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This is VAERS ID 74130

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 74130
VAERS Form:
Age:30.0
Sex:Female
Location:New York
Vaccinated:1995-03-31
Onset:1995-04-03
Submitted:1995-05-10
Entered:1995-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE VHA420A6 / 0 LA / IM
OPV: ORIMUNE / LEDERLE 378959 / - - / PO
TD: TD ADSORBED, ADULTS / WYETH 4948083 / - RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: URTICARIA, PRURITUS, ARTHROSIS

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? No
Previous Vaccinations: unk
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: s/p lyme disease-summer 1994
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': s/p lyme disease-summer 1994

Write-up: pt recv vax 31MAR95 & 3APR95 devel pruritis; 4APR95 devel hives on abd, lower back & legs; joints in toes on lt foot swelled; seen by MD given Pred;


Changed on 12/8/2009

VAERS ID: 74130 Before After
VAERS Form:
Age:30.0
Sex:Female
Location:New York
Vaccinated:1995-03-31
Onset:1995-04-03
Submitted:1995-05-10
Entered:1995-05-22 1995-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM VHA420A6 420A6 / 0 LA / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 378959 / - - / PO
TD: TD ADSORBED, ADULTS TD ADSORBED (NO BRAND NAME) / WYETH WYETH PHARMACEUTICALS, INC 4948083 / - RA / IM

Administered by: Private Unknown      Purchased by: Unknown
Symptoms: Osteoarthritis, Pruritus, Urticaria, URTICARIA, PRURITUS, ARTHROSIS

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? No
Previous Vaccinations: unk
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: s/p lyme disease-summer 1994
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type': s/p lyme disease-summer 1994 (blank)

Write-up: pt recv vax 31MAR95 & 3APR95 devel pruritis; 4APR95 devel hives on abd, lower back & legs; joints in toes on lt foot swelled; seen by MD given Pred;


Changed on 8/31/2010

VAERS ID: 74130 Before After
VAERS Form:
Age:30.0
Sex:Female
Location:New York
Vaccinated:1995-03-31
Onset:1995-04-03
Submitted:1995-05-10
Entered:1995-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 0 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES 378959 / - - / PO
TD: TD ADSORBED (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4948083 / - RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Osteoarthritis, Pruritus, Urticaria

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? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: s/p lyme disease-summer 1994
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt recv vax 31MAR95 & 3APR95 devel pruritis; 4APR95 devel hives on abd, lower back & legs; joints in toes on lt foot swelled; seen by MD given Pred;


Changed on 5/14/2017

VAERS ID: 74130 Before After
VAERS Form:
Age:30.0
Sex:Female
Location:New York
Vaccinated:1995-03-31
Onset:1995-04-03
Submitted:1995-05-10
Entered:1995-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 0 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 378959 / - - / PO
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4948083 / - RA / IM

Administered by: Unknown Private      Purchased by: Unknown Private
Symptoms: Osteoarthritis, Pruritus, Urticaria

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? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: s/p lyme disease-summer 1994
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt recv vax 31MAR95 & 3APR95 devel pruritis; 4APR95 devel hives on abd, lower back & legs; joints in toes on lt foot swelled; seen by MD given Pred;


Changed on 9/14/2017

VAERS ID: 74130 Before After
VAERS Form:(blank) 1
Age:30.0
Sex:Female
Location:New York
Vaccinated:1995-03-31
Onset:1995-04-03
Submitted:1995-05-10
Entered:1995-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 0 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 378959 / - UNK - MO / PO
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4948083 / - UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Osteoarthritis, Pruritus, Urticaria

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? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: s/p lyme disease-summer 1994
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt recv vax 31MAR95 & 3APR95 devel pruritis; 4APR95 devel hives on abd, lower back & legs; joints in toes on lt foot swelled; seen by MD given Pred;


Changed on 2/14/2018

VAERS ID: 74130 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:New York
Vaccinated:1995-03-31
Onset:1995-04-03
Submitted:1995-05-10
Entered:1995-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 378959 / UNK MO / PO
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4948083 / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Osteoarthritis, Pruritus, Urticaria

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? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: s/p lyme disease-summer 1994
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt recv vax 31MAR95 & 3APR95 devel pruritis; 4APR95 devel hives on abd, lower back & legs; joints in toes on lt foot swelled; seen by MD given Pred;


