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This is VAERS ID 79971

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 79971
VAERS Form:
Age:30.1
Sex:Female
Location:California
Vaccinated:1995-08-30
Onset:0000-00-00
Submitted:0000-00-00
Entered:1995-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE VHA429A6 / - - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
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: Macrodantin, Triphasil
Current Illness:
Preexisting Conditions: allergy to PCN & sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 30AUG95 pt recvd vax & about 5PM that evening had a nap gen itching noticed hives next morning on lt & rt elbow & lt & rt upper thigh;hives lasted til 5SEP when they completely disappeared;hives were localized to areas described above;


Changed on 12/8/2009

VAERS ID: 79971 Before After
VAERS Form:
Age:30.1
Sex:Female
Location:California
Vaccinated:1995-08-30
Onset:0000-00-00
Submitted:0000-00-00
Entered:1995-12-15 1995-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM VHA429A6 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pruritus, Urticaria, URTICARIA, PRURITUS

Life Threatening? No
Birth Defect? No
Died? No
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: Macrodantin, Triphasil
Current Illness:
Preexisting Conditions: allergy to PCN & sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 30AUG95 pt recvd vax & about 5PM that evening had a nap gen itching noticed hives next morning on lt & rt elbow & lt & rt upper thigh;hives lasted til 5SEP when they completely disappeared;hives were localized to areas described above;


Changed on 2/14/2017

VAERS ID: 79971 Before After
VAERS Form:
Age:30.1 30.0
Sex:Female
Location:California
Vaccinated:1995-08-30
Onset:0000-00-00
Submitted:0000-00-00
Entered:1995-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA429A6 / - - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
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: Macrodantin, Triphasil
Current Illness:
Preexisting Conditions: allergy to PCN & sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 30AUG95 pt recvd vax & about 5PM that evening had a nap gen itching noticed hives next morning on lt & rt elbow & lt & rt upper thigh;hives lasted til 5SEP when they completely disappeared;hives were localized to areas described above;


Changed on 5/14/2017

VAERS ID: 79971 Before After
VAERS Form:
Age:30.0
Sex:Female
Location:California
Vaccinated:1995-08-30
Onset:0000-00-00
Submitted:0000-00-00
Entered:1995-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA429A6 / - - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications: Macrodantin, Triphasil
Current Illness:
Preexisting Conditions: allergy to PCN & sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 30AUG95 pt recvd vax & about 5PM that evening had a nap gen itching noticed hives next morning on lt & rt elbow & lt & rt upper thigh;hives lasted til 5SEP when they completely disappeared;hives were localized to areas described above;


Changed on 9/14/2017

VAERS ID: 79971 Before After
VAERS Form:(blank) 1
Age:30.0
Sex:Female
Location:California
Vaccinated:1995-08-30
Onset:0000-00-00
Submitted:0000-00-00
Entered:1995-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA429A6 / - UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications: Macrodantin, Triphasil
Current Illness:
Preexisting Conditions: allergy to PCN & sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 30AUG95 pt recvd vax & about 5PM that evening had a nap gen itching noticed hives next morning on lt & rt elbow & lt & rt upper thigh;hives lasted til 5SEP when they completely disappeared;hives were localized to areas described above;


Changed on 2/14/2018

VAERS ID: 79971 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:California
Vaccinated:1995-08-30
Onset:0000-00-00
Submitted:0000-00-00
Entered:1995-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA429A6 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications: Macrodantin, Triphasil
Current Illness:
Preexisting Conditions: allergy to PCN & sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 30AUG95 pt recvd vax & about 5PM that evening had a nap gen itching noticed hives next morning on lt & rt elbow & lt & rt upper thigh;hives lasted til 5SEP when they completely disappeared;hives were localized to areas described above;


Changed on 6/14/2018

VAERS ID: 79971 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:California
Vaccinated:1995-08-30
Onset:0000-00-00
Submitted:0000-00-00
Entered:1995-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA429A6 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications: Macrodantin, Triphasil
Current Illness:
Preexisting Conditions: allergy to PCN & sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 30AUG95 pt recvd vax & about 5PM that evening had a nap gen itching noticed hives next morning on lt & rt elbow & lt & rt upper thigh;hives lasted til 5SEP when they completely disappeared;hives were localized to areas described above;


