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This is VAERS ID 421495

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/13/2011

VAERS ID: 421495
VAERS Form:
Age:0.1
Sex:Male
Location:New Hampshire
Vaccinated:2010-10-14
Onset:2010-11-01
Submitted:0000-00-00
Entered:2011-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1483Y / 1 RL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-01
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH04201103

Write-up: 10-14-10 Merck 1483Y.


Changed on 9/14/2017

VAERS ID: 421495 Before After
VAERS Form:(blank) 1
Age:0.1
Sex:Male
Location:New Hampshire
Vaccinated:2010-10-14
Onset:2010-11-01
Submitted:0000-00-00
Entered:2011-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1483Y / 1 2 RL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-01
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH04201103

Write-up: 10-14-10 Merck 1483Y.


Changed on 2/14/2018

VAERS ID: 421495 Before After
VAERS Form:1
Age:0.1
Sex:Male
Location:New Hampshire
Vaccinated:2010-10-14
Onset:2010-11-01
Submitted:0000-00-00
Entered:2011-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1483Y / 2 RL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-01
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH04201103

Write-up: 10-14-10 Merck 1483Y.


Changed on 6/14/2018

VAERS ID: 421495 Before After
VAERS Form:1
Age:0.1
Sex:Male
Location:New Hampshire
Vaccinated:2010-10-14
Onset:2010-11-01
Submitted:0000-00-00
Entered:2011-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1483Y / 2 RL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-01
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH04201103

Write-up: 10-14-10 Merck 1483Y.


Changed on 8/14/2018

VAERS ID: 421495 Before After
VAERS Form:1
Age:0.1
Sex:Male
Location:New Hampshire
Vaccinated:2010-10-14
Onset:2010-11-01
Submitted:0000-00-00
Entered:2011-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1483Y / 2 RL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-01
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH04201103

Write-up: 10-14-10 Merck 1483Y.


Changed on 9/14/2018

VAERS ID: 421495 Before After
VAERS Form:1
Age:0.1
Sex:Male
Location:New Hampshire
Vaccinated:2010-10-14
Onset:2010-11-01
Submitted:0000-00-00
Entered:2011-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1483Y / 2 RL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-01
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH04201103

Write-up: 10-14-10 Merck 1483Y.


Changed on 10/14/2018

VAERS ID: 421495 Before After
VAERS Form:1
Age:0.1
Sex:Male
Location:New Hampshire
Vaccinated:2010-10-14
Onset:2010-11-01
Submitted:0000-00-00
Entered:2011-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1483Y / 2 RL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-01
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH04201103

Write-up: 10-14-10 Merck 1483Y.


Changed on 12/24/2020

VAERS ID: 421495 Before After
VAERS Form:1
Age:0.1
Sex:Male
Location:New Hampshire
Vaccinated:2010-10-14
Onset:2010-11-01
Submitted:0000-00-00
Entered:2011-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1483Y / 2 RL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-01
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH04201103

Write-up: 10-14-10 Merck 1483Y.


Changed on 12/30/2020

VAERS ID: 421495 Before After
VAERS Form:1
Age:0.1
Sex:Male
Location:New Hampshire
Vaccinated:2010-10-14
Onset:2010-11-01
Submitted:0000-00-00
Entered:2011-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1483Y / 2 RL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-01
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH04201103

Write-up: 10-14-10 Merck 1483Y.


Changed on 5/7/2021

VAERS ID: 421495 Before After
VAERS Form:1
Age:0.1
Sex:Male
Location:New Hampshire
Vaccinated:2010-10-14
Onset:2010-11-01
Submitted:0000-00-00
Entered:2011-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1483Y / 2 RL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-01
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH04201103

Write-up: 10-14-10 Merck 1483Y.


Changed on 5/14/2021

VAERS ID: 421495 Before After
VAERS Form:1
Age:0.1
Sex:Male
Location:New Hampshire
Vaccinated:2010-10-14
Onset:2010-11-01
Submitted:0000-00-00
Entered:2011-04-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1483Y / 2 RL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-11-01
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NH04201103

Write-up: 10-14-10 Merck 1483Y.

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