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This is VAERS ID 237316

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 237316
VAERS Form:
Age:14.0
Sex:Male
Location:Nevada
Vaccinated:2004-06-02
Onset:2004-06-16
Submitted:2005-05-12
Entered:2005-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (UNKNOWN MFR) / UNKNOWN MFR UNKNOWN / 2 RA / IM
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE UNKNOWN / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: GI DIS, ILEITIS

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline for Acne.
Current Illness: None
Preexisting Conditions: Acne.
Allergies:
Diagnostic Lab Data: Endoscopy. Upper and lower GI. Cat scan with IV. Blood work. X-rays, swallowing barium solution. Ultra-sound.
CDC 'Split Type':

Write-up: Was diagnosed with Crohns disease by October 2004, after suffering with stomach problems since mid-June.


Changed on 12/8/2009

VAERS ID: 237316 Before After
VAERS Form:
Age:14.0
Sex:Male
Location:Nevada
Vaccinated:2004-06-02
Onset:2004-06-16
Submitted:2005-05-12
Entered:2005-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (UNKNOWN MFR) HEP B (NO BRAND NAME) / UNKNOWN MFR UNKNOWN MANUFACTURER UNKNOWN / 2 RA / IM
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE GLAXOSMITHKLINE BIOLOGICALS UNKNOWN / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Asthenia, Colitis, Crohn's disease, Diarrhoea, Gastrointestinal disorder, Headache, Laboratory test abnormal, Nausea, Weight decreased, GI DIS, ILEITIS

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline for Acne.
Current Illness: None
Preexisting Conditions: Acne. Information received from medical records states previous GI disease, dyspepsia. msv
Allergies:
Diagnostic Lab Data: Endoscopy. Upper and lower GI. Cat scan with IV. Blood work. X-rays, swallowing barium solution. Ultra-sound. Information from medical records states abnormal lab results. msv
CDC 'Split Type':

Write-up: Was diagnosed with Crohns disease by October 2004, after suffering with stomach problems since mid-June. Follow up on 7/12/05: Same as stated on initial report - Crohn''s Disease. Information from medical records state headache, asthenia, weight loss, nausea, diarrhea, colitis, abdominal pain. msv


Changed on 9/14/2017

VAERS ID: 237316 Before After
VAERS Form:(blank) 1
Age:14.0
Sex:Male
Location:Nevada
Vaccinated:2004-06-02
Onset:2004-06-16
Submitted:2005-05-12
Entered:2005-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 2 3 RA / IM
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS UNKNOWN / 0 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Asthenia, Colitis, Crohn's disease, Diarrhoea, Gastrointestinal disorder, Headache, Laboratory test abnormal, Nausea, Weight decreased

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline for Acne.
Current Illness: None
Preexisting Conditions: Acne. Information received from medical records states previous GI disease, dyspepsia. msv
Allergies:
Diagnostic Lab Data: Endoscopy. Upper and lower GI. Cat scan with IV. Blood work. X-rays, swallowing barium solution. Ultra-sound. Information from medical records states abnormal lab results. msv
CDC 'Split Type':

Write-up: Was diagnosed with Crohns disease by October 2004, after suffering with stomach problems since mid-June. Follow up on 7/12/05: Same as stated on initial report - Crohn''s Disease. Information from medical records state headache, asthenia, weight loss, nausea, diarrhea, colitis, abdominal pain. msv


Changed on 2/14/2018

VAERS ID: 237316 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Nevada
Vaccinated:2004-06-02
Onset:2004-06-16
Submitted:2005-05-12
Entered:2005-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 3 RA / IM
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS UNKNOWN / 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Asthenia, Colitis, Crohn's disease, Diarrhoea, Gastrointestinal disorder, Headache, Laboratory test abnormal, Nausea, Weight decreased

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline for Acne.
Current Illness: None
Preexisting Conditions: Acne. Information received from medical records states previous GI disease, dyspepsia. msv
Allergies:
Diagnostic Lab Data: Endoscopy. Upper and lower GI. Cat scan with IV. Blood work. X-rays, swallowing barium solution. Ultra-sound. Information from medical records states abnormal lab results. msv
CDC 'Split Type':

Write-up: Was diagnosed with Crohns disease by October 2004, after suffering with stomach problems since mid-June. Follow up on 7/12/05: Same as stated on initial report - Crohn''s Disease. Information from medical records state headache, asthenia, weight loss, nausea, diarrhea, colitis, abdominal pain. msv