Changed on 6/14/2018

VAERS ID: 74130 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:New York
Vaccinated:1995-03-31
Onset:1995-04-03
Submitted:1995-05-10
Entered:1995-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 378959 / UNK MO / PO
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4948083 / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Osteoarthritis, Pruritus, Urticaria

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? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: s/p lyme disease-summer 1994
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt recv vax 31MAR95 & 3APR95 devel pruritis; 4APR95 devel hives on abd, lower back & legs; joints in toes on lt foot swelled; seen by MD given Pred;


Changed on 8/14/2018

VAERS ID: 74130 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:New York
Vaccinated:1995-03-31
Onset:1995-04-03
Submitted:1995-05-10
Entered:1995-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 378959 / UNK MO / PO
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4948083 / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Osteoarthritis, Pruritus, Urticaria

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? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: s/p lyme disease-summer 1994
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt recv vax 31MAR95 & 3APR95 devel pruritis; 4APR95 devel hives on abd, lower back & legs; joints in toes on lt foot swelled; seen by MD given Pred;


Changed on 9/14/2018

VAERS ID: 74130 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:New York
Vaccinated:1995-03-31
Onset:1995-04-03
Submitted:1995-05-10
Entered:1995-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 378959 / UNK MO / PO
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4948083 / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Osteoarthritis, Pruritus, Urticaria

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? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: s/p lyme disease-summer 1994
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt recv vax 31MAR95 & 3APR95 devel pruritis; 4APR95 devel hives on abd, lower back & legs; joints in toes on lt foot swelled; seen by MD given Pred;


Changed on 10/14/2018

VAERS ID: 74130 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:New York
Vaccinated:1995-03-31
Onset:1995-04-03
Submitted:1995-05-10
Entered:1995-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 378959 / UNK MO / PO
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4948083 / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Osteoarthritis, Pruritus, Urticaria

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? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: s/p lyme disease-summer 1994
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt recv vax 31MAR95 & 3APR95 devel pruritis; 4APR95 devel hives on abd, lower back & legs; joints in toes on lt foot swelled; seen by MD given Pred;


Changed on 12/24/2020

VAERS ID: 74130 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:New York
Vaccinated:1995-03-31
Onset:1995-04-03
Submitted:1995-05-10
Entered:1995-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 378959 / UNK MO / PO
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4948083 / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Osteoarthritis, Pruritus, Urticaria

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? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: s/p lyme disease-summer 1994
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt recv vax 31MAR95 & 3APR95 devel pruritis; 4APR95 devel hives on abd, lower back & legs; joints in toes on lt foot swelled; seen by MD given Pred;


Changed on 12/30/2020

VAERS ID: 74130 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:New York
Vaccinated:1995-03-31
Onset:1995-04-03
Submitted:1995-05-10
Entered:1995-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 378959 / UNK MO / PO
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4948083 / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Osteoarthritis, Pruritus, Urticaria

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? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: s/p lyme disease-summer 1994
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt recv vax 31MAR95 & 3APR95 devel pruritis; 4APR95 devel hives on abd, lower back & legs; joints in toes on lt foot swelled; seen by MD given Pred;


Changed on 5/7/2021

VAERS ID: 74130 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:New York
Vaccinated:1995-03-31
Onset:1995-04-03
Submitted:1995-05-10
Entered:1995-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 378959 / UNK MO / PO
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4948083 / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Osteoarthritis, Pruritus, Urticaria

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? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: s/p lyme disease-summer 1994
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt recv vax 31MAR95 & 3APR95 devel pruritis; 4APR95 devel hives on abd, lower back & legs; joints in toes on lt foot swelled; seen by MD given Pred;


Changed on 5/14/2021

VAERS ID: 74130 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:New York
Vaccinated:1995-03-31
Onset:1995-04-03
Submitted:1995-05-10
Entered:1995-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 1 LA / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 378959 / UNK MO / PO
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4948083 / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Osteoarthritis, Pruritus, Urticaria

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? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: s/p lyme disease-summer 1994
Allergies:
Diagnostic Lab Data: unk
CDC 'Split Type':

Write-up: pt recv vax 31MAR95 & 3APR95 devel pruritis; 4APR95 devel hives on abd, lower back & legs; joints in toes on lt foot swelled; seen by MD given Pred;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=74130&WAYBACKHISTORY=ON

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