Changed on 8/14/2018

VAERS ID: 79971 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:California
Vaccinated:1995-08-30
Onset:0000-00-00
Submitted:0000-00-00
Entered:1995-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA429A6 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications: Macrodantin, Triphasil
Current Illness:
Preexisting Conditions: allergy to PCN & sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 30AUG95 pt recvd vax & about 5PM that evening had a nap gen itching noticed hives next morning on lt & rt elbow & lt & rt upper thigh;hives lasted til 5SEP when they completely disappeared;hives were localized to areas described above;


Changed on 9/14/2018

VAERS ID: 79971 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:California
Vaccinated:1995-08-30
Onset:0000-00-00
Submitted:0000-00-00
Entered:1995-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA429A6 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications: Macrodantin, Triphasil
Current Illness:
Preexisting Conditions: allergy to PCN & sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 30AUG95 pt recvd vax & about 5PM that evening had a nap gen itching noticed hives next morning on lt & rt elbow & lt & rt upper thigh;hives lasted til 5SEP when they completely disappeared;hives were localized to areas described above;


Changed on 10/14/2018

VAERS ID: 79971 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:California
Vaccinated:1995-08-30
Onset:0000-00-00
Submitted:0000-00-00
Entered:1995-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA429A6 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications: Macrodantin, Triphasil
Current Illness:
Preexisting Conditions: allergy to PCN & sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 30AUG95 pt recvd vax & about 5PM that evening had a nap gen itching noticed hives next morning on lt & rt elbow & lt & rt upper thigh;hives lasted til 5SEP when they completely disappeared;hives were localized to areas described above;


Changed on 12/24/2020

VAERS ID: 79971 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:California
Vaccinated:1995-08-30
Onset:0000-00-00
Submitted:0000-00-00
Entered:1995-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA429A6 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications: Macrodantin, Triphasil
Current Illness:
Preexisting Conditions: allergy to PCN & sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 30AUG95 pt recvd vax & about 5PM that evening had a nap gen itching noticed hives next morning on lt & rt elbow & lt & rt upper thigh;hives lasted til 5SEP when they completely disappeared;hives were localized to areas described above;


Changed on 12/30/2020

VAERS ID: 79971 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:California
Vaccinated:1995-08-30
Onset:0000-00-00
Submitted:0000-00-00
Entered:1995-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA429A6 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications: Macrodantin, Triphasil
Current Illness:
Preexisting Conditions: allergy to PCN & sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 30AUG95 pt recvd vax & about 5PM that evening had a nap gen itching noticed hives next morning on lt & rt elbow & lt & rt upper thigh;hives lasted til 5SEP when they completely disappeared;hives were localized to areas described above;


Changed on 5/7/2021

VAERS ID: 79971 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:California
Vaccinated:1995-08-30
Onset:0000-00-00
Submitted:0000-00-00
Entered:1995-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA429A6 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications: Macrodantin, Triphasil
Current Illness:
Preexisting Conditions: allergy to PCN & sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 30AUG95 pt recvd vax & about 5PM that evening had a nap gen itching noticed hives next morning on lt & rt elbow & lt & rt upper thigh;hives lasted til 5SEP when they completely disappeared;hives were localized to areas described above;


Changed on 5/14/2021

VAERS ID: 79971 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:California
Vaccinated:1995-08-30
Onset:0000-00-00
Submitted:0000-00-00
Entered:1995-12-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA429A6 / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
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: ~ ()~~~In patient
Other Medications: Macrodantin, Triphasil
Current Illness:
Preexisting Conditions: allergy to PCN & sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 30AUG95 pt recvd vax & about 5PM that evening had a nap gen itching noticed hives next morning on lt & rt elbow & lt & rt upper thigh;hives lasted til 5SEP when they completely disappeared;hives were localized to areas described above;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=79971&WAYBACKHISTORY=ON


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