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This is VAERS ID 25377

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25377
VAERS Form:
Age:42.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-04-17
Onset:1990-05-02
Submitted:0000-00-00
Entered:1990-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B / SMITHKLINE 586A4 / - NA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, HEADACHE, HEPATITIS, LIVER FUNC ABNORM, JAUNDICE

Life Threatening? No
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: N/A
Other Medications: HYDROCHLOROTHIAZIDE
Current Illness: NONE
Preexisting Conditions: HISTORY OF VIRAL HEPATITIS
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': HISTORY OF VIRAL HEPATITIS

Write-up: AFTER VAX, EXP INCREASED LIVER ENZYMES, JAUNDICE, AND MALAISE. TX & OUTCOME UNKNOWN. 3 wks p/ receiving vax, pt dev hepatitis (bili = 4.9). Testing for Hep A,B,C was neg. Sx resolved w/o tmt.


Changed on 12/8/2009

VAERS ID: 25377 Before After
VAERS Form:
Age:42.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-04-17
Onset:1990-05-02
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 586A4 / - NA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Headache, Hepatic function abnormal, Hepatitis, Jaundice, Malaise, Nausea, Pyrexia, Vomiting, Urine analysis abnormal, FEVER, HEADACHE, HEPATITIS, LIVER FUNC ABNORM, JAUNDICE

Life Threatening? No
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: N/A
Other Medications: HYDROCHLOROTHIAZIDE
Current Illness: NONE
Preexisting Conditions: HISTORY OF VIRAL HEPATITIS
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': HISTORY OF VIRAL HEPATITIS EBU900189

Write-up: AFTER VAX, EXP INCREASED LIVER ENZYMES, JAUNDICE, AND MALAISE. TX & OUTCOME UNKNOWN. 3 wks p/ receiving vax, pt dev hepatitis (bili = 4.9). Testing for Hep A,B,C was neg. Sx resolved w/o tmt.


Changed on 5/14/2017

VAERS ID: 25377 Before After
VAERS Form:
Age:42.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-04-17
Onset:1990-05-02
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / - NA / IM

Administered by: Private      Purchased by: Private
Symptoms: Headache, Hepatic function abnormal, Hepatitis, Jaundice, Malaise, Nausea, Pyrexia, Vomiting, Urine analysis abnormal

Life Threatening? No
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: N/A N/A~ ()~~~In patient
Other Medications: HYDROCHLOROTHIAZIDE
Current Illness: NONE
Preexisting Conditions: HISTORY OF VIRAL HEPATITIS
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900189

Write-up: AFTER VAX, EXP INCREASED LIVER ENZYMES, JAUNDICE, AND MALAISE. TX & OUTCOME UNKNOWN. 3 wks p/ receiving vax, pt dev hepatitis (bili = 4.9). Testing for Hep A,B,C was neg. Sx resolved w/o tmt.


Changed on 9/14/2017

VAERS ID: 25377 Before After
VAERS Form:(blank) 1
Age:42.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-04-17
Onset:1990-05-02
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / - UNK NA / IM

Administered by: Private      Purchased by: Private
Symptoms: Headache, Hepatic function abnormal, Hepatitis, Jaundice, Malaise, Nausea, Pyrexia, Vomiting, Urine analysis abnormal

Life Threatening? No
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: N/A~ ()~~~In patient
Other Medications: HYDROCHLOROTHIAZIDE
Current Illness: NONE
Preexisting Conditions: HISTORY OF VIRAL HEPATITIS
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900189

Write-up: AFTER VAX, EXP INCREASED LIVER ENZYMES, JAUNDICE, AND MALAISE. TX & OUTCOME UNKNOWN. 3 wks p/ receiving vax, pt dev hepatitis (bili = 4.9). Testing for Hep A,B,C was neg. Sx resolved w/o tmt.


