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This is VAERS ID 28823

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 28823
VAERS Form:
Age:36.8
Sex:Male
Location:Oregon
Vaccinated:1991-02-07
Onset:1991-02-09
Submitted:1991-02-21
Entered:1991-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB / MSD 1238S / 0 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: FEVER, NAUSEA, HYPOTENS, PAIN, DIARRHEA

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: 2     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: Was well at time of vaccine.
Preexisting Conditions: 3 wks post hernia repair; Immune compromised
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 3 wks post hernia repair; Immune compromised

Write-up: 9FEB91 generalized aching; 10FEB91 nausea, vomiting, diarrhea, temp 101, 11FEB91 hospitalized BP 90/60 - nausea, vomiting, diarrhea, temp continued, MD reported ""looked like had a sunburn from head to toe"" IV - re hydration


Changed on 12/8/2009

VAERS ID: 28823 Before After
VAERS Form:
Age:36.8
Sex:Male
Location:Oregon
Vaccinated:1991-02-07
Onset:1991-02-09
Submitted:1991-02-21
Entered:1991-03-13 1991-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB HEP B (RECOMBIVAX HB) / MSD MERCK & CO. INC. 1238S / 0 RA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Diarrhoea, Hypotension, Nausea, Pain, Pyrexia, Rash, Vomiting, FEVER, NAUSEA, HYPOTENS, PAIN, DIARRHEA

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: 2     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: Was well at time of vaccine.
Preexisting Conditions: 3 wks post hernia repair; Immune compromised
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': 3 wks post hernia repair; Immune compromised (blank)

Write-up: 9FEB91 generalized aching; 10FEB91 nausea, vomiting, diarrhea, temp 101, 11FEB91 hospitalized BP 90/60 - nausea, vomiting, diarrhea, temp continued, MD reported ""looked "looked like had a sunburn from head to toe"" toe" IV - re hydration


Changed on 2/14/2017

VAERS ID: 28823 Before After
VAERS Form:
Age:36.8 36.0
Sex:Male
Location:Oregon
Vaccinated:1991-02-07
Onset:1991-02-09
Submitted:1991-02-21
Entered:1991-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1238S / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Diarrhoea, Hypotension, Nausea, Pain, Pyrexia, Rash, Vomiting

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: 2     Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: Was well at time of vaccine.
Preexisting Conditions: 3 wks post hernia repair; Immune compromised
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 9FEB91 generalized aching; 10FEB91 nausea, vomiting, diarrhea, temp 101, 11FEB91 hospitalized BP 90/60 - nausea, vomiting, diarrhea, temp continued, MD reported "looked like had a sunburn from head to toe" IV - re hydration


Changed on 5/14/2017

VAERS ID: 28823 Before After
VAERS Form:
Age:36.0
Sex:Male
Location:Oregon
Vaccinated:1991-02-07
Onset:1991-02-09
Submitted:1991-02-21
Entered:1991-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1238S / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Diarrhoea, Hypotension, Nausea, Pain, Pyrexia, Rash, Vomiting

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: 2     Extended hospital stay? No
Previous Vaccinations: NONE NONE~ ()~~~In patient
Other Medications:
Current Illness: Was well at time of vaccine.
Preexisting Conditions: 3 wks post hernia repair; Immune compromised
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 9FEB91 generalized aching; 10FEB91 nausea, vomiting, diarrhea, temp 101, 11FEB91 hospitalized BP 90/60 - nausea, vomiting, diarrhea, temp continued, MD reported "looked like had a sunburn from head to toe" IV - re hydration


Changed on 9/14/2017

VAERS ID: 28823 Before After
VAERS Form:(blank) 1
Age:36.0
Sex:Male
Location:Oregon
Vaccinated:1991-02-07
Onset:1991-02-09
Submitted:1991-02-21
Entered:1991-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1238S / 0 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Diarrhoea, Hypotension, Nausea, Pain, Pyrexia, Rash, Vomiting

