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This is VAERS ID 25293

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25293
VAERS Form:
Age:31.0
Sex:Female
Location:North Carolina
Vaccinated:1990-02-28
Onset:1990-02-28
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B / SMITHKLINE ENG 587A4 / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: EDEMA INJECT SITE, INJECT SITE REACT, PAIN INJECT SITE

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: N/A
Current Illness:
Preexisting Conditions: ALLERG TO PENICILLIN AND CODEINE. 2-9-90 UNDERWENT BILATERAL TUBAL LIGATION.
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: PT ONSET OF EVENTS SAME DAY SHE RECVD ENGERIX-B:REDNESS, WARMTH AT SOI, WITH VERY SLIGHT SWELLING. TREATMENT OF ICE-PACK AND 2 TABLETS OF ADVIL.


Changed on 12/8/2009

VAERS ID: 25293 Before After
VAERS Form:
Age:31.0
Sex:Female
Location:North Carolina
Vaccinated:1990-02-28
Onset:1990-02-28
Submitted:0000-00-00
Entered:1990-07-23 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B HEP B (ENGERIX-B) / SMITHKLINE SMITHKLINE BEECHAM ENG 587A4 587A4 / - - / IM

Administered by: Private Unknown      Purchased by: Unknown
Symptoms: Injection site oedema, Injection site pain, Injection site reaction, EDEMA INJECT SITE, INJECT SITE REACT, PAIN INJECT SITE

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: N/A
Current Illness:
Preexisting Conditions: ALLERG TO PENICILLIN AND CODEINE. 2-9-90 UNDERWENT BILATERAL TUBAL LIGATION.
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': (blank) EBU900092

Write-up: PT ONSET OF EVENTS SAME DAY SHE RECVD ENGERIX-B:REDNESS, WARMTH AT SOI, WITH VERY SLIGHT SWELLING. TREATMENT OF ICE-PACK AND 2 TABLETS OF ADVIL.


Changed on 5/14/2017

VAERS ID: 25293 Before After
VAERS Form:
Age:31.0
Sex:Female
Location:North Carolina
Vaccinated:1990-02-28
Onset:1990-02-28
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 587A4 / - - / IM

Administered by: Unknown Private      Purchased by: Unknown Private
Symptoms: Injection site oedema, Injection site pain, Injection site reaction

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: N/A
Current Illness:
Preexisting Conditions: ALLERG TO PENICILLIN AND CODEINE. 2-9-90 UNDERWENT BILATERAL TUBAL LIGATION.
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900092

Write-up: PT ONSET OF EVENTS SAME DAY SHE RECVD ENGERIX-B:REDNESS, WARMTH AT SOI, WITH VERY SLIGHT SWELLING. TREATMENT OF ICE-PACK AND 2 TABLETS OF ADVIL.


Changed on 9/14/2017

VAERS ID: 25293 Before After
VAERS Form:(blank) 1
Age:31.0
Sex:Female
Location:North Carolina
Vaccinated:1990-02-28
Onset:1990-02-28
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 587A4 / - UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site pain, Injection site reaction

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: N/A
Current Illness:
Preexisting Conditions: ALLERG TO PENICILLIN AND CODEINE. 2-9-90 UNDERWENT BILATERAL TUBAL LIGATION.
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900092

Write-up: PT ONSET OF EVENTS SAME DAY SHE RECVD ENGERIX-B:REDNESS, WARMTH AT SOI, WITH VERY SLIGHT SWELLING. TREATMENT OF ICE-PACK AND 2 TABLETS OF ADVIL.


Changed on 2/14/2018

VAERS ID: 25293 Before After
VAERS Form:1
Age:31.0
Sex:Female
Location:North Carolina
Vaccinated:1990-02-28
Onset:1990-02-28
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 587A4 / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site pain, Injection site reaction

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: N/A
Current Illness:
Preexisting Conditions: ALLERG TO PENICILLIN AND CODEINE. 2-9-90 UNDERWENT BILATERAL TUBAL LIGATION.
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900092

Write-up: PT ONSET OF EVENTS SAME DAY SHE RECVD ENGERIX-B:REDNESS, WARMTH AT SOI, WITH VERY SLIGHT SWELLING. TREATMENT OF ICE-PACK AND 2 TABLETS OF ADVIL.


Changed on 6/14/2018

VAERS ID: 25293 Before After
VAERS Form:1
Age:31.0
Sex:Female
Location:North Carolina
Vaccinated:1990-02-28
Onset:1990-02-28
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 587A4 / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site pain, Injection site reaction

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: N/A
Current Illness:
Preexisting Conditions: ALLERG TO PENICILLIN AND CODEINE. 2-9-90 UNDERWENT BILATERAL TUBAL LIGATION.
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900092

Write-up: PT ONSET OF EVENTS SAME DAY SHE RECVD ENGERIX-B:REDNESS, WARMTH AT SOI, WITH VERY SLIGHT SWELLING. TREATMENT OF ICE-PACK AND 2 TABLETS OF ADVIL.


Changed on 8/14/2018

VAERS ID: 25293 Before After
VAERS Form:1
Age:31.0
Sex:Female
Location:North Carolina
Vaccinated:1990-02-28
Onset:1990-02-28
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 587A4 / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site pain, Injection site reaction

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: N/A
Current Illness:
Preexisting Conditions: ALLERG TO PENICILLIN AND CODEINE. 2-9-90 UNDERWENT BILATERAL TUBAL LIGATION.
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900092

Write-up: PT ONSET OF EVENTS SAME DAY SHE RECVD ENGERIX-B:REDNESS, WARMTH AT SOI, WITH VERY SLIGHT SWELLING. TREATMENT OF ICE-PACK AND 2 TABLETS OF ADVIL.


Changed on 9/14/2018

VAERS ID: 25293 Before After
VAERS Form:1
Age:31.0
Sex:Female
Location:North Carolina
Vaccinated:1990-02-28
Onset:1990-02-28
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 587A4 / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site pain, Injection site reaction

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: N/A
Current Illness:
Preexisting Conditions: ALLERG TO PENICILLIN AND CODEINE. 2-9-90 UNDERWENT BILATERAL TUBAL LIGATION.
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900092

Write-up: PT ONSET OF EVENTS SAME DAY SHE RECVD ENGERIX-B:REDNESS, WARMTH AT SOI, WITH VERY SLIGHT SWELLING. TREATMENT OF ICE-PACK AND 2 TABLETS OF ADVIL.


Changed on 10/14/2018

VAERS ID: 25293 Before After
VAERS Form:1
Age:31.0
Sex:Female
Location:North Carolina
Vaccinated:1990-02-28
Onset:1990-02-28
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 587A4 / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site oedema, Injection site pain, Injection site reaction

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: N/A
Current Illness:
Preexisting Conditions: ALLERG TO PENICILLIN AND CODEINE. 2-9-90 UNDERWENT BILATERAL TUBAL LIGATION.
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900092

Write-up: PT ONSET OF EVENTS SAME DAY SHE RECVD ENGERIX-B:REDNESS, WARMTH AT SOI, WITH VERY SLIGHT SWELLING. TREATMENT OF ICE-PACK AND 2 TABLETS OF ADVIL.

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