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This is VAERS ID 25379

Case Details

VAERS ID: 25379 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK - / NA

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: N/A~ ()~~~In patient
Other Medications: NONE
Current Illness: N//A
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type: EBU900192

Write-up: PT EXP HIVES FOLLOWING 1ST DOSE OF ENGERIX-B.


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