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This is VAERS ID 31177

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 31177
VAERS Form:
Age:53.6
Sex:Female
Location:Maryland
Vaccinated:1987-01-01
Onset:1987-03-01
Submitted:0000-00-00
Entered:1991-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEPTAVAX / MSD - / 2 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: ARTHRITIS, PAIN BACK, ARTHRALGIA, POS RECHAL

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: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: allergic to: nalfom, feldene, penicillin;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type':

Write-up: Pt given 1st dose of vax DEC86, 2nd dose of vax JAN87; in approx MAR87 exp arthritis in lt hip, lt knee, rt hip & back; tx Nalfon, Feldene & Motrin; Rec''d 3rd dose of vax JUN87, as of 30OCT90 episodes of hip, knee & back pain persisted;


Changed on 12/8/2009

VAERS ID: 31177 Before After
VAERS Form:
Age:53.6
Sex:Female
Location:Maryland
Vaccinated:1987-01-01
Onset:1987-03-01
Submitted:0000-00-00
Entered:1991-06-14 1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEPTAVAX HEP B (HEPTAVAX) / MSD MERCK & CO. INC. - / 2 - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Arthralgia, Arthritis, Back pain, Similar reaction on previous exposure to drug, ARTHRITIS, PAIN BACK, ARTHRALGIA, POS RECHAL

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: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: allergic to: nalfom, feldene, penicillin;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': (blank) WAES90110197

Write-up: Pt given 1st dose of vax DEC86, 2nd dose of vax JAN87; in approx MAR87 exp arthritis in lt hip, lt knee, rt hip & back; tx Nalfon, Feldene & Motrin; Rec''d 3rd dose of vax JUN87, as of 30OCT90 episodes of hip, knee & back pain persisted;


Changed on 8/31/2010

VAERS ID: 31177 Before After
VAERS Form:
Age:53.6
Sex:Female
Location:Maryland
Vaccinated:1987-01-01
Onset:1987-03-01
Submitted:0000-00-00
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (HEPTAVAX) HEP B (FOREIGN) / MERCK & CO. INC. - / 2 - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Arthritis, Back pain, Similar reaction on previous exposure to drug

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: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: allergic to: nalfom, feldene, penicillin;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES90110197

Write-up: Pt given 1st dose of vax DEC86, 2nd dose of vax JAN87; in approx MAR87 exp arthritis in lt hip, lt knee, rt hip & back; tx Nalfon, Feldene & Motrin; Rec''d 3rd dose of vax JUN87, as of 30OCT90 episodes of hip, knee & back pain persisted;


Changed on 2/14/2017

VAERS ID: 31177 Before After
VAERS Form:
Age:53.6 53.0
Sex:Female
Location:Maryland
Vaccinated:1987-01-01
Onset:1987-03-01
Submitted:0000-00-00
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (FOREIGN) / MERCK & CO. INC. - / 2 - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Arthritis, Back pain, Similar reaction on previous exposure to drug

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: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: allergic to: nalfom, feldene, penicillin;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES90110197

Write-up: Pt given 1st dose of vax DEC86, 2nd dose of vax JAN87; in approx MAR87 exp arthritis in lt hip, lt knee, rt hip & back; tx Nalfon, Feldene & Motrin; Rec''d 3rd dose of vax JUN87, as of 30OCT90 episodes of hip, knee & back pain persisted;


Changed on 5/14/2017

VAERS ID: 31177 Before After
VAERS Form:
Age:53.0
Sex:Female
Location:Maryland
Vaccinated:1987-01-01
Onset:1987-03-01
Submitted:0000-00-00
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (FOREIGN) / MERCK & CO. INC. - / 2 - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Arthritis, Back pain, Similar reaction on previous exposure to drug

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: 10     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness:
Preexisting Conditions: allergic to: nalfom, feldene, penicillin;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES90110197

Write-up: Pt given 1st dose of vax DEC86, 2nd dose of vax JAN87; in approx MAR87 exp arthritis in lt hip, lt knee, rt hip & back; tx Nalfon, Feldene & Motrin; Rec''d 3rd dose of vax JUN87, as of 30OCT90 episodes of hip, knee & back pain persisted;


Changed on 9/14/2017

VAERS ID: 31177 Before After
VAERS Form:(blank) 1
Age:53.0
Sex:Female
Location:Maryland
Vaccinated:1987-01-01
Onset:1987-03-01
Submitted:0000-00-00
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (FOREIGN) / MERCK & CO. INC. - / 2 3 - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Arthritis, Back 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: 10     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness:
Preexisting Conditions: allergic to: nalfom, feldene, penicillin;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES90110197

Write-up: Pt given 1st dose of vax DEC86, 2nd dose of vax JAN87; in approx MAR87 exp arthritis in lt hip, lt knee, rt hip & back; tx Nalfon, Feldene & Motrin; Rec''d 3rd dose of vax JUN87, as of 30OCT90 episodes of hip, knee & back pain persisted;


Changed on 2/14/2018

VAERS ID: 31177 Before After
VAERS Form:1
Age:53.0
Sex:Female
Location:Maryland
Vaccinated:1987-01-01
Onset:1987-03-01
Submitted:0000-00-00
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (FOREIGN) / MERCK & CO. INC. - / 3 - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Arthritis, Back 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: 10     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness:
Preexisting Conditions: allergic to: nalfom, feldene, penicillin;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES90110197

