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This is VAERS ID 25384

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25384
VAERS Form:
Age:42.0
Sex:Female
Location:North Carolina
Vaccinated:1990-04-17
Onset:1990-04-18
Submitted:0000-00-00
Entered:1990-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B / SMITHKLINE 591A4 / - LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: AGITATION, RHINITIS, LACRIMATION DIS

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: N/A
Other Medications: NONE
Current Illness: N/A
Preexisting Conditions: MANY ALLERGIES, HYPOGLYCEMIA
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': MANY ALLERGIES, HYPOGLYCEMIA

Write-up: VAX RECVD 1ST AND 2ND DOSE ON 4-17-90 AND ON 5-17-90 RESPECTIVELY. ON EACH OCCASION THE DAY AFTER INJECT PT EXP WATERY EYES, IRRATABILITY, RUNNY NOSE, SNEEZING, CONGESTION. CLEARED AFTER BENADRYL TAKEN.


Changed on 12/8/2009

VAERS ID: 25384 Before After
VAERS Form:
Age:42.0
Sex:Female
Location:North Carolina
Vaccinated:1990-04-17
Onset:1990-04-18
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 591A4 / - LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Agitation, Rhinitis, Lacrimal disorder, AGITATION, RHINITIS, LACRIMATION DIS

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: N/A
Other Medications: NONE
Current Illness: N/A
Preexisting Conditions: MANY ALLERGIES, HYPOGLYCEMIA
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': MANY ALLERGIES, HYPOGLYCEMIA EBU900197

Write-up: VAX RECVD 1ST AND 2ND DOSE ON 4-17-90 AND ON 5-17-90 RESPECTIVELY. ON EACH OCCASION THE DAY AFTER INJECT PT EXP WATERY EYES, IRRATABILITY, RUNNY NOSE, SNEEZING, CONGESTION. CLEARED AFTER BENADRYL TAKEN.


Changed on 5/14/2017

VAERS ID: 25384 Before After
VAERS Form:
Age:42.0
Sex:Female
Location:North Carolina
Vaccinated:1990-04-17
Onset:1990-04-18
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / - LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Rhinitis, Lacrimal disorder

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: N/A N/A~ ()~~~In patient
Other Medications: NONE
Current Illness: N/A
Preexisting Conditions: MANY ALLERGIES, HYPOGLYCEMIA
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900197

Write-up: VAX RECVD 1ST AND 2ND DOSE ON 4-17-90 AND ON 5-17-90 RESPECTIVELY. ON EACH OCCASION THE DAY AFTER INJECT PT EXP WATERY EYES, IRRATABILITY, RUNNY NOSE, SNEEZING, CONGESTION. CLEARED AFTER BENADRYL TAKEN.


Changed on 9/14/2017

VAERS ID: 25384 Before After
VAERS Form:(blank) 1
Age:42.0
Sex:Female
Location:North Carolina
Vaccinated:1990-04-17
Onset:1990-04-18
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / - UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Rhinitis, Lacrimal disorder

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: N/A~ ()~~~In patient
Other Medications: NONE
Current Illness: N/A
Preexisting Conditions: MANY ALLERGIES, HYPOGLYCEMIA
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900197

Write-up: VAX RECVD 1ST AND 2ND DOSE ON 4-17-90 AND ON 5-17-90 RESPECTIVELY. ON EACH OCCASION THE DAY AFTER INJECT PT EXP WATERY EYES, IRRATABILITY, RUNNY NOSE, SNEEZING, CONGESTION. CLEARED AFTER BENADRYL TAKEN.


Changed on 2/14/2018

VAERS ID: 25384 Before After
VAERS Form:1
Age:42.0
Sex:Female
Location:North Carolina
Vaccinated:1990-04-17
Onset:1990-04-18
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Rhinitis, Lacrimal disorder

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: N/A~ ()~~~In patient
Other Medications: NONE
Current Illness: N/A
Preexisting Conditions: MANY ALLERGIES, HYPOGLYCEMIA
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900197

Write-up: VAX RECVD 1ST AND 2ND DOSE ON 4-17-90 AND ON 5-17-90 RESPECTIVELY. ON EACH OCCASION THE DAY AFTER INJECT PT EXP WATERY EYES, IRRATABILITY, RUNNY NOSE, SNEEZING, CONGESTION. CLEARED AFTER BENADRYL TAKEN.


Changed on 6/14/2018

VAERS ID: 25384 Before After
VAERS Form:1
Age:42.0
Sex:Female
Location:North Carolina
Vaccinated:1990-04-17
Onset:1990-04-18
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Rhinitis, Lacrimal disorder

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: N/A~ ()~~~In patient
Other Medications: NONE
Current Illness: N/A
Preexisting Conditions: MANY ALLERGIES, HYPOGLYCEMIA
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900197

Write-up: VAX RECVD 1ST AND 2ND DOSE ON 4-17-90 AND ON 5-17-90 RESPECTIVELY. ON EACH OCCASION THE DAY AFTER INJECT PT EXP WATERY EYES, IRRATABILITY, RUNNY NOSE, SNEEZING, CONGESTION. CLEARED AFTER BENADRYL TAKEN.


Changed on 8/14/2018

VAERS ID: 25384 Before After
VAERS Form:1
Age:42.0
Sex:Female
Location:North Carolina
Vaccinated:1990-04-17
Onset:1990-04-18
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Rhinitis, Lacrimal disorder

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: N/A~ ()~~~In patient
Other Medications: NONE
Current Illness: N/A
Preexisting Conditions: MANY ALLERGIES, HYPOGLYCEMIA
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900197

Write-up: VAX RECVD 1ST AND 2ND DOSE ON 4-17-90 AND ON 5-17-90 RESPECTIVELY. ON EACH OCCASION THE DAY AFTER INJECT PT EXP WATERY EYES, IRRATABILITY, RUNNY NOSE, SNEEZING, CONGESTION. CLEARED AFTER BENADRYL TAKEN.


Changed on 9/14/2018

VAERS ID: 25384 Before After
VAERS Form:1
Age:42.0
Sex:Female
Location:North Carolina
Vaccinated:1990-04-17
Onset:1990-04-18
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Rhinitis, Lacrimal disorder

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: N/A~ ()~~~In patient
Other Medications: NONE
Current Illness: N/A
Preexisting Conditions: MANY ALLERGIES, HYPOGLYCEMIA
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900197

Write-up: VAX RECVD 1ST AND 2ND DOSE ON 4-17-90 AND ON 5-17-90 RESPECTIVELY. ON EACH OCCASION THE DAY AFTER INJECT PT EXP WATERY EYES, IRRATABILITY, RUNNY NOSE, SNEEZING, CONGESTION. CLEARED AFTER BENADRYL TAKEN.


Changed on 10/14/2018

VAERS ID: 25384 Before After
VAERS Form:1
Age:42.0
Sex:Female
Location:North Carolina
Vaccinated:1990-04-17
Onset:1990-04-18
Submitted:0000-00-00
Entered:1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Agitation, Rhinitis, Lacrimal disorder

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: N/A~ ()~~~In patient
Other Medications: NONE
Current Illness: N/A
Preexisting Conditions: MANY ALLERGIES, HYPOGLYCEMIA
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type': EBU900197

Write-up: VAX RECVD 1ST AND 2ND DOSE ON 4-17-90 AND ON 5-17-90 RESPECTIVELY. ON EACH OCCASION THE DAY AFTER INJECT PT EXP WATERY EYES, IRRATABILITY, RUNNY NOSE, SNEEZING, CONGESTION. CLEARED AFTER BENADRYL TAKEN.

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