Sex:Male
Location:Unknown
Vaccinated:1998-11-19
Onset:1998-11-19
Submitted:1998-11-22
Entered:1998-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS FAV030 / 1 2 AR / SC

Administered by: Military      Purchased by: Military
Symptoms: Angioneurotic oedema, Oedema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: pt exp mild lt jaw swelling w/dose 1 anthrax;~ ()~~0.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Developed mild, Lt jaw swelling after anthrax vacc #1, treated as dental infection. Developed marked (L) jaw swelling after anthrax vacc #2, treated an angioedema - observed overnight in ward & treated w/antihistamines/parenteral steroids.


Changed on 2/14/2018

VAERS ID: 117106 Before After
VAERS Form:1
Age:23.0
Sex:Male
Location:Unknown
Vaccinated:1998-11-19
Onset:1998-11-19
Submitted:1998-11-22
Entered:1998-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS FAV030 / 2 AR / SC

Administered by: Military      Purchased by: Military
Symptoms: Angioneurotic oedema, Oedema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: pt exp mild lt jaw swelling w/dose 1 anthrax;~ ()~~0.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Developed mild, Lt jaw swelling after anthrax vacc #1, treated as dental infection. Developed marked (L) jaw swelling after anthrax vacc #2, treated an angioedema - observed overnight in ward & treated w/antihistamines/parenteral steroids.


Changed on 6/14/2018

VAERS ID: 117106 Before After
VAERS Form:1
Age:23.0
Sex:Male
Location:Unknown
Vaccinated:1998-11-19
Onset:1998-11-19
Submitted:1998-11-22
Entered:1998-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS FAV030 / 2 AR / SC

Administered by: Military      Purchased by: Military
Symptoms: Angioneurotic oedema, Oedema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: pt exp mild lt jaw swelling w/dose 1 anthrax;~ ()~~0.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Developed mild, Lt jaw swelling after anthrax vacc #1, treated as dental infection. Developed marked (L) jaw swelling after anthrax vacc #2, treated an angioedema - observed overnight in ward & treated w/antihistamines/parenteral steroids.


Changed on 8/14/2018

VAERS ID: 117106 Before After
VAERS Form:1
Age:23.0
Sex:Male
Location:Unknown
Vaccinated:1998-11-19
Onset:1998-11-19
Submitted:1998-11-22
Entered:1998-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS FAV030 / 2 AR / SC

Administered by: Military      Purchased by: Military
Symptoms: Angioneurotic oedema, Oedema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: pt exp mild lt jaw swelling w/dose 1 anthrax;~ ()~~0.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Developed mild, Lt jaw swelling after anthrax vacc #1, treated as dental infection. Developed marked (L) jaw swelling after anthrax vacc #2, treated an angioedema - observed overnight in ward & treated w/antihistamines/parenteral steroids.


Changed on 9/14/2018

VAERS ID: 117106 Before After
VAERS Form:1
Age:23.0
Sex:Male
Location:Unknown
Vaccinated:1998-11-19
Onset:1998-11-19
Submitted:1998-11-22
Entered:1998-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS FAV030 / 2 AR / SC

Administered by: Military      Purchased by: Military
Symptoms: Angioneurotic oedema, Oedema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: pt exp mild lt jaw swelling w/dose 1 anthrax;~ ()~~0.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Developed mild, Lt jaw swelling after anthrax vacc #1, treated as dental infection. Developed marked (L) jaw swelling after anthrax vacc #2, treated an angioedema - observed overnight in ward & treated w/antihistamines/parenteral steroids.


Changed on 10/14/2018

VAERS ID: 117106 Before After
VAERS Form:1
Age:23.0
Sex:Male
Location:Unknown
Vaccinated:1998-11-19
Onset:1998-11-19
Submitted:1998-11-22
Entered:1998-12-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS FAV030 / 2 AR / SC

Administered by: Military      Purchased by: Military
Symptoms: Angioneurotic oedema, Oedema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: pt exp mild lt jaw swelling w/dose 1 anthrax;~ ()~~0.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Developed mild, Lt jaw swelling after anthrax vacc #1, treated as dental infection. Developed marked (L) jaw swelling after anthrax vacc #2, treated an angioedema - observed overnight in ward & treated w/antihistamines/parenteral steroids.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=117106&WAYBACKHISTORY=ON


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166