National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 119781

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 119781
VAERS Form:
Age:22.1
Gender:Male
Location:Georgia
Vaccinated:1998-09-22
Onset:1998-09-22
Submitted:1999-03-01
Entered:1999-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX ADSORBED / MICHIGAN DPH FAV020 / 3 - / -

Administered by: Military      Purchased by: Unknown
Symptoms: CHILLS, ARTHRALGIA, ASTHENIA, AMNESIA, ALOPECIA

Life Threatening? Yes
Birth Defect? No
Died? No
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: pt recv anthrax lot# FAV020 given 17MAR98, 31MAR98 & 14APR98 (cont. in comments)
Other Medications: pt recv anthrax lot# FAV020 given 17MAR98, 31MAR98 & 14APR98;
Current Illness:
Preexisting Conditions: pt had heat injury prior to vax before leaving for Middle East
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': pt had heat injury prior to vax before leaving for Middle East

Write-up: black outs/cold sweats/heart racing w/o any activity;severe h/a, worse than ever in the past;dizzy & clumsy @ times & loose balance, mood swings;exp joint & muscle pains; weakness;memory problems;fatigue;weight loss, rash;swollen glands


Changed on 12/8/2009

VAERS ID: 119781 Before After
VAERS Form:
Age:22.1
Gender:Male
Location:Georgia
Vaccinated:1998-09-22
Onset:1998-09-22
Submitted:1999-03-01
Entered:1999-03-09 1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX ADSORBED ANTHRAX (NO BRAND NAME) / MICHIGAN DPH MICHIGAN DEPT PUB HLTH FAV020 / 3 - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Alopecia, Amnesia, Arthralgia, Asthenia, Chest pain, Chills, Convulsion, Diarrhoea, Dizziness, Gastrointestinal disorder, Headache, Hyperhidrosis, Influenza, Insomnia, Lymphadenopathy, Myalgia, Rash, Syncope, Tachycardia, Weight decreased, Weight increased, Affect lability, Similar reaction on previous exposure to drug, CHILLS, ARTHRALGIA, ASTHENIA, AMNESIA, ALOPECIA

Life Threatening? Yes
Birth Defect? No
Died? No
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: pt recv anthrax lot# FAV020 given 17MAR98, 31MAR98 & 14APR98 (cont. in comments)
Other Medications: pt recv anthrax lot# FAV020 given 17MAR98, 31MAR98 & 14APR98;
Current Illness:
Preexisting Conditions: pt had heat injury prior to vax before leaving for Middle East
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': pt had heat injury prior to vax before leaving for Middle East

Write-up: black outs/cold sweats/heart racing w/o any activity;severe h/a, worse than ever in the past;dizzy & clumsy @ times & loose balance, mood swings;exp joint & muscle pains; weakness;memory problems;fatigue;weight loss, rash;swollen glands


Changed on 1/5/2010

VAERS ID: 119781 Before After
VAERS Form:
Age:22.1 22.0
Gender:Male
Location:Georgia
Vaccinated:1998-09-22
Onset:1998-09-22
Submitted:1999-03-01
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV020 / 3 - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Alopecia, Amnesia, Arthralgia, Asthenia, Chest pain, Chills, Convulsion, Diarrhoea, Dizziness, Gastrointestinal disorder, Headache, Hyperhidrosis, Influenza, Insomnia, Lymphadenopathy, Myalgia, Rash, Syncope, Tachycardia, Weight decreased, Weight increased, Affect lability, Similar reaction on previous exposure to drug

Life Threatening? Yes
Birth Defect? No
Died? No
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: pt recv anthrax lot# FAV020 given 17MAR98, 31MAR98 & 14APR98 (cont. in comments)
Other Medications: pt recv anthrax lot# FAV020 given 17MAR98, 31MAR98 & 14APR98;
Current Illness:
Preexisting Conditions: pt had heat injury prior to vax before leaving for Middle East
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': pt had heat injury prior to vax before leaving for Middle East (blank)

Write-up: black outs/cold sweats/heart racing w/o any activity;severe h/a, worse than ever in the past;dizzy & clumsy @ times & loose balance, mood swings;exp joint & muscle pains; weakness;memory problems;fatigue;weight loss, rash;swollen glands Per follow-up, pt has not recovered, he is still sick and he is unable to hold a job or support his family on a regular basis.


Changed on 1/7/2013

VAERS ID: 119781 Before After
VAERS Form:
Age:22.0
Gender:Male
Location:Georgia
Vaccinated:1998-09-22
Onset:1998-09-22
Submitted:1999-03-01
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV020 / 3 - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Alopecia, Amnesia, Arthralgia, Asthenia, Chest pain, Chills, Convulsion, Diarrhoea, Dizziness, Gastrointestinal disorder, Headache, Hyperhidrosis, Insomnia, Lymphadenopathy, Myalgia, Rash, Syncope, Weight decreased, Weight increased, Affect lability

Life Threatening? Yes
Birth Defect? No
Died? No
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: pt recv anthrax lot# FAV020 given 17MAR98, 31MAR98 & 14APR98;
Current Illness:
Preexisting Conditions: pt had heat injury prior to vax before leaving for Middle East abroad
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: black outs/cold sweats/heart racing w/o any activity;severe h/a, worse than ever in the past;dizzy & clumsy @ times & loose balance, mood swings;exp joint & muscle pains; weakness;memory problems;fatigue;weight loss, rash;swollen glands Per follow-up, pt has not recovered, he is still sick and he is unable to hold a job or support his family on a regular basis.


