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This is VAERS ID 25235

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25235
VAERS Form:
Age:44.0
Sex:Female
Location:Florida
Vaccinated:1990-04-10
Onset:1990-04-10
Submitted:0000-00-00
Entered:1990-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B / SMITHKLINE - / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: SOMNOLENCE, MUCOUS MEM DIS, RASH VESIC BULL

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: DAY OF VAX., PT BECAME LETHARGIC, DEVELOPED BLISTERS AND REDNESS(INFLAMMATION) OF MUCOUS MEMBRANE OF MOUTH. TREATED WITH BENADRYL. OUTCOME: NO INJURY.


Changed on 12/8/2009

VAERS ID: 25235 Before After
VAERS Form:
Age:44.0
Sex:Female
Location:Florida
Vaccinated:1990-04-10
Onset:1990-04-10
Submitted:0000-00-00
Entered:1990-07-24 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B HEP B (ENGERIX-B) / SMITHKLINE SMITHKLINE BEECHAM - / - - / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Dermatitis bullous, Mucous membrane disorder, Somnolence, SOMNOLENCE, MUCOUS MEM DIS, RASH VESIC BULL

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': (blank) EBU900161

Write-up: DAY OF VAX., PT BECAME LETHARGIC, DEVELOPED BLISTERS AND REDNESS(INFLAMMATION) OF MUCOUS MEMBRANE OF MOUTH. TREATED WITH BENADRYL. OUTCOME: NO INJURY.


Changed on 5/14/2017

VAERS ID: 25235 Before After
VAERS Form:
Age:44.0
Sex:Female
Location:Florida
Vaccinated:1990-04-10
Onset:1990-04-10
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / - - / IM

Administered by: Private      Purchased by: Private
Symptoms: Dermatitis bullous, Mucous membrane disorder, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900161

Write-up: DAY OF VAX., PT BECAME LETHARGIC, DEVELOPED BLISTERS AND REDNESS(INFLAMMATION) OF MUCOUS MEMBRANE OF MOUTH. TREATED WITH BENADRYL. OUTCOME: NO INJURY.


Changed on 9/14/2017

VAERS ID: 25235 Before After
VAERS Form:(blank) 1
Age:44.0
Sex:Female
Location:Florida
Vaccinated:1990-04-10
Onset:1990-04-10
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / - UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Dermatitis bullous, Mucous membrane disorder, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900161

Write-up: DAY OF VAX., PT BECAME LETHARGIC, DEVELOPED BLISTERS AND REDNESS(INFLAMMATION) OF MUCOUS MEMBRANE OF MOUTH. TREATED WITH BENADRYL. OUTCOME: NO INJURY.


Changed on 2/14/2018

VAERS ID: 25235 Before After
VAERS Form:1
Age:44.0
Sex:Female
Location:Florida
Vaccinated:1990-04-10
Onset:1990-04-10
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Dermatitis bullous, Mucous membrane disorder, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900161

Write-up: DAY OF VAX., PT BECAME LETHARGIC, DEVELOPED BLISTERS AND REDNESS(INFLAMMATION) OF MUCOUS MEMBRANE OF MOUTH. TREATED WITH BENADRYL. OUTCOME: NO INJURY.


Changed on 6/14/2018

VAERS ID: 25235 Before After
VAERS Form:1
Age:44.0
Sex:Female
Location:Florida
Vaccinated:1990-04-10
Onset:1990-04-10
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Dermatitis bullous, Mucous membrane disorder, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900161

Write-up: DAY OF VAX., PT BECAME LETHARGIC, DEVELOPED BLISTERS AND REDNESS(INFLAMMATION) OF MUCOUS MEMBRANE OF MOUTH. TREATED WITH BENADRYL. OUTCOME: NO INJURY.


Changed on 8/14/2018

VAERS ID: 25235 Before After
VAERS Form:1
Age:44.0
Sex:Female
Location:Florida
Vaccinated:1990-04-10
Onset:1990-04-10
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Dermatitis bullous, Mucous membrane disorder, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900161

Write-up: DAY OF VAX., PT BECAME LETHARGIC, DEVELOPED BLISTERS AND REDNESS(INFLAMMATION) OF MUCOUS MEMBRANE OF MOUTH. TREATED WITH BENADRYL. OUTCOME: NO INJURY.


Changed on 9/14/2018

VAERS ID: 25235 Before After
VAERS Form:1
Age:44.0
Sex:Female
Location:Florida
Vaccinated:1990-04-10
Onset:1990-04-10
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Dermatitis bullous, Mucous membrane disorder, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900161

Write-up: DAY OF VAX., PT BECAME LETHARGIC, DEVELOPED BLISTERS AND REDNESS(INFLAMMATION) OF MUCOUS MEMBRANE OF MOUTH. TREATED WITH BENADRYL. OUTCOME: NO INJURY.


Changed on 10/14/2018

VAERS ID: 25235 Before After
VAERS Form:1
Age:44.0
Sex:Female
Location:Florida
Vaccinated:1990-04-10
Onset:1990-04-10
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Dermatitis bullous, Mucous membrane disorder, Somnolence

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900161

Write-up: DAY OF VAX., PT BECAME LETHARGIC, DEVELOPED BLISTERS AND REDNESS(INFLAMMATION) OF MUCOUS MEMBRANE OF MOUTH. TREATED WITH BENADRYL. OUTCOME: NO INJURY.

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