National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 28336

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 28336
VAERS Form:
Age:43.6
Sex:Male
Location:New York
Vaccinated:1991-01-04
Onset:1991-01-11
Submitted:0000-00-00
Entered:1991-02-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB / MSD - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: DYSPNEA, PAIN CHEST, ESR INC, ECG ABNORM, EFFUS PERICARD

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: Zantac, ASA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt vax /w Hepatitis B vaccine. Within 2 weeks of vax pt was hospitalized /w pericarditis. Additional info has been requested.


Changed on 12/8/2009

VAERS ID: 28336 Before After
VAERS Form:
Age:43.6
Sex:Male
Location:New York
Vaccinated:1991-01-04
Onset:1991-01-11
Submitted:0000-00-00
Entered:1991-02-21 1991-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB HEP B (RECOMBIVAX HB) / MSD MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dyspnoea, Electrocardiogram abnormal, Pericardial effusion, Pericarditis, Red blood cell sedimentation rate increased, DYSPNEA, PAIN CHEST, ESR INC, ECG ABNORM, EFFUS PERICARD

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: Zantac, ASA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES91020460

Write-up: Pt vax /w Hepatitis B vaccine. Within 2 weeks of vax pt was hospitalized /w pericarditis. Additional info has been requested.


Changed on 2/14/2017

VAERS ID: 28336 Before After
VAERS Form:
Age:43.6 43.0
Sex:Male
Location:New York
Vaccinated:1991-01-04
Onset:1991-01-11
Submitted:0000-00-00
Entered:1991-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dyspnoea, Electrocardiogram abnormal, Pericardial effusion, Pericarditis, Red blood cell sedimentation rate increased

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: Zantac, ASA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES91020460

Write-up: Pt vax /w Hepatitis B vaccine. Within 2 weeks of vax pt was hospitalized /w pericarditis. Additional info has been requested.


Changed on 5/14/2017

VAERS ID: 28336 Before After
VAERS Form:
Age:43.0
Sex:Male
Location:New York
Vaccinated:1991-01-04
Onset:1991-01-11
Submitted:0000-00-00
Entered:1991-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dyspnoea, Electrocardiogram abnormal, Pericardial effusion, Pericarditis, Red blood cell sedimentation rate increased

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: ~ ()~~~In patient
Other Medications: Zantac, ASA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES91020460

Write-up: Pt vax /w Hepatitis B vaccine. Within 2 weeks of vax pt was hospitalized /w pericarditis. Additional info has been requested.


Changed on 9/14/2017

VAERS ID: 28336 Before After
VAERS Form:(blank) 1
Age:43.0
Sex:Male
Location:New York
Vaccinated:1991-01-04
Onset:1991-01-11
Submitted:0000-00-00
Entered:1991-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dyspnoea, Electrocardiogram abnormal, Pericardial effusion, Pericarditis, Red blood cell sedimentation rate increased

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: ~ ()~~~In patient
Other Medications: Zantac, ASA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES91020460

Write-up: Pt vax /w Hepatitis B vaccine. Within 2 weeks of vax pt was hospitalized /w pericarditis. Additional info has been requested.


Changed on 2/14/2018

VAERS ID: 28336 Before After
VAERS Form:1
Age:43.0
Sex:Male
Location:New York
Vaccinated:1991-01-04
Onset:1991-01-11
Submitted:0000-00-00
Entered:1991-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dyspnoea, Electrocardiogram abnormal, Pericardial effusion, Pericarditis, Red blood cell sedimentation rate increased

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: ~ ()~~~In patient
Other Medications: Zantac, ASA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES91020460

Write-up: Pt vax /w Hepatitis B vaccine. Within 2 weeks of vax pt was hospitalized /w pericarditis. Additional info has been requested.


Changed on 6/14/2018

VAERS ID: 28336 Before After
VAERS Form:1
Age:43.0
Sex:Male
Location:New York
Vaccinated:1991-01-04
Onset:1991-01-11
Submitted:0000-00-00
Entered:1991-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dyspnoea, Electrocardiogram abnormal, Pericardial effusion, Pericarditis, Red blood cell sedimentation rate increased

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: ~ ()~~~In patient
Other Medications: Zantac, ASA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES91020460

Write-up: Pt vax /w Hepatitis B vaccine. Within 2 weeks of vax pt was hospitalized /w pericarditis. Additional info has been requested.


Changed on 8/14/2018

VAERS ID: 28336 Before After
VAERS Form:1
Age:43.0
Sex:Male
Location:New York
Vaccinated:1991-01-04
Onset:1991-01-11
Submitted:0000-00-00
Entered:1991-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dyspnoea, Electrocardiogram abnormal, Pericardial effusion, Pericarditis, Red blood cell sedimentation rate increased

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: ~ ()~~~In patient
Other Medications: Zantac, ASA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES91020460

Write-up: Pt vax /w Hepatitis B vaccine. Within 2 weeks of vax pt was hospitalized /w pericarditis. Additional info has been requested.


Changed on 9/14/2018

VAERS ID: 28336 Before After
VAERS Form:1
Age:43.0
Sex:Male
Location:New York
Vaccinated:1991-01-04
Onset:1991-01-11
Submitted:0000-00-00
Entered:1991-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dyspnoea, Electrocardiogram abnormal, Pericardial effusion, Pericarditis, Red blood cell sedimentation rate increased

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: ~ ()~~~In patient
Other Medications: Zantac, ASA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES91020460

Write-up: Pt vax /w Hepatitis B vaccine. Within 2 weeks of vax pt was hospitalized /w pericarditis. Additional info has been requested.


Changed on 10/14/2018

VAERS ID: 28336 Before After
VAERS Form:1
Age:43.0
Sex:Male
Location:New York
Vaccinated:1991-01-04
Onset:1991-01-11
Submitted:0000-00-00
Entered:1991-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dyspnoea, Electrocardiogram abnormal, Pericardial effusion, Pericarditis, Red blood cell sedimentation rate increased

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: ~ ()~~~In patient
Other Medications: Zantac, ASA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES91020460

Write-up: Pt vax /w Hepatitis B vaccine. Within 2 weeks of vax pt was hospitalized /w pericarditis. Additional info has been requested.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=28336&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166