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This is VAERS ID 29774

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 29774
VAERS Form:
Age:50.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:1990-03-01
Submitted:0000-00-00
Entered:1991-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB / MSD 1772R / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: HEMATURIA, PAIN

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Allergies:
Diagnostic Lab Data: Cystoscopy-blood from ureteral orifices, CT scan-shadow on rt kidney, Sonogram-negative, Angiogram-negative, IVP-negative, CT scan (1Sep90)-no shadow on rt kidney
CDC 'Split Type':

Write-up: Vax /w Hepta B(recomb).1Mar90 developed"gross"hematuria & lt flank pain.Cystoscopy-blood from both ureteral orifices.Pt hospitalized 14Mar90 X 4 days.Hematuria persisted as of 6Apr90.2nd dose admin 12May90.Hematuria < kidney pain recurred


Changed on 12/8/2009

VAERS ID: 29774 Before After
VAERS Form:
Age:50.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:1990-03-01
Submitted:0000-00-00
Entered:1991-04-15 1991-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB HEP B (RECOMBIVAX HB) / MSD MERCK & CO. INC. 1772R / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Haematuria, Pain, HEMATURIA, PAIN

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Allergies:
Diagnostic Lab Data: Cystoscopy-blood from ureteral orifices, CT scan-shadow on rt kidney, Sonogram-negative, Angiogram-negative, IVP-negative, CT scan (1Sep90)-no shadow on rt kidney
CDC 'Split Type': (blank) WAES90050968

Write-up: Vax /w Hepta B(recomb).1Mar90 developed"gross"hematuria & lt flank pain.Cystoscopy-blood from both ureteral orifices.Pt hospitalized 14Mar90 X 4 days.Hematuria persisted as of 6Apr90.2nd dose admin 12May90.Hematuria < kidney pain recurred


Changed on 5/14/2017

VAERS ID: 29774 Before After
VAERS Form:
Age:50.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:1990-03-01
Submitted:0000-00-00
Entered:1991-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1772R / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Haematuria, Pain

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Allergies:
Diagnostic Lab Data: Cystoscopy-blood from ureteral orifices, CT scan-shadow on rt kidney, Sonogram-negative, Angiogram-negative, IVP-negative, CT scan (1Sep90)-no shadow on rt kidney
CDC 'Split Type': WAES90050968

Write-up: Vax /w Hepta B(recomb).1Mar90 developed"gross"hematuria & lt flank pain.Cystoscopy-blood from both ureteral orifices.Pt hospitalized 14Mar90 X 4 days.Hematuria persisted as of 6Apr90.2nd dose admin 12May90.Hematuria < kidney pain recurred


Changed on 9/14/2017

VAERS ID: 29774 Before After
VAERS Form:(blank) 1
Age:50.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:1990-03-01
Submitted:0000-00-00
Entered:1991-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1772R / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Haematuria, Pain

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Allergies:
Diagnostic Lab Data: Cystoscopy-blood from ureteral orifices, CT scan-shadow on rt kidney, Sonogram-negative, Angiogram-negative, IVP-negative, CT scan (1Sep90)-no shadow on rt kidney
CDC 'Split Type': WAES90050968

Write-up: Vax /w Hepta B(recomb).1Mar90 developed"gross"hematuria & lt flank pain.Cystoscopy-blood from both ureteral orifices.Pt hospitalized 14Mar90 X 4 days.Hematuria persisted as of 6Apr90.2nd dose admin 12May90.Hematuria < kidney pain recurred


Changed on 2/14/2018

VAERS ID: 29774 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:1990-03-01
Submitted:0000-00-00
Entered:1991-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1772R / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Haematuria, Pain

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Allergies:
Diagnostic Lab Data: Cystoscopy-blood from ureteral orifices, CT scan-shadow on rt kidney, Sonogram-negative, Angiogram-negative, IVP-negative, CT scan (1Sep90)-no shadow on rt kidney
CDC 'Split Type': WAES90050968

Write-up: Vax /w Hepta B(recomb).1Mar90 developed"gross"hematuria & lt flank pain.Cystoscopy-blood from both ureteral orifices.Pt hospitalized 14Mar90 X 4 days.Hematuria persisted as of 6Apr90.2nd dose admin 12May90.Hematuria < kidney pain recurred


Changed on 6/14/2018

VAERS ID: 29774 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:1990-03-01
Submitted:0000-00-00
Entered:1991-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1772R / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Haematuria, Pain

