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This is VAERS ID 27765

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27765
VAERS Form:
Age:38.0
Sex:Female
Location:Washington
Vaccinated:1990-07-01
Onset:1990-07-01
Submitted:0000-00-00
Entered:1991-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB / MSD - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: CONFUS, ASTHENIA, ANAPHYL, CSF ABNORM, AMNESIA

Life Threatening? Yes
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: migraine headache, allergy shellfish, iodine
Allergies:
Diagnostic Lab Data: CT scan 4SEP90 normal; EEG 4SEP90- normal; Doppler 4SEP90 normal; MRI 16NOV90 brain-normal; Lumbar puncture 19NOV90 inc. spinal pressure 26cm
CDC 'Split Type':

Write-up: Immed p/vax anaphylactic rxn w/respiratory distress, increased pulse & sudden hypertension; extreme sharp throbbing pain in back of head; JUL & AUG90 ""suffered almost daily"" from headaches, memory loss; On 4SEP90 driving lt arm & neck pain.


Changed on 12/8/2009

VAERS ID: 27765 Before After
VAERS Form:
Age:38.0
Sex:Female
Location:Washington
Vaccinated:1990-07-01
Onset:1990-07-01
Submitted:0000-00-00
Entered:1991-02-09 1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB HEP B (RECOMBIVAX HB) / MSD MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Anaphylactoid reaction, Asthenia, Confusional state, Dyspnoea, Facial palsy, Headache, Hypertension, Intracranial pressure increased, Migraine, Myasthenic syndrome, Neck pain, Papilloedema, Somnolence, Speech disorder, Tachycardia, Visual disturbance, CSF test abnormal, CONFUS, ASTHENIA, ANAPHYL, CSF ABNORM, AMNESIA

Life Threatening? Yes
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: migraine headache, allergy shellfish, iodine
Allergies:
Diagnostic Lab Data: CT scan 4SEP90 normal; EEG 4SEP90- normal; Doppler 4SEP90 normal; MRI 16NOV90 brain-normal; Lumbar puncture 19NOV90 inc. spinal pressure 26cm
CDC 'Split Type': (blank) WAES91010597

Write-up: Immed p/vax anaphylactic rxn w/respiratory distress, increased pulse & sudden hypertension; extreme sharp throbbing pain in back of head; JUL & AUG90 ""suffered "suffered almost daily"" daily" from headaches, memory loss; On 4SEP90 driving lt arm & neck pain.


Changed on 5/14/2017

VAERS ID: 27765 Before After
VAERS Form:
Age:38.0
Sex:Female
Location:Washington
Vaccinated:1990-07-01
Onset:1990-07-01
Submitted:0000-00-00
Entered:1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Anaphylactoid reaction, Asthenia, Confusional state, Dyspnoea, Facial palsy, Headache, Hypertension, Intracranial pressure increased, Migraine, Myasthenic syndrome, Neck pain, Papilloedema, Somnolence, Speech disorder, Tachycardia, Visual disturbance, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: migraine headache, allergy shellfish, iodine
Allergies:
Diagnostic Lab Data: CT scan 4SEP90 normal; EEG 4SEP90- normal; Doppler 4SEP90 normal; MRI 16NOV90 brain-normal; Lumbar puncture 19NOV90 inc. spinal pressure 26cm
CDC 'Split Type': WAES91010597

Write-up: Immed p/vax anaphylactic rxn w/respiratory distress, increased pulse & sudden hypertension; extreme sharp throbbing pain in back of head; JUL & AUG90 "suffered almost daily" from headaches, memory loss; On 4SEP90 driving lt arm & neck pain.


Changed on 9/14/2017

VAERS ID: 27765 Before After
VAERS Form:(blank) 1
Age:38.0
Sex:Female
Location:Washington
Vaccinated:1990-07-01
Onset:1990-07-01
Submitted:0000-00-00
Entered:1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Anaphylactoid reaction, Asthenia, Confusional state, Dyspnoea, Facial palsy, Headache, Hypertension, Intracranial pressure increased, Migraine, Myasthenic syndrome, Neck pain, Papilloedema, Somnolence, Speech disorder, Tachycardia, Visual disturbance, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: migraine headache, allergy shellfish, iodine
Allergies:
Diagnostic Lab Data: CT scan 4SEP90 normal; EEG 4SEP90- normal; Doppler 4SEP90 normal; MRI 16NOV90 brain-normal; Lumbar puncture 19NOV90 inc. spinal pressure 26cm
CDC 'Split Type': WAES91010597

Write-up: Immed p/vax anaphylactic rxn w/respiratory distress, increased pulse & sudden hypertension; extreme sharp throbbing pain in back of head; JUL & AUG90 "suffered almost daily" from headaches, memory loss; On 4SEP90 driving lt arm & neck pain.


