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This is VAERS ID 27629

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27629
VAERS Form:
Age:37.3
Sex:Female
Location:Colorado
Vaccinated:1990-12-20
Onset:1991-01-04
Submitted:1991-01-14
Entered:1991-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B / SMITHKLINE 592A2 / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: SYNCOPE, EDEMA FACE

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
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':

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.


Changed on 12/8/2009

VAERS ID: 27629 Before After
VAERS Form:
Age:37.3
Sex:Female
Location:Colorado
Vaccinated:1990-12-20
Onset:1991-01-04
Submitted:1991-01-14
Entered:1991-01-31 1991-01-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B HEP B (ENGERIX-B) / SMITHKLINE SMITHKLINE BEECHAM 592A2 / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Face oedema, Syncope, SYNCOPE, EDEMA FACE

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
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': (blank) 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.


Changed on 2/14/2017

VAERS ID: 27629 Before After
VAERS Form:
Age:37.3 37.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-20
Onset:1991-01-04
Submitted:1991-01-14
Entered:1991-01-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 592A2 / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Face oedema, Syncope

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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
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.


Changed on 5/14/2017

VAERS ID: 27629 Before After
VAERS Form:
Age:37.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-20
Onset:1991-01-04
Submitted:1991-01-14
Entered:1991-01-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 592A2 / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Face oedema, Syncope

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? Yes, days: 1     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.


Changed on 9/14/2017

VAERS ID: 27629 Before After
VAERS Form:(blank) 1
Age:37.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-20
Onset:1991-01-04
Submitted:1991-01-14
Entered:1991-01-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 592A2 / 0 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Face oedema, Syncope

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? Yes, days: 1     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.


Changed on 2/14/2018

VAERS ID: 27629 Before After
VAERS Form:1
Age:37.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-20
Onset:1991-01-04
Submitted:1991-01-14
Entered:1991-01-28
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

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? Yes, days: 1     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.


Changed on 6/14/2018

VAERS ID: 27629 Before After
VAERS Form:1
Age:37.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-20
Onset:1991-01-04
Submitted:1991-01-14
Entered:1991-01-28
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

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? Yes, days: 1     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.


Changed on 8/14/2018

VAERS ID: 27629 Before After
VAERS Form:1
Age:37.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-20
Onset:1991-01-04
Submitted:1991-01-14
Entered:1991-01-28
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

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? Yes, days: 1     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.


Changed on 9/14/2018

VAERS ID: 27629 Before After
VAERS Form:1
Age:37.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-20
Onset:1991-01-04
Submitted:1991-01-14
Entered:1991-01-28
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

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? Yes, days: 1     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.


Changed on 10/14/2018

VAERS ID: 27629 Before After
VAERS Form:1
Age:37.0
Sex:Female
Location:Colorado
Vaccinated:1990-12-20
Onset:1991-01-04
Submitted:1991-01-14
Entered:1991-01-28
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

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? Yes, days: 1     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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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=27629&WAYBACKHISTORY=ON


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