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Allergies:
Diagnostic Lab Data: Cystoscopy-blood from ureteral orifices, CT scan-shadow on rt kidney, Sonogram-negative, Angiogram-negative, IVP-negative, CT scan (1Sep90)-no shadow on rt kidney
CDC 'Split Type': WAES90050968

Write-up: Vax /w Hepta B(recomb).1Mar90 developed"gross"hematuria & lt flank pain.Cystoscopy-blood from both ureteral orifices.Pt hospitalized 14Mar90 X 4 days.Hematuria persisted as of 6Apr90.2nd dose admin 12May90.Hematuria < kidney pain recurred


Changed on 8/14/2018

VAERS ID: 29774 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:1990-03-01
Submitted:0000-00-00
Entered:1991-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1772R / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Haematuria, Pain

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Allergies:
Diagnostic Lab Data: Cystoscopy-blood from ureteral orifices, CT scan-shadow on rt kidney, Sonogram-negative, Angiogram-negative, IVP-negative, CT scan (1Sep90)-no shadow on rt kidney
CDC 'Split Type': WAES90050968

Write-up: Vax /w Hepta B(recomb).1Mar90 developed"gross"hematuria & lt flank pain.Cystoscopy-blood from both ureteral orifices.Pt hospitalized 14Mar90 X 4 days.Hematuria persisted as of 6Apr90.2nd dose admin 12May90.Hematuria < kidney pain recurred


Changed on 9/14/2018

VAERS ID: 29774 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:1990-03-01
Submitted:0000-00-00
Entered:1991-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1772R / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Haematuria, Pain

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Allergies:
Diagnostic Lab Data: Cystoscopy-blood from ureteral orifices, CT scan-shadow on rt kidney, Sonogram-negative, Angiogram-negative, IVP-negative, CT scan (1Sep90)-no shadow on rt kidney
CDC 'Split Type': WAES90050968

Write-up: Vax /w Hepta B(recomb).1Mar90 developed"gross"hematuria & lt flank pain.Cystoscopy-blood from both ureteral orifices.Pt hospitalized 14Mar90 X 4 days.Hematuria persisted as of 6Apr90.2nd dose admin 12May90.Hematuria < kidney pain recurred


Changed on 10/14/2018

VAERS ID: 29774 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:1990-03-01
Submitted:0000-00-00
Entered:1991-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1772R / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Haematuria, Pain

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Allergies:
Diagnostic Lab Data: Cystoscopy-blood from ureteral orifices, CT scan-shadow on rt kidney, Sonogram-negative, Angiogram-negative, IVP-negative, CT scan (1Sep90)-no shadow on rt kidney
CDC 'Split Type': WAES90050968

Write-up: Vax /w Hepta B(recomb).1Mar90 developed"gross"hematuria & lt flank pain.Cystoscopy-blood from both ureteral orifices.Pt hospitalized 14Mar90 X 4 days.Hematuria persisted as of 6Apr90.2nd dose admin 12May90.Hematuria < kidney pain recurred


Changed on 12/24/2020

VAERS ID: 29774 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:1990-03-01
Submitted:0000-00-00
Entered:1991-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1772R / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Haematuria, Pain

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Allergies:
Diagnostic Lab Data: Cystoscopy-blood from ureteral orifices, CT scan-shadow on rt kidney, Sonogram-negative, Angiogram-negative, IVP-negative, CT scan (1Sep90)-no shadow on rt kidney
CDC 'Split Type': WAES90050968

Write-up: Vax /w Hepta B(recomb).1Mar90 developed"gross"hematuria & lt flank pain.Cystoscopy-blood from both ureteral orifices.Pt hospitalized 14Mar90 X 4 days.Hematuria persisted as of 6Apr90.2nd dose admin 12May90.Hematuria < kidney pain recurred


Changed on 12/30/2020

VAERS ID: 29774 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:1990-03-01
Submitted:0000-00-00
Entered:1991-04-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1772R / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Haematuria, Pain

Life Threatening? No
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Allergies:
Diagnostic Lab Data: Cystoscopy-blood from ureteral orifices, CT scan-shadow on rt kidney, Sonogram-negative, Angiogram-negative, IVP-negative, CT scan (1Sep90)-no shadow on rt kidney
CDC 'Split Type': WAES90050968

Write-up: Vax /w Hepta B(recomb).1Mar90 developed"gross"hematuria & lt flank pain.Cystoscopy-blood from both ureteral orifices.Pt hospitalized 14Mar90 X 4 days.Hematuria persisted as of 6Apr90.2nd dose admin 12May90.Hematuria < kidney pain recurred

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