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: 2     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: Was well at time of vaccine.
Preexisting Conditions: 3 wks post hernia repair; Immune compromised
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 9FEB91 generalized aching; 10FEB91 nausea, vomiting, diarrhea, temp 101, 11FEB91 hospitalized BP 90/60 - nausea, vomiting, diarrhea, temp continued, MD reported "looked like had a sunburn from head to toe" IV - re hydration


Changed on 2/14/2018

VAERS ID: 28823 Before After
VAERS Form:1
Age:36.0
Sex:Male
Location:Oregon
Vaccinated:1991-02-07
Onset:1991-02-09
Submitted:1991-02-21
Entered:1991-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1238S / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Diarrhoea, Hypotension, Nausea, Pain, Pyrexia, Rash, Vomiting

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: 2     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: Was well at time of vaccine.
Preexisting Conditions: 3 wks post hernia repair; Immune compromised
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 9FEB91 generalized aching; 10FEB91 nausea, vomiting, diarrhea, temp 101, 11FEB91 hospitalized BP 90/60 - nausea, vomiting, diarrhea, temp continued, MD reported "looked like had a sunburn from head to toe" IV - re hydration


Changed on 6/14/2018

VAERS ID: 28823 Before After
VAERS Form:1
Age:36.0
Sex:Male
Location:Oregon
Vaccinated:1991-02-07
Onset:1991-02-09
Submitted:1991-02-21
Entered:1991-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1238S / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Diarrhoea, Hypotension, Nausea, Pain, Pyrexia, Rash, Vomiting

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: 2     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: Was well at time of vaccine.
Preexisting Conditions: 3 wks post hernia repair; Immune compromised
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 9FEB91 generalized aching; 10FEB91 nausea, vomiting, diarrhea, temp 101, 11FEB91 hospitalized BP 90/60 - nausea, vomiting, diarrhea, temp continued, MD reported "looked like had a sunburn from head to toe" IV - re hydration


Changed on 8/14/2018

VAERS ID: 28823 Before After
VAERS Form:1
Age:36.0
Sex:Male
Location:Oregon
Vaccinated:1991-02-07
Onset:1991-02-09
Submitted:1991-02-21
Entered:1991-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1238S / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Diarrhoea, Hypotension, Nausea, Pain, Pyrexia, Rash, Vomiting

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: 2     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: Was well at time of vaccine.
Preexisting Conditions: 3 wks post hernia repair; Immune compromised
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 9FEB91 generalized aching; 10FEB91 nausea, vomiting, diarrhea, temp 101, 11FEB91 hospitalized BP 90/60 - nausea, vomiting, diarrhea, temp continued, MD reported "looked like had a sunburn from head to toe" IV - re hydration


Changed on 9/14/2018

VAERS ID: 28823 Before After
VAERS Form:1
Age:36.0
Sex:Male
Location:Oregon
Vaccinated:1991-02-07
Onset:1991-02-09
Submitted:1991-02-21
Entered:1991-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1238S / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Diarrhoea, Hypotension, Nausea, Pain, Pyrexia, Rash, Vomiting

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: 2     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: Was well at time of vaccine.
Preexisting Conditions: 3 wks post hernia repair; Immune compromised
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 9FEB91 generalized aching; 10FEB91 nausea, vomiting, diarrhea, temp 101, 11FEB91 hospitalized BP 90/60 - nausea, vomiting, diarrhea, temp continued, MD reported "looked like had a sunburn from head to toe" IV - re hydration


Changed on 10/14/2018

VAERS ID: 28823 Before After
VAERS Form:1
Age:36.0
Sex:Male
Location:Oregon
Vaccinated:1991-02-07
Onset:1991-02-09
Submitted:1991-02-21
Entered:1991-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1238S / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Diarrhoea, Hypotension, Nausea, Pain, Pyrexia, Rash, Vomiting

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: 2     Extended hospital stay? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: Was well at time of vaccine.
Preexisting Conditions: 3 wks post hernia repair; Immune compromised
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: 9FEB91 generalized aching; 10FEB91 nausea, vomiting, diarrhea, temp 101, 11FEB91 hospitalized BP 90/60 - nausea, vomiting, diarrhea, temp continued, MD reported "looked like had a sunburn from head to toe" IV - re hydration

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