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This is VAERS ID 74483

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 74483
VAERS Form:
Age:56.2
Sex:Male
Location:Pennsylvania
Vaccinated:1995-05-15
Onset:1995-05-19
Submitted:1995-05-30
Entered:1995-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE - / - - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: CHILLS, FEVER, MYALGIA, INSOMNIA, CONJUNCTIVITIS

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: insulin, hytrin, prozac;
Current Illness: none
Preexisting Conditions: Insulin-dependent diabetes mellitus;
Allergies:
Diagnostic Lab Data: CBC, U/A, ESR, SMA-12 (incl CPK), CXR, EKG all nl;
CDC 'Split Type':

Write-up: pt recv vax;lower limb girdle ache followed w/in 24 hr upper limb girdle aches;awakened fr sleep;ASA, codeine; no tenderness or weakness;fever to 102R; chills & mild conjunctivitis but disappeared on 28may95;


Changed on 12/8/2009

VAERS ID: 74483 Before After
VAERS Form:
Age:56.2
Sex:Male
Location:Pennsylvania
Vaccinated:1995-05-15
Onset:1995-05-19
Submitted:1995-05-30
Entered:1995-06-07 1995-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM - / - - / -

Administered by: Unknown      Purchased by: Unknown Private
Symptoms: Chills, Conjunctivitis, Insomnia, Myalgia, Pyrexia, CHILLS, FEVER, MYALGIA, INSOMNIA, CONJUNCTIVITIS

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: insulin, hytrin, prozac;
Current Illness: none
Preexisting Conditions: Insulin-dependent diabetes mellitus;
Allergies:
Diagnostic Lab Data: CBC, U/A, ESR, SMA-12 (incl CPK), CXR, EKG all nl;
CDC 'Split Type':

Write-up: pt recv vax;lower limb girdle ache followed w/in 24 hr upper limb girdle aches;awakened fr sleep;ASA, codeine; no tenderness or weakness;fever to 102R; chills & mild conjunctivitis but disappeared on 28may95;


Changed on 2/14/2017

VAERS ID: 74483 Before After
VAERS Form:
Age:56.2 56.0
Sex:Male
Location:Pennsylvania
Vaccinated:1995-05-15
Onset:1995-05-19
Submitted:1995-05-30
Entered:1995-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / - - / -

Administered by: Unknown      Purchased by: Private
Symptoms: Chills, Conjunctivitis, Insomnia, Myalgia, Pyrexia

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: insulin, hytrin, prozac;
Current Illness: none
Preexisting Conditions: Insulin-dependent diabetes mellitus;
Allergies:
Diagnostic Lab Data: CBC, U/A, ESR, SMA-12 (incl CPK), CXR, EKG all nl;
CDC 'Split Type':

Write-up: pt recv vax;lower limb girdle ache followed w/in 24 hr upper limb girdle aches;awakened fr sleep;ASA, codeine; no tenderness or weakness;fever to 102R; chills & mild conjunctivitis but disappeared on 28may95;


Changed on 5/14/2017

VAERS ID: 74483 Before After
VAERS Form:
Age:56.0
Sex:Male
Location:Pennsylvania
Vaccinated:1995-05-15
Onset:1995-05-19
Submitted:1995-05-30
Entered:1995-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / - - / -

Administered by: Unknown      Purchased by: Private
Symptoms: Chills, Conjunctivitis, Insomnia, Myalgia, Pyrexia

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: ~ ()~~~In patient
Other Medications: insulin, hytrin, prozac;
Current Illness: none
Preexisting Conditions: Insulin-dependent diabetes mellitus;
Allergies:
Diagnostic Lab Data: CBC, U/A, ESR, SMA-12 (incl CPK), CXR, EKG all nl;
CDC 'Split Type':

Write-up: pt recv vax;lower limb girdle ache followed w/in 24 hr upper limb girdle aches;awakened fr sleep;ASA, codeine; no tenderness or weakness;fever to 102R; chills & mild conjunctivitis but disappeared on 28may95;


Changed on 9/14/2017

VAERS ID: 74483 Before After
VAERS Form:(blank) 1
Age:56.0
Sex:Male
Location:Pennsylvania
Vaccinated:1995-05-15
Onset:1995-05-19
Submitted:1995-05-30
Entered:1995-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / - UNK - / -

Administered by: Unknown      Purchased by: Private
Symptoms: Chills, Conjunctivitis, Insomnia, Myalgia, Pyrexia