Changed on 6/14/2018

VAERS ID: 237316 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Nevada
Vaccinated:2004-06-02
Onset:2004-06-16
Submitted:2005-05-12
Entered:2005-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 3 RA / IM
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS UNKNOWN / 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Asthenia, Colitis, Crohn's disease, Diarrhoea, Gastrointestinal disorder, Headache, Laboratory test abnormal, Nausea, Weight decreased

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline for Acne.
Current Illness: None
Preexisting Conditions: Acne. Information received from medical records states previous GI disease, dyspepsia. msv
Allergies:
Diagnostic Lab Data: Endoscopy. Upper and lower GI. Cat scan with IV. Blood work. X-rays, swallowing barium solution. Ultra-sound. Information from medical records states abnormal lab results. msv
CDC 'Split Type':

Write-up: Was diagnosed with Crohns disease by October 2004, after suffering with stomach problems since mid-June. Follow up on 7/12/05: Same as stated on initial report - Crohn''s Disease. Information from medical records state headache, asthenia, weight loss, nausea, diarrhea, colitis, abdominal pain. msv


Changed on 8/14/2018

VAERS ID: 237316 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Nevada
Vaccinated:2004-06-02
Onset:2004-06-16
Submitted:2005-05-12
Entered:2005-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 3 RA / IM
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS UNKNOWN / 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Asthenia, Colitis, Crohn's disease, Diarrhoea, Gastrointestinal disorder, Headache, Laboratory test abnormal, Nausea, Weight decreased

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline for Acne.
Current Illness: None
Preexisting Conditions: Acne. Information received from medical records states previous GI disease, dyspepsia. msv
Allergies:
Diagnostic Lab Data: Endoscopy. Upper and lower GI. Cat scan with IV. Blood work. X-rays, swallowing barium solution. Ultra-sound. Information from medical records states abnormal lab results. msv
CDC 'Split Type':

Write-up: Was diagnosed with Crohns disease by October 2004, after suffering with stomach problems since mid-June. Follow up on 7/12/05: Same as stated on initial report - Crohn''s Disease. Information from medical records state headache, asthenia, weight loss, nausea, diarrhea, colitis, abdominal pain. msv


Changed on 9/14/2018

VAERS ID: 237316 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Nevada
Vaccinated:2004-06-02
Onset:2004-06-16
Submitted:2005-05-12
Entered:2005-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 3 RA / IM
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS UNKNOWN / 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Asthenia, Colitis, Crohn's disease, Diarrhoea, Gastrointestinal disorder, Headache, Laboratory test abnormal, Nausea, Weight decreased

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline for Acne.
Current Illness: None
Preexisting Conditions: Acne. Information received from medical records states previous GI disease, dyspepsia. msv
Allergies:
Diagnostic Lab Data: Endoscopy. Upper and lower GI. Cat scan with IV. Blood work. X-rays, swallowing barium solution. Ultra-sound. Information from medical records states abnormal lab results. msv
CDC 'Split Type':

Write-up: Was diagnosed with Crohns disease by October 2004, after suffering with stomach problems since mid-June. Follow up on 7/12/05: Same as stated on initial report - Crohn''s Disease. Information from medical records state headache, asthenia, weight loss, nausea, diarrhea, colitis, abdominal pain. msv


Changed on 10/14/2018

VAERS ID: 237316 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Nevada
Vaccinated:2004-06-02
Onset:2004-06-16
Submitted:2005-05-12
Entered:2005-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 3 RA / IM
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS UNKNOWN / 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Asthenia, Colitis, Crohn's disease, Diarrhoea, Gastrointestinal disorder, Headache, Laboratory test abnormal, Nausea, Weight decreased

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline for Acne.
Current Illness: None
Preexisting Conditions: Acne. Information received from medical records states previous GI disease, dyspepsia. msv
Allergies:
Diagnostic Lab Data: Endoscopy. Upper and lower GI. Cat scan with IV. Blood work. X-rays, swallowing barium solution. Ultra-sound. Information from medical records states abnormal lab results. msv
CDC 'Split Type':

Write-up: Was diagnosed with Crohns disease by October 2004, after suffering with stomach problems since mid-June. Follow up on 7/12/05: Same as stated on initial report - Crohn''s Disease. Information from medical records state headache, asthenia, weight loss, nausea, diarrhea, colitis, abdominal pain. msv