Changed on 6/14/2014

VAERS ID: 119781 Before After
VAERS Form:
Age:22.0
Gender:Male
Location:Georgia
Vaccinated:1998-09-22
Onset:1998-09-22
Submitted:1999-03-01
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV020 / 3 - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Alopecia, Amnesia, Arthralgia, Asthenia, Chest pain, Chills, Convulsion, Diarrhoea, Dizziness, Gastrointestinal disorder, Headache, Hyperhidrosis, Insomnia, Lymphadenopathy, Myalgia, Rash, Syncope, Weight decreased, Weight increased, Affect lability

Life Threatening? Yes
Birth Defect? No
Died? No
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: pt recv anthrax lot# FAV020 given 17MAR98, 31MAR98 & 14APR98;
Current Illness:
Preexisting Conditions: pt had heat injury prior to vax before leaving abroad
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: black outs/cold sweats/heart racing w/o any activity;severe h/a, worse than ever in the past;dizzy & clumsy @ times & loose balance, mood swings;exp joint & muscle pains; weakness;memory problems;fatigue;weight loss, rash;swollen glands Per follow-up, pt has not recovered, he is still sick and he is unable to hold a job or support his family on a regular basis.


Changed on 3/14/2015

VAERS ID: 119781 Before After
VAERS Form:
Age:22.0
Gender:Male
Location:Georgia
Vaccinated:1998-09-22
Onset:1998-09-22
Submitted:1999-03-01
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV020 / 3 - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Alopecia, Amnesia, Arthralgia, Asthenia, Chest pain, Chills, Convulsion, Diarrhoea, Dizziness, Gastrointestinal disorder, Headache, Hyperhidrosis, Insomnia, Lymphadenopathy, Myalgia, Rash, Syncope, Weight decreased, Weight increased, Affect lability

Life Threatening? Yes
Birth Defect? No
Died? No
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: pt recv anthrax lot# FAV020 given 17MAR98, 31MAR98 & 14APR98;
Current Illness:
Preexisting Conditions: pt had heat injury prior to vax before leaving abroad
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: black outs/cold sweats/heart racing w/o any activity;severe h/a, worse than ever in the past;dizzy & clumsy @ times & loose balance, mood swings;exp joint & muscle pains; weakness;memory problems;fatigue;weight loss, rash;swollen glands Per follow-up, pt has not recovered, he is still sick and he is unable to hold a job or support his family on a regular basis.


Changed on 9/14/2017

VAERS ID: 119781 Before After
VAERS Form:(blank) 1
Age:22.0
Gender:Male
Location:Georgia
Vaccinated:1998-09-22
Onset:1998-09-22
Submitted:1999-03-01
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV020 / 3 4 - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Alopecia, Amnesia, Arthralgia, Asthenia, Chest pain, Chills, Convulsion, Diarrhoea, Dizziness, Gastrointestinal disorder, Headache, Hyperhidrosis, Insomnia, Lymphadenopathy, Myalgia, Rash, Syncope, Weight decreased, Weight increased, Affect lability

Life Threatening? Yes
Birth Defect? No
Died? No
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: pt recv anthrax lot# FAV020 given 17MAR98, 31MAR98 & 14APR98;
Current Illness:
Preexisting Conditions: pt had heat injury prior to vax before leaving abroad
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: black outs/cold sweats/heart racing w/o any activity;severe h/a, worse than ever in the past;dizzy & clumsy @ times & loose balance, mood swings;exp joint & muscle pains; weakness;memory problems;fatigue;weight loss, rash;swollen glands Per follow-up, pt has not recovered, he is still sick and he is unable to hold a job or support his family on a regular basis.


Changed on 2/14/2018

VAERS ID: 119781 Before After
VAERS Form:1
Age:22.0
Gender:Male
Location:Georgia
Vaccinated:1998-09-22
Onset:1998-09-22
Submitted:1999-03-01
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV020 / 4 - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Alopecia, Amnesia, Arthralgia, Asthenia, Chest pain, Chills, Convulsion, Diarrhoea, Dizziness, Gastrointestinal disorder, Headache, Hyperhidrosis, Insomnia, Lymphadenopathy, Myalgia, Rash, Syncope, Weight decreased, Weight increased, Affect lability

Life Threatening? Yes
Birth Defect? No
Died? No
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: pt recv anthrax lot# FAV020 given 17MAR98, 31MAR98 & 14APR98;
Current Illness:
Preexisting Conditions: pt had heat injury prior to vax before leaving abroad
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: black outs/cold sweats/heart racing w/o any activity;severe h/a, worse than ever in the past;dizzy & clumsy @ times & loose balance, mood swings;exp joint & muscle pains; weakness;memory problems;fatigue;weight loss, rash;swollen glands Per follow-up, pt has not recovered, he is still sick and he is unable to hold a job or support his family on a regular basis.


