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This is VAERS ID 27629

Case Details

VAERS ID: 27629 (history)  
Form: Version 1.0  
Age: 37.0  
Sex: Female  
Location: Colorado  
Vaccinated:1990-12-20
Onset:1991-01-04
   Days after vaccination:15
Submitted: 1991-01-14
   Days after onset:10
Entered: 1991-01-28
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 592A2 / 1 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Face oedema, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Mild allergy to pollen & grasses
Allergies:
Diagnostic Lab Data: CXR & Blood work done at hosp. "Normal things not elevated" according to patient
CDC Split Type: CO912

Write-up: 4JAN91 Hives. 5JAN91 Swollen ears. MD prescribed Benadryl; 7JAN91 swelling of eyes & lips. Given Atarax. 8JAN91 fainted when got out of bed. Taken to ER given Prednisone.


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