Write-up: Pt given 1st dose of vax DEC86, 2nd dose of vax JAN87; in approx MAR87 exp arthritis in lt hip, lt knee, rt hip & back; tx Nalfon, Feldene & Motrin; Rec''d 3rd dose of vax JUN87, as of 30OCT90 episodes of hip, knee & back pain persisted;


Changed on 6/14/2018

VAERS ID: 31177 Before After
VAERS Form:1
Age:53.0
Sex:Female
Location:Maryland
Vaccinated:1987-01-01
Onset:1987-03-01
Submitted:0000-00-00
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (FOREIGN) / MERCK & CO. INC. - / 3 - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Arthritis, Back 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: 10     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness:
Preexisting Conditions: allergic to: nalfom, feldene, penicillin;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES90110197

Write-up: Pt given 1st dose of vax DEC86, 2nd dose of vax JAN87; in approx MAR87 exp arthritis in lt hip, lt knee, rt hip & back; tx Nalfon, Feldene & Motrin; Rec''d 3rd dose of vax JUN87, as of 30OCT90 episodes of hip, knee & back pain persisted;


Changed on 8/14/2018

VAERS ID: 31177 Before After
VAERS Form:1
Age:53.0
Sex:Female
Location:Maryland
Vaccinated:1987-01-01
Onset:1987-03-01
Submitted:0000-00-00
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (FOREIGN) / MERCK & CO. INC. - / 3 - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Arthritis, Back 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: 10     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness:
Preexisting Conditions: allergic to: nalfom, feldene, penicillin;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES90110197

Write-up: Pt given 1st dose of vax DEC86, 2nd dose of vax JAN87; in approx MAR87 exp arthritis in lt hip, lt knee, rt hip & back; tx Nalfon, Feldene & Motrin; Rec''d 3rd dose of vax JUN87, as of 30OCT90 episodes of hip, knee & back pain persisted;


Changed on 9/14/2018

VAERS ID: 31177 Before After
VAERS Form:1
Age:53.0
Sex:Female
Location:Maryland
Vaccinated:1987-01-01
Onset:1987-03-01
Submitted:0000-00-00
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (FOREIGN) / MERCK & CO. INC. - / 3 - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Arthritis, Back 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: 10     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness:
Preexisting Conditions: allergic to: nalfom, feldene, penicillin;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES90110197

Write-up: Pt given 1st dose of vax DEC86, 2nd dose of vax JAN87; in approx MAR87 exp arthritis in lt hip, lt knee, rt hip & back; tx Nalfon, Feldene & Motrin; Rec''d 3rd dose of vax JUN87, as of 30OCT90 episodes of hip, knee & back pain persisted;


Changed on 10/14/2018

VAERS ID: 31177 Before After
VAERS Form:1
Age:53.0
Sex:Female
Location:Maryland
Vaccinated:1987-01-01
Onset:1987-03-01
Submitted:0000-00-00
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (FOREIGN) / MERCK & CO. INC. - / 3 - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Arthritis, Back 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: 10     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness:
Preexisting Conditions: allergic to: nalfom, feldene, penicillin;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES90110197

Write-up: Pt given 1st dose of vax DEC86, 2nd dose of vax JAN87; in approx MAR87 exp arthritis in lt hip, lt knee, rt hip & back; tx Nalfon, Feldene & Motrin; Rec''d 3rd dose of vax JUN87, as of 30OCT90 episodes of hip, knee & back pain persisted;


Changed on 12/24/2020

VAERS ID: 31177 Before After
VAERS Form:1
Age:53.0
Sex:Female
Location:Maryland
Vaccinated:1987-01-01
Onset:1987-03-01
Submitted:0000-00-00
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (FOREIGN) / MERCK & CO. INC. - / 3 - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Arthritis, Back 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: 10     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness:
Preexisting Conditions: allergic to: nalfom, feldene, penicillin;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES90110197

Write-up: Pt given 1st dose of vax DEC86, 2nd dose of vax JAN87; in approx MAR87 exp arthritis in lt hip, lt knee, rt hip & back; tx Nalfon, Feldene & Motrin; Rec''d 3rd dose of vax JUN87, as of 30OCT90 episodes of hip, knee & back pain persisted;


Changed on 12/30/2020

VAERS ID: 31177 Before After
VAERS Form:1
Age:53.0
Sex:Female
Location:Maryland
Vaccinated:1987-01-01
Onset:1987-03-01
Submitted:0000-00-00
Entered:1991-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (FOREIGN) / MERCK & CO. INC. - / 3 - / -

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Arthritis, Back 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: 10     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: UNK
Current Illness:
Preexisting Conditions: allergic to: nalfom, feldene, penicillin;
Allergies:
Diagnostic Lab Data: No relevant data
CDC 'Split Type': WAES90110197

Write-up: Pt given 1st dose of vax DEC86, 2nd dose of vax JAN87; in approx MAR87 exp arthritis in lt hip, lt knee, rt hip & back; tx Nalfon, Feldene & Motrin; Rec''d 3rd dose of vax JUN87, as of 30OCT90 episodes of hip, knee & back pain persisted;

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