Changed on 2/14/2018

VAERS ID: 25377 Before After
VAERS Form:1
Age:42.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-04-17
Onset:1990-05-02
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK NA / IM

Administered by: Private      Purchased by: Private
Symptoms: Headache, Hepatic function abnormal, Hepatitis, Jaundice, Malaise, Nausea, Pyrexia, Vomiting, Urine analysis abnormal

Life Threatening? No
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: N/A~ ()~~~In patient
Other Medications: HYDROCHLOROTHIAZIDE
Current Illness: NONE
Preexisting Conditions: HISTORY OF VIRAL HEPATITIS
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900189

Write-up: AFTER VAX, EXP INCREASED LIVER ENZYMES, JAUNDICE, AND MALAISE. TX & OUTCOME UNKNOWN. 3 wks p/ receiving vax, pt dev hepatitis (bili = 4.9). Testing for Hep A,B,C was neg. Sx resolved w/o tmt.


Changed on 6/14/2018

VAERS ID: 25377 Before After
VAERS Form:1
Age:42.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-04-17
Onset:1990-05-02
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK NA / IM

Administered by: Private      Purchased by: Private
Symptoms: Headache, Hepatic function abnormal, Hepatitis, Jaundice, Malaise, Nausea, Pyrexia, Vomiting, Urine analysis abnormal

Life Threatening? No
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: N/A~ ()~~~In patient
Other Medications: HYDROCHLOROTHIAZIDE
Current Illness: NONE
Preexisting Conditions: HISTORY OF VIRAL HEPATITIS
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900189

Write-up: AFTER VAX, EXP INCREASED LIVER ENZYMES, JAUNDICE, AND MALAISE. TX & OUTCOME UNKNOWN. 3 wks p/ receiving vax, pt dev hepatitis (bili = 4.9). Testing for Hep A,B,C was neg. Sx resolved w/o tmt.


Changed on 8/14/2018

VAERS ID: 25377 Before After
VAERS Form:1
Age:42.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-04-17
Onset:1990-05-02
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK NA / IM

Administered by: Private      Purchased by: Private
Symptoms: Headache, Hepatic function abnormal, Hepatitis, Jaundice, Malaise, Nausea, Pyrexia, Vomiting, Urine analysis abnormal

Life Threatening? No
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: N/A~ ()~~~In patient
Other Medications: HYDROCHLOROTHIAZIDE
Current Illness: NONE
Preexisting Conditions: HISTORY OF VIRAL HEPATITIS
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900189

Write-up: AFTER VAX, EXP INCREASED LIVER ENZYMES, JAUNDICE, AND MALAISE. TX & OUTCOME UNKNOWN. 3 wks p/ receiving vax, pt dev hepatitis (bili = 4.9). Testing for Hep A,B,C was neg. Sx resolved w/o tmt.


Changed on 9/14/2018

VAERS ID: 25377 Before After
VAERS Form:1
Age:42.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-04-17
Onset:1990-05-02
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK NA / IM

Administered by: Private      Purchased by: Private
Symptoms: Headache, Hepatic function abnormal, Hepatitis, Jaundice, Malaise, Nausea, Pyrexia, Vomiting, Urine analysis abnormal

Life Threatening? No
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: N/A~ ()~~~In patient
Other Medications: HYDROCHLOROTHIAZIDE
Current Illness: NONE
Preexisting Conditions: HISTORY OF VIRAL HEPATITIS
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900189

Write-up: AFTER VAX, EXP INCREASED LIVER ENZYMES, JAUNDICE, AND MALAISE. TX & OUTCOME UNKNOWN. 3 wks p/ receiving vax, pt dev hepatitis (bili = 4.9). Testing for Hep A,B,C was neg. Sx resolved w/o tmt.


Changed on 10/14/2018

VAERS ID: 25377 Before After
VAERS Form:1
Age:42.0
Sex:Female
Location:Massachusetts
Vaccinated:1990-04-17
Onset:1990-05-02
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK NA / IM

Administered by: Private      Purchased by: Private
Symptoms: Headache, Hepatic function abnormal, Hepatitis, Jaundice, Malaise, Nausea, Pyrexia, Vomiting, Urine analysis abnormal

Life Threatening? No
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: N/A~ ()~~~In patient
Other Medications: HYDROCHLOROTHIAZIDE
Current Illness: NONE
Preexisting Conditions: HISTORY OF VIRAL HEPATITIS
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900189

Write-up: AFTER VAX, EXP INCREASED LIVER ENZYMES, JAUNDICE, AND MALAISE. TX & OUTCOME UNKNOWN. 3 wks p/ receiving vax, pt dev hepatitis (bili = 4.9). Testing for Hep A,B,C was neg. Sx resolved w/o tmt.

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