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This is VAERS ID 25581

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25581
VAERS Form:
Age:70.0
Sex:Male
Location:Oregon
Vaccinated:1990-01-25
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B / SMITHKLINE ENG585A4 / 1 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: INFECT, ENCEPHALITIS, NO DRUG EFFECT

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-05-19
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:
Current Illness:
Preexisting Conditions: no known allergies, non responder to previous 3 dose /w MSD vaccine
Allergies:
Diagnostic Lab Data: 10Jan90 titer test = non responsive, Herpes varicella recovered from brain
CDC 'Split Type':

Write-up: Pt given a series of 3 MSD Hep-B vaccines, & 2 Engerix-B vaccines due to being non responder. Pt developed encephalitis & died. Herpes varicella recovered form brain


Changed on 12/8/2009

VAERS ID: 25581 Before After
VAERS Form:
Age:70.0
Sex:Male
Location:Oregon
Vaccinated:1990-01-25
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-26 1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B HEP B (ENGERIX-B) / SMITHKLINE SMITHKLINE BEECHAM ENG585A4 585A4 / 1 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Drug ineffective, Encephalitis, Infection, INFECT, ENCEPHALITIS, NO DRUG EFFECT

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-05-19
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:
Current Illness:
Preexisting Conditions: no known allergies, non responder to previous 3 dose /w MSD vaccine
Allergies:
Diagnostic Lab Data: 10Jan90 titer test = non responsive, Herpes varicella recovered from brain
CDC 'Split Type': (blank) EBU900170

Write-up: Pt given a series of 3 MSD Hep-B vaccines, & 2 Engerix-B vaccines due to being non responder. Pt developed encephalitis & died. Herpes varicella recovered form brain


Changed on 9/14/2017

VAERS ID: 25581 Before After
VAERS Form:(blank) 1
Age:70.0
Sex:Male
Location:Oregon
Vaccinated:1990-01-25
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 585A4 / 1 2 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Drug ineffective, Encephalitis, Infection

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-05-19
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:
Current Illness:
Preexisting Conditions: no known allergies, non responder to previous 3 dose /w MSD vaccine
Allergies:
Diagnostic Lab Data: 10Jan90 titer test = non responsive, Herpes varicella recovered from brain
CDC 'Split Type': EBU900170

Write-up: Pt given a series of 3 MSD Hep-B vaccines, & 2 Engerix-B vaccines due to being non responder. Pt developed encephalitis & died. Herpes varicella recovered form brain


Changed on 2/14/2018

VAERS ID: 25581 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:Oregon
Vaccinated:1990-01-25
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 585A4 / 2 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Drug ineffective, Encephalitis, Infection

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-05-19
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:
Current Illness:
Preexisting Conditions: no known allergies, non responder to previous 3 dose /w MSD vaccine
Allergies:
Diagnostic Lab Data: 10Jan90 titer test = non responsive, Herpes varicella recovered from brain
CDC 'Split Type': EBU900170

Write-up: Pt given a series of 3 MSD Hep-B vaccines, & 2 Engerix-B vaccines due to being non responder. Pt developed encephalitis & died. Herpes varicella recovered form brain


Changed on 6/14/2018

VAERS ID: 25581 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:Oregon
Vaccinated:1990-01-25
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 585A4 / 2 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Drug ineffective, Encephalitis, Infection

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-05-19
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:
Current Illness:
Preexisting Conditions: no known allergies, non responder to previous 3 dose /w MSD vaccine
Allergies:
Diagnostic Lab Data: 10Jan90 titer test = non responsive, Herpes varicella recovered from brain
CDC 'Split Type': EBU900170

Write-up: Pt given a series of 3 MSD Hep-B vaccines, & 2 Engerix-B vaccines due to being non responder. Pt developed encephalitis & died. Herpes varicella recovered form brain


Changed on 8/14/2018

VAERS ID: 25581 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:Oregon
Vaccinated:1990-01-25
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 585A4 / 2 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Drug ineffective, Encephalitis, Infection

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-05-19
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:
Current Illness:
Preexisting Conditions: no known allergies, non responder to previous 3 dose /w MSD vaccine
Allergies:
Diagnostic Lab Data: 10Jan90 titer test = non responsive, Herpes varicella recovered from brain
CDC 'Split Type': EBU900170

Write-up: Pt given a series of 3 MSD Hep-B vaccines, & 2 Engerix-B vaccines due to being non responder. Pt developed encephalitis & died. Herpes varicella recovered form brain


Changed on 9/14/2018

VAERS ID: 25581 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:Oregon
Vaccinated:1990-01-25
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 585A4 / 2 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Drug ineffective, Encephalitis, Infection

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-05-19
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:
Current Illness:
Preexisting Conditions: no known allergies, non responder to previous 3 dose /w MSD vaccine
Allergies:
Diagnostic Lab Data: 10Jan90 titer test = non responsive, Herpes varicella recovered from brain
CDC 'Split Type': EBU900170

Write-up: Pt given a series of 3 MSD Hep-B vaccines, & 2 Engerix-B vaccines due to being non responder. Pt developed encephalitis & died. Herpes varicella recovered form brain


Changed on 10/14/2018

VAERS ID: 25581 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:Oregon
Vaccinated:1990-01-25
Onset:0000-00-00
Submitted:0000-00-00
Entered:1990-07-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 585A4 / 2 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Drug ineffective, Encephalitis, Infection

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-05-19
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:
Current Illness:
Preexisting Conditions: no known allergies, non responder to previous 3 dose /w MSD vaccine
Allergies:
Diagnostic Lab Data: 10Jan90 titer test = non responsive, Herpes varicella recovered from brain
CDC 'Split Type': EBU900170

Write-up: Pt given a series of 3 MSD Hep-B vaccines, & 2 Engerix-B vaccines due to being non responder. Pt developed encephalitis & died. Herpes varicella recovered form brain

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