Changed on 6/14/2018

VAERS ID: 119781 Before After
VAERS Form:1
Age:22.0
Gender:Male
Location:Georgia
Vaccinated:1998-09-22
Onset:1998-09-22
Submitted:1999-03-01
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV020 / 4 - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Alopecia, Amnesia, Arthralgia, Asthenia, Chest pain, Chills, Convulsion, Diarrhoea, Dizziness, Gastrointestinal disorder, Headache, Hyperhidrosis, Insomnia, Lymphadenopathy, Myalgia, Rash, Syncope, Weight decreased, Weight increased, Affect lability

Life Threatening? Yes
Birth Defect? No
Died? No
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: pt recv anthrax lot# FAV020 given 17MAR98, 31MAR98 & 14APR98;
Current Illness:
Preexisting Conditions: pt had heat injury prior to vax before leaving abroad
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: black outs/cold sweats/heart racing w/o any activity;severe h/a, worse than ever in the past;dizzy & clumsy @ times & loose balance, mood swings;exp joint & muscle pains; weakness;memory problems;fatigue;weight loss, rash;swollen glands Per follow-up, pt has not recovered, he is still sick and he is unable to hold a job or support his family on a regular basis.


Changed on 8/14/2018

VAERS ID: 119781 Before After
VAERS Form:1
Age:22.0
Gender:Male
Location:Georgia
Vaccinated:1998-09-22
Onset:1998-09-22
Submitted:1999-03-01
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV020 / 4 - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Alopecia, Amnesia, Arthralgia, Asthenia, Chest pain, Chills, Convulsion, Diarrhoea, Dizziness, Gastrointestinal disorder, Headache, Hyperhidrosis, Insomnia, Lymphadenopathy, Myalgia, Rash, Syncope, Weight decreased, Weight increased, Affect lability

Life Threatening? Yes
Birth Defect? No
Died? No
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: pt recv anthrax lot# FAV020 given 17MAR98, 31MAR98 & 14APR98;
Current Illness:
Preexisting Conditions: pt had heat injury prior to vax before leaving abroad
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: black outs/cold sweats/heart racing w/o any activity;severe h/a, worse than ever in the past;dizzy & clumsy @ times & loose balance, mood swings;exp joint & muscle pains; weakness;memory problems;fatigue;weight loss, rash;swollen glands Per follow-up, pt has not recovered, he is still sick and he is unable to hold a job or support his family on a regular basis.


Changed on 9/14/2018

VAERS ID: 119781 Before After
VAERS Form:1
Age:22.0
Gender:Male
Location:Georgia
Vaccinated:1998-09-22
Onset:1998-09-22
Submitted:1999-03-01
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV020 / 4 - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Alopecia, Amnesia, Arthralgia, Asthenia, Chest pain, Chills, Convulsion, Diarrhoea, Dizziness, Gastrointestinal disorder, Headache, Hyperhidrosis, Insomnia, Lymphadenopathy, Myalgia, Rash, Syncope, Weight decreased, Weight increased, Affect lability

Life Threatening? Yes
Birth Defect? No
Died? No
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: pt recv anthrax lot# FAV020 given 17MAR98, 31MAR98 & 14APR98;
Current Illness:
Preexisting Conditions: pt had heat injury prior to vax before leaving abroad
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: black outs/cold sweats/heart racing w/o any activity;severe h/a, worse than ever in the past;dizzy & clumsy @ times & loose balance, mood swings;exp joint & muscle pains; weakness;memory problems;fatigue;weight loss, rash;swollen glands Per follow-up, pt has not recovered, he is still sick and he is unable to hold a job or support his family on a regular basis.


Changed on 10/14/2018

VAERS ID: 119781 Before After
VAERS Form:1
Age:22.0
Gender:Male
Location:Georgia
Vaccinated:1998-09-22
Onset:1998-09-22
Submitted:1999-03-01
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH FAV020 / 4 - / -

Administered by: Military      Purchased by: Unknown
Symptoms: Alopecia, Amnesia, Arthralgia, Asthenia, Chest pain, Chills, Convulsion, Diarrhoea, Dizziness, Gastrointestinal disorder, Headache, Hyperhidrosis, Insomnia, Lymphadenopathy, Myalgia, Rash, Syncope, Weight decreased, Weight increased, Affect lability

Life Threatening? Yes
Birth Defect? No
Died? No
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: pt recv anthrax lot# FAV020 given 17MAR98, 31MAR98 & 14APR98;
Current Illness:
Preexisting Conditions: pt had heat injury prior to vax before leaving abroad
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: black outs/cold sweats/heart racing w/o any activity;severe h/a, worse than ever in the past;dizzy & clumsy @ times & loose balance, mood swings;exp joint & muscle pains; weakness;memory problems;fatigue;weight loss, rash;swollen glands Per follow-up, pt has not recovered, he is still sick and he is unable to hold a job or support his family on a regular basis.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=119781&WAYBACKHISTORY=ON


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