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This is VAERS ID 26236

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26236
VAERS Form:
Age:52.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-03
Onset:1990-01-01
Submitted:0000-00-00
Entered:1990-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB / MSD CP284 / 3 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: EDEMA LUNG, SEPSIS, LIVER FAIL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-29
Permanent Disability? Yes
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: CVA; Seizure disorder; Diabetes mellitus; End stage renal disease; Hypertension; Ischemic heart disease
Allergies:
Diagnostic Lab Data: No relevant data.
CDC 'Split Type':

Write-up: Pt w/diabetes mellitus vaccinated w/Recombivax HB entered a study comparing safey & efficacy of hepatitis B (Pre S2+S) vaccine Reocmb & Hepatitis B Vac Recomb in dialysis pt. Was hospitalized because pulmonary edema then sepsis & liver fail


Changed on 12/8/2009

VAERS ID: 26236 Before After
VAERS Form:
Age:52.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-03
Onset:1990-01-01
Submitted:0000-00-00
Entered:1990-10-17 1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB HEP B (RECOMBIVAX HB) / MSD MERCK & CO. INC. CP284 / 3 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hepatic failure, Pulmonary oedema, Sepsis, EDEMA LUNG, SEPSIS, LIVER FAIL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-29
Permanent Disability? Yes
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: CVA; Seizure disorder; Diabetes mellitus; End stage renal disease; Hypertension; Ischemic heart disease
Allergies:
Diagnostic Lab Data: No relevant data.
CDC 'Split Type': (blank) WAES90011108

Write-up: Pt w/diabetes mellitus vaccinated w/Recombivax HB entered a study comparing safey & efficacy of hepatitis B (Pre S2+S) vaccine Reocmb & Hepatitis B Vac Recomb in dialysis pt. Was hospitalized because pulmonary edema then sepsis & liver fail


Changed on 5/14/2017

VAERS ID: 26236 Before After
VAERS Form:
Age:52.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-03
Onset:1990-01-01
Submitted:0000-00-00
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. CP284 / 3 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hepatic failure, Pulmonary oedema, Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-29
Permanent Disability? Yes
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:
Current Illness:
Preexisting Conditions: CVA; Seizure disorder; Diabetes mellitus; End stage renal disease; Hypertension; Ischemic heart disease
Allergies:
Diagnostic Lab Data: No relevant data.
CDC 'Split Type': WAES90011108

Write-up: Pt w/diabetes mellitus vaccinated w/Recombivax HB entered a study comparing safey & efficacy of hepatitis B (Pre S2+S) vaccine Reocmb & Hepatitis B Vac Recomb in dialysis pt. Was hospitalized because pulmonary edema then sepsis & liver fail


Changed on 9/14/2017

VAERS ID: 26236 Before After
VAERS Form:(blank) 1
Age:52.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-03
Onset:1990-01-01
Submitted:0000-00-00
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. CP284 / 3 4 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hepatic failure, Pulmonary oedema, Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-29
Permanent Disability? Yes
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:
Current Illness:
Preexisting Conditions: CVA; Seizure disorder; Diabetes mellitus; End stage renal disease; Hypertension; Ischemic heart disease
Allergies:
Diagnostic Lab Data: No relevant data.
CDC 'Split Type': WAES90011108

Write-up: Pt w/diabetes mellitus vaccinated w/Recombivax HB entered a study comparing safey & efficacy of hepatitis B (Pre S2+S) vaccine Reocmb & Hepatitis B Vac Recomb in dialysis pt. Was hospitalized because pulmonary edema then sepsis & liver fail


Changed on 2/14/2018

VAERS ID: 26236 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-03
Onset:1990-01-01
Submitted:0000-00-00
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. CP284 / 4 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hepatic failure, Pulmonary oedema, Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-29
Permanent Disability? Yes
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:
Current Illness:
Preexisting Conditions: CVA; Seizure disorder; Diabetes mellitus; End stage renal disease; Hypertension; Ischemic heart disease
Allergies:
Diagnostic Lab Data: No relevant data.
CDC 'Split Type': WAES90011108

