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This is VAERS ID 30763

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 30763
VAERS Form:
Age:44.0
Sex:Female
Location:Missouri
Vaccinated:1990-06-07
Onset:1990-06-07
Submitted:0000-00-00
Entered:1991-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB / MSD 1878R / - LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: DYSPNEA, PHARYNGITIS, VASODILAT, VOICE ALTERAT, EDEMA TONGUE

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: benadryl, epinephrine
Current Illness:
Preexisting Conditions: allergy - reglan, tetracycline
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type':

Write-up: 07jun90 pt vax hepta B. 1hr aft vax pt devel. diffuse flushing, a subjective feeling of her throat closing and tongue swelling, hoarsness of voice and shortness of breath. pt to er and tx w/ epinephrine, benadryl, and solu-medrol.


Changed on 12/8/2009

VAERS ID: 30763 Before After
VAERS Form:
Age:44.0
Sex:Female
Location:Missouri
Vaccinated:1990-06-07
Onset:1990-06-07
Submitted:0000-00-00
Entered:1991-06-04 1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB HEP B (RECOMBIVAX HB) / MSD MERCK & CO. INC. 1878R / - LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dysphonia, Dyspnoea, Pharyngitis, Tongue oedema, Vasodilatation, DYSPNEA, PHARYNGITIS, VASODILAT, VOICE ALTERAT, EDEMA TONGUE

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: benadryl, epinephrine
Current Illness:
Preexisting Conditions: allergy - reglan, tetracycline
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': (blank) WAES90071189

Write-up: 07jun90 pt vax hepta B. 1hr aft vax pt devel. diffuse flushing, a subjective feeling of her throat closing and tongue swelling, hoarsness of voice and shortness of breath. pt to er and tx w/ epinephrine, benadryl, and solu-medrol.


Changed on 5/14/2017

VAERS ID: 30763 Before After
VAERS Form:
Age:44.0
Sex:Female
Location:Missouri
Vaccinated:1990-06-07
Onset:1990-06-07
Submitted:0000-00-00
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1878R / - LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dysphonia, Dyspnoea, Pharyngitis, Tongue oedema, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: benadryl, epinephrine
Current Illness:
Preexisting Conditions: allergy - reglan, tetracycline
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': WAES90071189

Write-up: 07jun90 pt vax hepta B. 1hr aft vax pt devel. diffuse flushing, a subjective feeling of her throat closing and tongue swelling, hoarsness of voice and shortness of breath. pt to er and tx w/ epinephrine, benadryl, and solu-medrol.


Changed on 9/14/2017

VAERS ID: 30763 Before After
VAERS Form:(blank) 1
Age:44.0
Sex:Female
Location:Missouri
Vaccinated:1990-06-07
Onset:1990-06-07
Submitted:0000-00-00
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1878R / - UNK LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dysphonia, Dyspnoea, Pharyngitis, Tongue oedema, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: benadryl, epinephrine
Current Illness:
Preexisting Conditions: allergy - reglan, tetracycline
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': WAES90071189

Write-up: 07jun90 pt vax hepta B. 1hr aft vax pt devel. diffuse flushing, a subjective feeling of her throat closing and tongue swelling, hoarsness of voice and shortness of breath. pt to er and tx w/ epinephrine, benadryl, and solu-medrol.


Changed on 2/14/2018

VAERS ID: 30763 Before After
VAERS Form:1
Age:44.0
Sex:Female
Location:Missouri
Vaccinated:1990-06-07
Onset:1990-06-07
Submitted:0000-00-00
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1878R / UNK LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dysphonia, Dyspnoea, Pharyngitis, Tongue oedema, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: benadryl, epinephrine
Current Illness:
Preexisting Conditions: allergy - reglan, tetracycline
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': WAES90071189

Write-up: 07jun90 pt vax hepta B. 1hr aft vax pt devel. diffuse flushing, a subjective feeling of her throat closing and tongue swelling, hoarsness of voice and shortness of breath. pt to er and tx w/ epinephrine, benadryl, and solu-medrol.


Changed on 6/14/2018

VAERS ID: 30763 Before After
VAERS Form:1
Age:44.0
Sex:Female
Location:Missouri
Vaccinated:1990-06-07
Onset:1990-06-07
Submitted:0000-00-00
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1878R / UNK LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dysphonia, Dyspnoea, Pharyngitis, Tongue oedema, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: benadryl, epinephrine
Current Illness:
Preexisting Conditions: allergy - reglan, tetracycline
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': WAES90071189

Write-up: 07jun90 pt vax hepta B. 1hr aft vax pt devel. diffuse flushing, a subjective feeling of her throat closing and tongue swelling, hoarsness of voice and shortness of breath. pt to er and tx w/ epinephrine, benadryl, and solu-medrol.


Changed on 8/14/2018

VAERS ID: 30763 Before After
VAERS Form:1
Age:44.0
Sex:Female
Location:Missouri
Vaccinated:1990-06-07
Onset:1990-06-07
Submitted:0000-00-00
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1878R / UNK LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dysphonia, Dyspnoea, Pharyngitis, Tongue oedema, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: benadryl, epinephrine
Current Illness:
Preexisting Conditions: allergy - reglan, tetracycline
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': WAES90071189

Write-up: 07jun90 pt vax hepta B. 1hr aft vax pt devel. diffuse flushing, a subjective feeling of her throat closing and tongue swelling, hoarsness of voice and shortness of breath. pt to er and tx w/ epinephrine, benadryl, and solu-medrol.


Changed on 9/14/2018

VAERS ID: 30763 Before After
VAERS Form:1
Age:44.0
Sex:Female
Location:Missouri
Vaccinated:1990-06-07
Onset:1990-06-07
Submitted:0000-00-00
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1878R / UNK LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dysphonia, Dyspnoea, Pharyngitis, Tongue oedema, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: benadryl, epinephrine
Current Illness:
Preexisting Conditions: allergy - reglan, tetracycline
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': WAES90071189

Write-up: 07jun90 pt vax hepta B. 1hr aft vax pt devel. diffuse flushing, a subjective feeling of her throat closing and tongue swelling, hoarsness of voice and shortness of breath. pt to er and tx w/ epinephrine, benadryl, and solu-medrol.


Changed on 10/14/2018

VAERS ID: 30763 Before After
VAERS Form:1
Age:44.0
Sex:Female
Location:Missouri
Vaccinated:1990-06-07
Onset:1990-06-07
Submitted:0000-00-00
Entered:1991-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1878R / UNK LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dysphonia, Dyspnoea, Pharyngitis, Tongue oedema, Vasodilatation

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: benadryl, epinephrine
Current Illness:
Preexisting Conditions: allergy - reglan, tetracycline
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': WAES90071189

Write-up: 07jun90 pt vax hepta B. 1hr aft vax pt devel. diffuse flushing, a subjective feeling of her throat closing and tongue swelling, hoarsness of voice and shortness of breath. pt to er and tx w/ epinephrine, benadryl, and solu-medrol.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=30763&WAYBACKHISTORY=ON


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