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This is VAERS ID 25520

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25520
VAERS Form:
Age:71.0
Sex:Male
Location:Unknown
Vaccinated:1988-02-03
Onset:1990-02-17
Submitted:0000-00-00
Entered:1990-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB / MSD - / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: SEPSIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-17
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:
Other Medications: Tolbutamide, Vitamin B, Vitamin C
Current Illness: Presenile dementia; Diabetes mellitus
Preexisting Conditions: Renal dialysis; Renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 71 yr old male w/presenile dementia, diabetes mellitus, & renal failure received Hepatitis B vaccine, recombinant, 40 mcg, IM. Dialysis shunt became infected Dx w/sepsis therapy initiated w/flucloxacillin, however pt died that day.


Changed on 12/8/2009

VAERS ID: 25520 Before After
VAERS Form:
Age:71.0
Sex:Male
Location:Unknown
Vaccinated:1988-02-03
Onset:1990-02-17
Submitted:0000-00-00
Entered:1990-07-18 1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB HEP B (RECOMBIVAX HB) / MSD MERCK & CO. INC. - / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sepsis, SEPSIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-17
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:
Other Medications: Tolbutamide, Vitamin B, Vitamin C
Current Illness: Presenile dementia; Diabetes mellitus
Preexisting Conditions: Renal dialysis; Renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES90060030

Write-up: 71 yr old male w/presenile dementia, diabetes mellitus, & renal failure received Hepatitis B vaccine, recombinant, 40 mcg, IM. Dialysis shunt became infected Dx w/sepsis therapy initiated w/flucloxacillin, however pt died that day.


Changed on 5/14/2017

VAERS ID: 25520 Before After
VAERS Form:
Age:71.0
Sex:Male
Location:Unknown
Vaccinated:1988-02-03
Onset:1990-02-17
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-17
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: ~ ()~~~In patient
Other Medications: Tolbutamide, Vitamin B, Vitamin C
Current Illness: Presenile dementia; Diabetes mellitus
Preexisting Conditions: Renal dialysis; Renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90060030

Write-up: 71 yr old male w/presenile dementia, diabetes mellitus, & renal failure received Hepatitis B vaccine, recombinant, 40 mcg, IM. Dialysis shunt became infected Dx w/sepsis therapy initiated w/flucloxacillin, however pt died that day.


Changed on 9/14/2017

VAERS ID: 25520 Before After
VAERS Form:(blank) 1
Age:71.0
Sex:Male
Location:Unknown
Vaccinated:1988-02-03
Onset:1990-02-17
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-17
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: ~ ()~~~In patient
Other Medications: Tolbutamide, Vitamin B, Vitamin C
Current Illness: Presenile dementia; Diabetes mellitus
Preexisting Conditions: Renal dialysis; Renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90060030

Write-up: 71 yr old male w/presenile dementia, diabetes mellitus, & renal failure received Hepatitis B vaccine, recombinant, 40 mcg, IM. Dialysis shunt became infected Dx w/sepsis therapy initiated w/flucloxacillin, however pt died that day.


Changed on 2/14/2018

VAERS ID: 25520 Before After
VAERS Form:1
Age:71.0
Sex:Male
Location:Unknown
Vaccinated:1988-02-03
Onset:1990-02-17
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-17
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: ~ ()~~~In patient
Other Medications: Tolbutamide, Vitamin B, Vitamin C
Current Illness: Presenile dementia; Diabetes mellitus
Preexisting Conditions: Renal dialysis; Renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90060030

Write-up: 71 yr old male w/presenile dementia, diabetes mellitus, & renal failure received Hepatitis B vaccine, recombinant, 40 mcg, IM. Dialysis shunt became infected Dx w/sepsis therapy initiated w/flucloxacillin, however pt died that day.


Changed on 6/14/2018

VAERS ID: 25520 Before After
VAERS Form:1
Age:71.0
Sex:Male
Location:Unknown
Vaccinated:1988-02-03
Onset:1990-02-17
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-17
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: ~ ()~~~In patient
Other Medications: Tolbutamide, Vitamin B, Vitamin C
Current Illness: Presenile dementia; Diabetes mellitus
Preexisting Conditions: Renal dialysis; Renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90060030

Write-up: 71 yr old male w/presenile dementia, diabetes mellitus, & renal failure received Hepatitis B vaccine, recombinant, 40 mcg, IM. Dialysis shunt became infected Dx w/sepsis therapy initiated w/flucloxacillin, however pt died that day.


Changed on 8/14/2018

VAERS ID: 25520 Before After
VAERS Form:1
Age:71.0
Sex:Male
Location:Unknown
Vaccinated:1988-02-03
Onset:1990-02-17
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-17
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: ~ ()~~~In patient
Other Medications: Tolbutamide, Vitamin B, Vitamin C
Current Illness: Presenile dementia; Diabetes mellitus
Preexisting Conditions: Renal dialysis; Renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90060030

Write-up: 71 yr old male w/presenile dementia, diabetes mellitus, & renal failure received Hepatitis B vaccine, recombinant, 40 mcg, IM. Dialysis shunt became infected Dx w/sepsis therapy initiated w/flucloxacillin, however pt died that day.


Changed on 9/14/2018

VAERS ID: 25520 Before After
VAERS Form:1
Age:71.0
Sex:Male
Location:Unknown
Vaccinated:1988-02-03
Onset:1990-02-17
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-17
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: ~ ()~~~In patient
Other Medications: Tolbutamide, Vitamin B, Vitamin C
Current Illness: Presenile dementia; Diabetes mellitus
Preexisting Conditions: Renal dialysis; Renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90060030

Write-up: 71 yr old male w/presenile dementia, diabetes mellitus, & renal failure received Hepatitis B vaccine, recombinant, 40 mcg, IM. Dialysis shunt became infected Dx w/sepsis therapy initiated w/flucloxacillin, however pt died that day.


Changed on 10/14/2018

VAERS ID: 25520 Before After
VAERS Form:1
Age:71.0
Sex:Male
Location:Unknown
Vaccinated:1988-02-03
Onset:1990-02-17
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-02-17
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: ~ ()~~~In patient
Other Medications: Tolbutamide, Vitamin B, Vitamin C
Current Illness: Presenile dementia; Diabetes mellitus
Preexisting Conditions: Renal dialysis; Renal failure
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES90060030

Write-up: 71 yr old male w/presenile dementia, diabetes mellitus, & renal failure received Hepatitis B vaccine, recombinant, 40 mcg, IM. Dialysis shunt became infected Dx w/sepsis therapy initiated w/flucloxacillin, however pt died that day.

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