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This is VAERS ID 435682

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/11/2011

VAERS ID: 435682
VAERS Form:
Age:0.0
Sex:Male
Location:New Hampshire
Vaccinated:2011-05-16
Onset:2011-05-28
Submitted:2011-09-12
Entered:2011-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 8482Z / 0 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-28
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': 08121114

Write-up: Death.


Changed on 2/14/2017

VAERS ID: 435682 Before After
VAERS Form:
Age:0.0 0.02
Sex:Male
Location:New Hampshire
Vaccinated:2011-05-16
Onset:2011-05-28
Submitted:2011-09-12
Entered:2011-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 8482Z / 0 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-28
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': 08121114

Write-up: Death.


Changed on 9/14/2017

VAERS ID: 435682 Before After
VAERS Form:(blank) 1
Age:0.02
Sex:Male
Location:New Hampshire
Vaccinated:2011-05-16
Onset:2011-05-28
Submitted:2011-09-12
Entered:2011-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 8482Z / 0 1 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-28
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': 08121114

Write-up: Death.


Changed on 2/14/2018

VAERS ID: 435682 Before After
VAERS Form:1
Age:0.02
Sex:Male
Location:New Hampshire
Vaccinated:2011-05-16
Onset:2011-05-28
Submitted:2011-09-12
Entered:2011-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 8482Z / 1 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-28
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': 08121114

Write-up: Death.


Changed on 6/14/2018

VAERS ID: 435682 Before After
VAERS Form:1
Age:0.02
Sex:Male
Location:New Hampshire
Vaccinated:2011-05-16
Onset:2011-05-28
Submitted:2011-09-12
Entered:2011-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 8482Z / 1 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-28
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': 08121114

Write-up: Death.


Changed on 8/14/2018

VAERS ID: 435682 Before After
VAERS Form:1
Age:0.02
Sex:Male
Location:New Hampshire
Vaccinated:2011-05-16
Onset:2011-05-28
Submitted:2011-09-12
Entered:2011-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 8482Z / 1 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-28
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': 08121114

Write-up: Death.


Changed on 9/14/2018

VAERS ID: 435682 Before After
VAERS Form:1
Age:0.02
Sex:Male
Location:New Hampshire
Vaccinated:2011-05-16
Onset:2011-05-28
Submitted:2011-09-12
Entered:2011-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 8482Z / 1 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-28
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': 08121114

Write-up: Death.


Changed on 10/14/2018

VAERS ID: 435682 Before After
VAERS Form:1
Age:0.02
Sex:Male
Location:New Hampshire
Vaccinated:2011-05-16
Onset:2011-05-28
Submitted:2011-09-12
Entered:2011-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 8482Z / 1 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-28
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': 08121114

Write-up: Death.


Changed on 12/24/2020

VAERS ID: 435682 Before After
VAERS Form:1
Age:0.02
Sex:Male
Location:New Hampshire
Vaccinated:2011-05-16
Onset:2011-05-28
Submitted:2011-09-12
Entered:2011-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 8482Z / 1 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-28
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': 08121114

Write-up: Death.


Changed on 12/30/2020

VAERS ID: 435682 Before After
VAERS Form:1
Age:0.02
Sex:Male
Location:New Hampshire
Vaccinated:2011-05-16
Onset:2011-05-28
Submitted:2011-09-12
Entered:2011-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 8482Z / 1 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-28
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': 08121114

Write-up: Death.


Changed on 5/7/2021

VAERS ID: 435682 Before After
VAERS Form:1
Age:0.02
Sex:Male
Location:New Hampshire
Vaccinated:2011-05-16
Onset:2011-05-28
Submitted:2011-09-12
Entered:2011-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 8482Z / 1 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-28
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': 08121114

Write-up: Death.


Changed on 5/14/2021

VAERS ID: 435682 Before After
VAERS Form:1
Age:0.02
Sex:Male
Location:New Hampshire
Vaccinated:2011-05-16
Onset:2011-05-28
Submitted:2011-09-12
Entered:2011-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 8482Z / 1 UN / IM

Administered by: Private      Purchased by: Public
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2011-05-28
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': 08121114

Write-up: Death.

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