Changed on 12/24/2020

VAERS ID: 237316 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Nevada
Vaccinated:2004-06-02
Onset:2004-06-16
Submitted:2005-05-12
Entered:2005-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 3 RA / IM
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS UNKNOWN / 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Asthenia, Colitis, Crohn's disease, Diarrhoea, Gastrointestinal disorder, Headache, Laboratory test abnormal, Nausea, Weight decreased

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline for Acne.
Current Illness: None
Preexisting Conditions: Acne. Information received from medical records states previous GI disease, dyspepsia. msv
Allergies:
Diagnostic Lab Data: Endoscopy. Upper and lower GI. Cat scan with IV. Blood work. X-rays, swallowing barium solution. Ultra-sound. Information from medical records states abnormal lab results. msv
CDC 'Split Type':

Write-up: Was diagnosed with Crohns disease by October 2004, after suffering with stomach problems since mid-June. Follow up on 7/12/05: Same as stated on initial report - Crohn''s Disease. Information from medical records state headache, asthenia, weight loss, nausea, diarrhea, colitis, abdominal pain. msv


Changed on 12/30/2020

VAERS ID: 237316 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Nevada
Vaccinated:2004-06-02
Onset:2004-06-16
Submitted:2005-05-12
Entered:2005-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 3 RA / IM
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS UNKNOWN / 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Asthenia, Colitis, Crohn's disease, Diarrhoea, Gastrointestinal disorder, Headache, Laboratory test abnormal, Nausea, Weight decreased

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline for Acne.
Current Illness: None
Preexisting Conditions: Acne. Information received from medical records states previous GI disease, dyspepsia. msv
Allergies:
Diagnostic Lab Data: Endoscopy. Upper and lower GI. Cat scan with IV. Blood work. X-rays, swallowing barium solution. Ultra-sound. Information from medical records states abnormal lab results. msv
CDC 'Split Type':

Write-up: Was diagnosed with Crohns disease by October 2004, after suffering with stomach problems since mid-June. Follow up on 7/12/05: Same as stated on initial report - Crohn''s Disease. Information from medical records state headache, asthenia, weight loss, nausea, diarrhea, colitis, abdominal pain. msv


Changed on 5/7/2021

VAERS ID: 237316 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Nevada
Vaccinated:2004-06-02
Onset:2004-06-16
Submitted:2005-05-12
Entered:2005-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 3 RA / IM
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS UNKNOWN / 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Asthenia, Colitis, Crohn's disease, Diarrhoea, Gastrointestinal disorder, Headache, Laboratory test abnormal, Nausea, Weight decreased

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline for Acne.
Current Illness: None
Preexisting Conditions: Acne. Information received from medical records states previous GI disease, dyspepsia. msv
Allergies:
Diagnostic Lab Data: Endoscopy. Upper and lower GI. Cat scan with IV. Blood work. X-rays, swallowing barium solution. Ultra-sound. Information from medical records states abnormal lab results. msv
CDC 'Split Type':

Write-up: Was diagnosed with Crohns disease by October 2004, after suffering with stomach problems since mid-June. Follow up on 7/12/05: Same as stated on initial report - Crohn''s Disease. Information from medical records state headache, asthenia, weight loss, nausea, diarrhea, colitis, abdominal pain. msv


Changed on 5/14/2021

VAERS ID: 237316 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Nevada
Vaccinated:2004-06-02
Onset:2004-06-16
Submitted:2005-05-12
Entered:2005-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 3 RA / IM
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS UNKNOWN / 1 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Asthenia, Colitis, Crohn's disease, Diarrhoea, Gastrointestinal disorder, Headache, Laboratory test abnormal, Nausea, Weight decreased

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline for Acne.
Current Illness: None
Preexisting Conditions: Acne. Information received from medical records states previous GI disease, dyspepsia. msv
Allergies:
Diagnostic Lab Data: Endoscopy. Upper and lower GI. Cat scan with IV. Blood work. X-rays, swallowing barium solution. Ultra-sound. Information from medical records states abnormal lab results. msv
CDC 'Split Type':

Write-up: Was diagnosed with Crohns disease by October 2004, after suffering with stomach problems since mid-June. Follow up on 7/12/05: Same as stated on initial report - Crohn''s Disease. Information from medical records state headache, asthenia, weight loss, nausea, diarrhea, colitis, abdominal pain. msv

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