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This is VAERS ID 75247

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 75247
VAERS Form:
Age:31.5
Sex:Female
Location:Pennsylvania
Vaccinated:1995-05-12
Onset:1995-05-15
Submitted:1995-06-10
Entered:1995-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE V8A427A6 / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: PRURITUS, RASH MAC PAP

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Tri-levlin BCP''s;
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Nonerythematous papular rash, pruritic, generalized @ 10 days; began @ 3 d p/immunization; rx: DPH/chlortrimeton;


Changed on 12/8/2009

VAERS ID: 75247 Before After
VAERS Form:
Age:31.5 31.0
Sex:Female
Location:Pennsylvania
Vaccinated:1995-05-12
Onset:1995-05-15
Submitted:1995-06-10
Entered:1995-06-26 1995-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM V8A427A6 427A6 / 0 RA / IM

Administered by: Private Unknown      Purchased by: Unknown
Symptoms: Pruritus, Rash maculo-papular, PRURITUS, RASH MAC PAP

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Tri-levlin BCP''s;
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Nonerythematous papular rash, pruritic, generalized @ 10 days; began @ 3 d p/immunization; rx: DPH/chlortrimeton;


Changed on 5/14/2017

VAERS ID: 75247 Before After
VAERS Form:
Age:31.0
Sex:Female
Location:Pennsylvania
Vaccinated:1995-05-12
Onset:1995-05-15
Submitted:1995-06-10
Entered:1995-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 427A6 / 0 RA / IM

Administered by: Unknown Private      Purchased by: Unknown Private
Symptoms: Pruritus, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Tri-levlin BCP''s;
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Nonerythematous papular rash, pruritic, generalized @ 10 days; began @ 3 d p/immunization; rx: DPH/chlortrimeton;


Changed on 9/14/2017

VAERS ID: 75247 Before After
VAERS Form:(blank) 1
Age:31.0
Sex:Female
Location:Pennsylvania
Vaccinated:1995-05-12
Onset:1995-05-15
Submitted:1995-06-10
Entered:1995-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 427A6 / 0 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Tri-levlin BCP''s;
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Nonerythematous papular rash, pruritic, generalized @ 10 days; began @ 3 d p/immunization; rx: DPH/chlortrimeton;


Changed on 2/14/2018

VAERS ID: 75247 Before After
VAERS Form:1
Age:31.0
Sex:Female
Location:Pennsylvania
Vaccinated:1995-05-12
Onset:1995-05-15
Submitted:1995-06-10
Entered:1995-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 427A6 / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Tri-levlin BCP''s;
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Nonerythematous papular rash, pruritic, generalized @ 10 days; began @ 3 d p/immunization; rx: DPH/chlortrimeton;


Changed on 6/14/2018

VAERS ID: 75247 Before After
VAERS Form:1
Age:31.0
Sex:Female
Location:Pennsylvania
Vaccinated:1995-05-12
Onset:1995-05-15
Submitted:1995-06-10
Entered:1995-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 427A6 / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Tri-levlin BCP''s;
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Nonerythematous papular rash, pruritic, generalized @ 10 days; began @ 3 d p/immunization; rx: DPH/chlortrimeton;


Changed on 8/14/2018

VAERS ID: 75247 Before After
VAERS Form:1
Age:31.0
Sex:Female
Location:Pennsylvania
Vaccinated:1995-05-12
Onset:1995-05-15
Submitted:1995-06-10
Entered:1995-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 427A6 / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Tri-levlin BCP''s;
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Nonerythematous papular rash, pruritic, generalized @ 10 days; began @ 3 d p/immunization; rx: DPH/chlortrimeton;


Changed on 9/14/2018

VAERS ID: 75247 Before After
VAERS Form:1
Age:31.0
Sex:Female
Location:Pennsylvania
Vaccinated:1995-05-12
Onset:1995-05-15
Submitted:1995-06-10
Entered:1995-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 427A6 / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Tri-levlin BCP''s;
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Nonerythematous papular rash, pruritic, generalized @ 10 days; began @ 3 d p/immunization; rx: DPH/chlortrimeton;


Changed on 10/14/2018

VAERS ID: 75247 Before After
VAERS Form:1
Age:31.0
Sex:Female
Location:Pennsylvania
Vaccinated:1995-05-12
Onset:1995-05-15
Submitted:1995-06-10
Entered:1995-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 427A6 / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Tri-levlin BCP''s;
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Nonerythematous papular rash, pruritic, generalized @ 10 days; began @ 3 d p/immunization; rx: DPH/chlortrimeton;


Changed on 12/10/2020

VAERS ID: 75247 Before After
VAERS Form:1
Age:31.0
Sex:Female
Location:Pennsylvania Georgia
Vaccinated:1995-05-12
Onset:1995-05-15
Submitted:1995-06-10
Entered:1995-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 427A6 / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Tri-levlin BCP''s;
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Nonerythematous papular rash, pruritic, generalized @ 10 days; began @ 3 d p/immunization; rx: DPH/chlortrimeton;


Changed on 12/24/2020

VAERS ID: 75247 Before After
VAERS Form:1
Age:31.0
Sex:Female
Location:Georgia
Vaccinated:1995-05-12
Onset:1995-05-15
Submitted:1995-06-10
Entered:1995-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 427A6 / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Tri-levlin BCP''s;
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Nonerythematous papular rash, pruritic, generalized @ 10 days; began @ 3 d p/immunization; rx: DPH/chlortrimeton;


Changed on 12/30/2020

VAERS ID: 75247 Before After
VAERS Form:1
Age:31.0
Sex:Female
Location:Georgia
Vaccinated:1995-05-12
Onset:1995-05-15
Submitted:1995-06-10
Entered:1995-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 427A6 / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Tri-levlin BCP''s;
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Nonerythematous papular rash, pruritic, generalized @ 10 days; began @ 3 d p/immunization; rx: DPH/chlortrimeton;


Changed on 5/7/2021

VAERS ID: 75247 Before After
VAERS Form:1
Age:31.0
Sex:Female
Location:Georgia
Vaccinated:1995-05-12
Onset:1995-05-15
Submitted:1995-06-10
Entered:1995-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 427A6 / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Tri-levlin BCP''s;
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Nonerythematous papular rash, pruritic, generalized @ 10 days; began @ 3 d p/immunization; rx: DPH/chlortrimeton;


Changed on 5/14/2021

VAERS ID: 75247 Before After
VAERS Form:1
Age:31.0
Sex:Female
Location:Georgia
Vaccinated:1995-05-12
Onset:1995-05-15
Submitted:1995-06-10
Entered:1995-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 427A6 / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Rash maculo-papular

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Tri-levlin BCP''s;
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Nonerythematous papular rash, pruritic, generalized @ 10 days; began @ 3 d p/immunization; rx: DPH/chlortrimeton;

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