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: ~ ()~~~In patient
Other Medications: insulin, hytrin, prozac;
Current Illness: none
Preexisting Conditions: Insulin-dependent diabetes mellitus;
Allergies:
Diagnostic Lab Data: CBC, U/A, ESR, SMA-12 (incl CPK), CXR, EKG all nl;
CDC 'Split Type':

Write-up: pt recv vax;lower limb girdle ache followed w/in 24 hr upper limb girdle aches;awakened fr sleep;ASA, codeine; no tenderness or weakness;fever to 102R; chills & mild conjunctivitis but disappeared on 28may95;


Changed on 2/14/2018

VAERS ID: 74483 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:Pennsylvania
Vaccinated:1995-05-15
Onset:1995-05-19
Submitted:1995-05-30
Entered:1995-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Unknown      Purchased by: Private
Symptoms: Chills, Conjunctivitis, Insomnia, Myalgia, Pyrexia

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: ~ ()~~~In patient
Other Medications: insulin, hytrin, prozac;
Current Illness: none
Preexisting Conditions: Insulin-dependent diabetes mellitus;
Allergies:
Diagnostic Lab Data: CBC, U/A, ESR, SMA-12 (incl CPK), CXR, EKG all nl;
CDC 'Split Type':

Write-up: pt recv vax;lower limb girdle ache followed w/in 24 hr upper limb girdle aches;awakened fr sleep;ASA, codeine; no tenderness or weakness;fever to 102R; chills & mild conjunctivitis but disappeared on 28may95;


Changed on 6/14/2018

VAERS ID: 74483 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:Pennsylvania
Vaccinated:1995-05-15
Onset:1995-05-19
Submitted:1995-05-30
Entered:1995-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Unknown      Purchased by: Private
Symptoms: Chills, Conjunctivitis, Insomnia, Myalgia, Pyrexia

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: ~ ()~~~In patient
Other Medications: insulin, hytrin, prozac;
Current Illness: none
Preexisting Conditions: Insulin-dependent diabetes mellitus;
Allergies:
Diagnostic Lab Data: CBC, U/A, ESR, SMA-12 (incl CPK), CXR, EKG all nl;
CDC 'Split Type':

Write-up: pt recv vax;lower limb girdle ache followed w/in 24 hr upper limb girdle aches;awakened fr sleep;ASA, codeine; no tenderness or weakness;fever to 102R; chills & mild conjunctivitis but disappeared on 28may95;


Changed on 8/14/2018

VAERS ID: 74483 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:Pennsylvania
Vaccinated:1995-05-15
Onset:1995-05-19
Submitted:1995-05-30
Entered:1995-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Unknown      Purchased by: Private
Symptoms: Chills, Conjunctivitis, Insomnia, Myalgia, Pyrexia

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: ~ ()~~~In patient
Other Medications: insulin, hytrin, prozac;
Current Illness: none
Preexisting Conditions: Insulin-dependent diabetes mellitus;
Allergies:
Diagnostic Lab Data: CBC, U/A, ESR, SMA-12 (incl CPK), CXR, EKG all nl;
CDC 'Split Type':

Write-up: pt recv vax;lower limb girdle ache followed w/in 24 hr upper limb girdle aches;awakened fr sleep;ASA, codeine; no tenderness or weakness;fever to 102R; chills & mild conjunctivitis but disappeared on 28may95;


Changed on 9/14/2018

VAERS ID: 74483 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:Pennsylvania
Vaccinated:1995-05-15
Onset:1995-05-19
Submitted:1995-05-30
Entered:1995-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Unknown      Purchased by: Private
Symptoms: Chills, Conjunctivitis, Insomnia, Myalgia, Pyrexia

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: ~ ()~~~In patient
Other Medications: insulin, hytrin, prozac;
Current Illness: none
Preexisting Conditions: Insulin-dependent diabetes mellitus;
Allergies:
Diagnostic Lab Data: CBC, U/A, ESR, SMA-12 (incl CPK), CXR, EKG all nl;
CDC 'Split Type':

Write-up: pt recv vax;lower limb girdle ache followed w/in 24 hr upper limb girdle aches;awakened fr sleep;ASA, codeine; no tenderness or weakness;fever to 102R; chills & mild conjunctivitis but disappeared on 28may95;


Changed on 10/14/2018

VAERS ID: 74483 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:Pennsylvania
Vaccinated:1995-05-15
Onset:1995-05-19
Submitted:1995-05-30
Entered:1995-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Unknown      Purchased by: Private
Symptoms: Chills, Conjunctivitis, Insomnia, Myalgia, Pyrexia

