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This is VAERS ID 25291

Case Details

VAERS ID: 25291 (history)  
Form: Version 1.0  
Age: 25.0  
Sex: Female  
Location: Indiana  
Vaccinated:1990-01-15
Onset:1990-01-19
   Days after vaccination:4
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: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: FIRST VAX~ ()~~~In patient
Other Medications: N/A
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type: EBU900088

Write-up: PT BROKE OUT WITH HIVES 4 DAYS AFTER RECVD FIRST ENGERIX B INOCULATION. HIVES HAVE CONTINUED FOUR WEEKS. ANTIHISTAMINE THERAPY.


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