Changed on 2/14/2018

VAERS ID: 27765 Before After
VAERS Form:1
Age:38.0
Sex:Female
Location:Washington
Vaccinated:1990-07-01
Onset:1990-07-01
Submitted:0000-00-00
Entered:1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Anaphylactoid reaction, Asthenia, Confusional state, Dyspnoea, Facial palsy, Headache, Hypertension, Intracranial pressure increased, Migraine, Myasthenic syndrome, Neck pain, Papilloedema, Somnolence, Speech disorder, Tachycardia, Visual disturbance, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: migraine headache, allergy shellfish, iodine
Allergies:
Diagnostic Lab Data: CT scan 4SEP90 normal; EEG 4SEP90- normal; Doppler 4SEP90 normal; MRI 16NOV90 brain-normal; Lumbar puncture 19NOV90 inc. spinal pressure 26cm
CDC 'Split Type': WAES91010597

Write-up: Immed p/vax anaphylactic rxn w/respiratory distress, increased pulse & sudden hypertension; extreme sharp throbbing pain in back of head; JUL & AUG90 "suffered almost daily" from headaches, memory loss; On 4SEP90 driving lt arm & neck pain.


Changed on 6/14/2018

VAERS ID: 27765 Before After
VAERS Form:1
Age:38.0
Sex:Female
Location:Washington
Vaccinated:1990-07-01
Onset:1990-07-01
Submitted:0000-00-00
Entered:1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Anaphylactoid reaction, Asthenia, Confusional state, Dyspnoea, Facial palsy, Headache, Hypertension, Intracranial pressure increased, Migraine, Myasthenic syndrome, Neck pain, Papilloedema, Somnolence, Speech disorder, Tachycardia, Visual disturbance, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: migraine headache, allergy shellfish, iodine
Allergies:
Diagnostic Lab Data: CT scan 4SEP90 normal; EEG 4SEP90- normal; Doppler 4SEP90 normal; MRI 16NOV90 brain-normal; Lumbar puncture 19NOV90 inc. spinal pressure 26cm
CDC 'Split Type': WAES91010597

Write-up: Immed p/vax anaphylactic rxn w/respiratory distress, increased pulse & sudden hypertension; extreme sharp throbbing pain in back of head; JUL & AUG90 "suffered almost daily" from headaches, memory loss; On 4SEP90 driving lt arm & neck pain.


Changed on 8/14/2018

VAERS ID: 27765 Before After
VAERS Form:1
Age:38.0
Sex:Female
Location:Washington
Vaccinated:1990-07-01
Onset:1990-07-01
Submitted:0000-00-00
Entered:1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Anaphylactoid reaction, Asthenia, Confusional state, Dyspnoea, Facial palsy, Headache, Hypertension, Intracranial pressure increased, Migraine, Myasthenic syndrome, Neck pain, Papilloedema, Somnolence, Speech disorder, Tachycardia, Visual disturbance, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: migraine headache, allergy shellfish, iodine
Allergies:
Diagnostic Lab Data: CT scan 4SEP90 normal; EEG 4SEP90- normal; Doppler 4SEP90 normal; MRI 16NOV90 brain-normal; Lumbar puncture 19NOV90 inc. spinal pressure 26cm
CDC 'Split Type': WAES91010597

Write-up: Immed p/vax anaphylactic rxn w/respiratory distress, increased pulse & sudden hypertension; extreme sharp throbbing pain in back of head; JUL & AUG90 "suffered almost daily" from headaches, memory loss; On 4SEP90 driving lt arm & neck pain.


Changed on 9/14/2018

VAERS ID: 27765 Before After
VAERS Form:1
Age:38.0
Sex:Female
Location:Washington
Vaccinated:1990-07-01
Onset:1990-07-01
Submitted:0000-00-00
Entered:1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Anaphylactoid reaction, Asthenia, Confusional state, Dyspnoea, Facial palsy, Headache, Hypertension, Intracranial pressure increased, Migraine, Myasthenic syndrome, Neck pain, Papilloedema, Somnolence, Speech disorder, Tachycardia, Visual disturbance, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: migraine headache, allergy shellfish, iodine
Allergies:
Diagnostic Lab Data: CT scan 4SEP90 normal; EEG 4SEP90- normal; Doppler 4SEP90 normal; MRI 16NOV90 brain-normal; Lumbar puncture 19NOV90 inc. spinal pressure 26cm
CDC 'Split Type': WAES91010597

Write-up: Immed p/vax anaphylactic rxn w/respiratory distress, increased pulse & sudden hypertension; extreme sharp throbbing pain in back of head; JUL & AUG90 "suffered almost daily" from headaches, memory loss; On 4SEP90 driving lt arm & neck pain.


Changed on 10/14/2018

VAERS ID: 27765 Before After
VAERS Form:1
Age:38.0
Sex:Female
Location:Washington
Vaccinated:1990-07-01
Onset:1990-07-01
Submitted:0000-00-00
Entered:1991-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Anaphylactoid reaction, Asthenia, Confusional state, Dyspnoea, Facial palsy, Headache, Hypertension, Intracranial pressure increased, Migraine, Myasthenic syndrome, Neck pain, Papilloedema, Somnolence, Speech disorder, Tachycardia, Visual disturbance, CSF test abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: migraine headache, allergy shellfish, iodine
Allergies:
Diagnostic Lab Data: CT scan 4SEP90 normal; EEG 4SEP90- normal; Doppler 4SEP90 normal; MRI 16NOV90 brain-normal; Lumbar puncture 19NOV90 inc. spinal pressure 26cm
CDC 'Split Type': WAES91010597

Write-up: Immed p/vax anaphylactic rxn w/respiratory distress, increased pulse & sudden hypertension; extreme sharp throbbing pain in back of head; JUL & AUG90 "suffered almost daily" from headaches, memory loss; On 4SEP90 driving lt arm & neck pain.

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