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: ~ ()~~~In patient
Other Medications: insulin, hytrin, prozac;
Current Illness: none
Preexisting Conditions: Insulin-dependent diabetes mellitus;
Allergies:
Diagnostic Lab Data: CBC, U/A, ESR, SMA-12 (incl CPK), CXR, EKG all nl;
CDC 'Split Type':

Write-up: pt recv vax;lower limb girdle ache followed w/in 24 hr upper limb girdle aches;awakened fr sleep;ASA, codeine; no tenderness or weakness;fever to 102R; chills & mild conjunctivitis but disappeared on 28may95;


Changed on 12/24/2020

VAERS ID: 74483 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:Pennsylvania
Vaccinated:1995-05-15
Onset:1995-05-19
Submitted:1995-05-30
Entered:1995-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Unknown      Purchased by: Private
Symptoms: Chills, Conjunctivitis, Insomnia, Myalgia, Pyrexia

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: ~ ()~~~In patient
Other Medications: insulin, hytrin, prozac;
Current Illness: none
Preexisting Conditions: Insulin-dependent diabetes mellitus;
Allergies:
Diagnostic Lab Data: CBC, U/A, ESR, SMA-12 (incl CPK), CXR, EKG all nl;
CDC 'Split Type':

Write-up: pt recv vax;lower limb girdle ache followed w/in 24 hr upper limb girdle aches;awakened fr sleep;ASA, codeine; no tenderness or weakness;fever to 102R; chills & mild conjunctivitis but disappeared on 28may95;


Changed on 12/30/2020

VAERS ID: 74483 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:Pennsylvania
Vaccinated:1995-05-15
Onset:1995-05-19
Submitted:1995-05-30
Entered:1995-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Unknown      Purchased by: Private
Symptoms: Chills, Conjunctivitis, Insomnia, Myalgia, Pyrexia

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: ~ ()~~~In patient
Other Medications: insulin, hytrin, prozac;
Current Illness: none
Preexisting Conditions: Insulin-dependent diabetes mellitus;
Allergies:
Diagnostic Lab Data: CBC, U/A, ESR, SMA-12 (incl CPK), CXR, EKG all nl;
CDC 'Split Type':

Write-up: pt recv vax;lower limb girdle ache followed w/in 24 hr upper limb girdle aches;awakened fr sleep;ASA, codeine; no tenderness or weakness;fever to 102R; chills & mild conjunctivitis but disappeared on 28may95;


Changed on 5/7/2021

VAERS ID: 74483 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:Pennsylvania
Vaccinated:1995-05-15
Onset:1995-05-19
Submitted:1995-05-30
Entered:1995-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Unknown      Purchased by: Private
Symptoms: Chills, Conjunctivitis, Insomnia, Myalgia, Pyrexia

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: ~ ()~~~In patient
Other Medications: insulin, hytrin, prozac;
Current Illness: none
Preexisting Conditions: Insulin-dependent diabetes mellitus;
Allergies:
Diagnostic Lab Data: CBC, U/A, ESR, SMA-12 (incl CPK), CXR, EKG all nl;
CDC 'Split Type':

Write-up: pt recv vax;lower limb girdle ache followed w/in 24 hr upper limb girdle aches;awakened fr sleep;ASA, codeine; no tenderness or weakness;fever to 102R; chills & mild conjunctivitis but disappeared on 28may95;


Changed on 5/14/2021

VAERS ID: 74483 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:Pennsylvania
Vaccinated:1995-05-15
Onset:1995-05-19
Submitted:1995-05-30
Entered:1995-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Unknown      Purchased by: Private
Symptoms: Chills, Conjunctivitis, Insomnia, Myalgia, Pyrexia

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: ~ ()~~~In patient
Other Medications: insulin, hytrin, prozac;
Current Illness: none
Preexisting Conditions: Insulin-dependent diabetes mellitus;
Allergies:
Diagnostic Lab Data: CBC, U/A, ESR, SMA-12 (incl CPK), CXR, EKG all nl;
CDC 'Split Type':

Write-up: pt recv vax;lower limb girdle ache followed w/in 24 hr upper limb girdle aches;awakened fr sleep;ASA, codeine; no tenderness or weakness;fever to 102R; chills & mild conjunctivitis but disappeared on 28may95;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=74483&WAYBACKHISTORY=ON

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