Write-up: Pt w/diabetes mellitus vaccinated w/Recombivax HB entered a study comparing safey & efficacy of hepatitis B (Pre S2+S) vaccine Reocmb & Hepatitis B Vac Recomb in dialysis pt. Was hospitalized because pulmonary edema then sepsis & liver fail


Changed on 6/14/2018

VAERS ID: 26236 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-03
Onset:1990-01-01
Submitted:0000-00-00
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. CP284 / 4 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hepatic failure, Pulmonary oedema, Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-29
Permanent Disability? Yes
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:
Current Illness:
Preexisting Conditions: CVA; Seizure disorder; Diabetes mellitus; End stage renal disease; Hypertension; Ischemic heart disease
Allergies:
Diagnostic Lab Data: No relevant data.
CDC 'Split Type': WAES90011108

Write-up: Pt w/diabetes mellitus vaccinated w/Recombivax HB entered a study comparing safey & efficacy of hepatitis B (Pre S2+S) vaccine Reocmb & Hepatitis B Vac Recomb in dialysis pt. Was hospitalized because pulmonary edema then sepsis & liver fail


Changed on 8/14/2018

VAERS ID: 26236 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-03
Onset:1990-01-01
Submitted:0000-00-00
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. CP284 / 4 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hepatic failure, Pulmonary oedema, Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-29
Permanent Disability? Yes
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:
Current Illness:
Preexisting Conditions: CVA; Seizure disorder; Diabetes mellitus; End stage renal disease; Hypertension; Ischemic heart disease
Allergies:
Diagnostic Lab Data: No relevant data.
CDC 'Split Type': WAES90011108

Write-up: Pt w/diabetes mellitus vaccinated w/Recombivax HB entered a study comparing safey & efficacy of hepatitis B (Pre S2+S) vaccine Reocmb & Hepatitis B Vac Recomb in dialysis pt. Was hospitalized because pulmonary edema then sepsis & liver fail


Changed on 9/14/2018

VAERS ID: 26236 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-03
Onset:1990-01-01
Submitted:0000-00-00
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. CP284 / 4 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hepatic failure, Pulmonary oedema, Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-29
Permanent Disability? Yes
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:
Current Illness:
Preexisting Conditions: CVA; Seizure disorder; Diabetes mellitus; End stage renal disease; Hypertension; Ischemic heart disease
Allergies:
Diagnostic Lab Data: No relevant data.
CDC 'Split Type': WAES90011108

Write-up: Pt w/diabetes mellitus vaccinated w/Recombivax HB entered a study comparing safey & efficacy of hepatitis B (Pre S2+S) vaccine Reocmb & Hepatitis B Vac Recomb in dialysis pt. Was hospitalized because pulmonary edema then sepsis & liver fail


Changed on 10/14/2018

VAERS ID: 26236 Before After
VAERS Form:1
Age:52.0
Sex:Female
Location:Missouri
Vaccinated:1989-10-03
Onset:1990-01-01
Submitted:0000-00-00
Entered:1990-10-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. CP284 / 4 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Hepatic failure, Pulmonary oedema, Sepsis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1990-01-29
Permanent Disability? Yes
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:
Current Illness:
Preexisting Conditions: CVA; Seizure disorder; Diabetes mellitus; End stage renal disease; Hypertension; Ischemic heart disease
Allergies:
Diagnostic Lab Data: No relevant data.
CDC 'Split Type': WAES90011108

Write-up: Pt w/diabetes mellitus vaccinated w/Recombivax HB entered a study comparing safey & efficacy of hepatitis B (Pre S2+S) vaccine Reocmb & Hepatitis B Vac Recomb in dialysis pt. Was hospitalized because pulmonary edema then sepsis & liver fail

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=26236&WAYBACKHISTORY=ON


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