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This is VAERS ID 27767

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 27767
VAERS Form:
Age:41.0
Sex:Female
Location:California
Vaccinated:1990-07-01
Onset:1990-10-01
Submitted:0000-00-00
Entered:1991-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B / SMITHKLINE G591A4 / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: NO DRUG EFFECT

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Anti HBS (prior to vax = 0.8; Serology @NOV90: Anti HBC - borderline ; Anti HBS = 6.2 HBSAG = nondetectable;
CDC 'Split Type':

Write-up: Received 1st & 2nd does of Engerix-B Jun & Jul90. Oct90 hospitalized w/dx of acute hepatitis B.


Changed on 12/8/2009

VAERS ID: 27767 Before After
VAERS Form:
Age:41.0
Sex:Female
Location:California
Vaccinated:1990-07-01
Onset:1990-10-01
Submitted:0000-00-00
Entered:1991-02-09 1991-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B HEP B (ENGERIX-B) / SMITHKLINE SMITHKLINE BEECHAM G591A4 591A4 / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Drug ineffective, NO DRUG EFFECT

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? Yes No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Anti HBS (prior to vax = 0.8; Serology @NOV90: Anti HBC - borderline ; Anti HBS = 6.2 HBSAG = nondetectable;
CDC 'Split Type': (blank) EBU910041

Write-up: Received 1st & 2nd does of Engerix-B Jun & Jul90. Oct90 hospitalized w/dx of acute hepatitis B.


Changed on 9/14/2017

VAERS ID: 27767 Before After
VAERS Form:(blank) 1
Age:41.0
Sex:Female
Location:California
Vaccinated:1990-07-01
Onset:1990-10-01
Submitted:0000-00-00
Entered:1991-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / 1 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Drug ineffective

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Anti HBS (prior to vax = 0.8; Serology @NOV90: Anti HBC - borderline ; Anti HBS = 6.2 HBSAG = nondetectable;
CDC 'Split Type': EBU910041

Write-up: Received 1st & 2nd does of Engerix-B Jun & Jul90. Oct90 hospitalized w/dx of acute hepatitis B.


Changed on 2/14/2018

VAERS ID: 27767 Before After
VAERS Form:1
Age:41.0
Sex:Female
Location:California
Vaccinated:1990-07-01
Onset:1990-10-01
Submitted:0000-00-00
Entered:1991-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Drug ineffective

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Anti HBS (prior to vax = 0.8; Serology @NOV90: Anti HBC - borderline ; Anti HBS = 6.2 HBSAG = nondetectable;
CDC 'Split Type': EBU910041

Write-up: Received 1st & 2nd does of Engerix-B Jun & Jul90. Oct90 hospitalized w/dx of acute hepatitis B.


Changed on 6/14/2018

VAERS ID: 27767 Before After
VAERS Form:1
Age:41.0
Sex:Female
Location:California
Vaccinated:1990-07-01
Onset:1990-10-01
Submitted:0000-00-00
Entered:1991-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Drug ineffective

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Anti HBS (prior to vax = 0.8; Serology @NOV90: Anti HBC - borderline ; Anti HBS = 6.2 HBSAG = nondetectable;
CDC 'Split Type': EBU910041

Write-up: Received 1st & 2nd does of Engerix-B Jun & Jul90. Oct90 hospitalized w/dx of acute hepatitis B.


Changed on 8/14/2018

VAERS ID: 27767 Before After
VAERS Form:1
Age:41.0
Sex:Female
Location:California
Vaccinated:1990-07-01
Onset:1990-10-01
Submitted:0000-00-00
Entered:1991-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Drug ineffective

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Anti HBS (prior to vax = 0.8; Serology @NOV90: Anti HBC - borderline ; Anti HBS = 6.2 HBSAG = nondetectable;
CDC 'Split Type': EBU910041

Write-up: Received 1st & 2nd does of Engerix-B Jun & Jul90. Oct90 hospitalized w/dx of acute hepatitis B.


Changed on 9/14/2018

VAERS ID: 27767 Before After
VAERS Form:1
Age:41.0
Sex:Female
Location:California
Vaccinated:1990-07-01
Onset:1990-10-01
Submitted:0000-00-00
Entered:1991-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Drug ineffective

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Anti HBS (prior to vax = 0.8; Serology @NOV90: Anti HBC - borderline ; Anti HBS = 6.2 HBSAG = nondetectable;
CDC 'Split Type': EBU910041

Write-up: Received 1st & 2nd does of Engerix-B Jun & Jul90. Oct90 hospitalized w/dx of acute hepatitis B.


Changed on 10/14/2018

VAERS ID: 27767 Before After
VAERS Form:1
Age:41.0
Sex:Female
Location:California
Vaccinated:1990-07-01
Onset:1990-10-01
Submitted:0000-00-00
Entered:1991-02-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Drug ineffective

Life Threatening? No
Birth Defect? No
Died? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Anti HBS (prior to vax = 0.8; Serology @NOV90: Anti HBC - borderline ; Anti HBS = 6.2 HBSAG = nondetectable;
CDC 'Split Type': EBU910041

Write-up: Received 1st & 2nd does of Engerix-B Jun & Jul90. Oct90 hospitalized w/dx of acute hepatitis B.

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