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This is VAERS ID 80357

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 80357
VAERS Form:
Age:72.6
Sex:Female
Location:Florida
Vaccinated:1995-11-13
Onset:1995-11-13
Submitted:1995-11-27
Entered:1996-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE VHA460A6 / 0 RA / IM
TYP: TYPHOID / WYETH 4958185 / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: MYALGIA, PAIN, EDEMA PERIPH, ECCHYMOSIS

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: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine

Write-up: 13NOV95 pt devel 2" swelling in rt delt-IM w/in 1 min of vax;pt didn''t know of having prev rxn to any components of vax;pt advised to put ice on it&go to ER if diff breathing;27NOV95 pt concerned w/yellow circle w/4 10" purple specks


Changed on 12/8/2009

VAERS ID: 80357 Before After
VAERS Form:
Age:72.6
Sex:Female
Location:Florida
Vaccinated:1995-11-13
Onset:1995-11-13
Submitted:1995-11-27
Entered:1996-01-02 1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM VHA460A6 / 0 RA / IM
TYP: TYPHOID TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / WYETH WYETH PHARMACEUTICALS, INC 4958185 / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Ecchymosis, Myalgia, Oedema peripheral, Pain, MYALGIA, PAIN, EDEMA PERIPH, ECCHYMOSIS

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: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine FL95091

Write-up: 13NOV95 pt devel 2" swelling in rt delt-IM w/in 1 min of vax;pt didn''t know of having prev rxn to any components of vax;pt advised to put ice on it&go to ER if diff breathing;27NOV95 pt concerned w/yellow circle w/4 10" purple specks


Changed on 8/31/2010

VAERS ID: 80357 Before After
VAERS Form:
Age:72.6
Sex:Female
Location:Florida
Vaccinated:1995-11-13
Onset:1995-11-13
Submitted:1995-11-27
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 0 RA / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4958185 / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Ecchymosis, Myalgia, Oedema peripheral, Pain

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: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FL95091

Write-up: 13NOV95 pt devel 2" swelling in rt delt-IM w/in 1 min of vax;pt didn''t know of having prev rxn to any components of vax;pt advised to put ice on it&go to ER if diff breathing;27NOV95 pt concerned w/yellow circle w/4 10" purple specks


Changed on 2/14/2017

VAERS ID: 80357 Before After
VAERS Form:
Age:72.6 72.0
Sex:Female
Location:Florida
Vaccinated:1995-11-13
Onset:1995-11-13
Submitted:1995-11-27
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 0 RA / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958185 / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Ecchymosis, Myalgia, Oedema peripheral, Pain

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: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FL95091

Write-up: 13NOV95 pt devel 2" swelling in rt delt-IM w/in 1 min of vax;pt didn''t know of having prev rxn to any components of vax;pt advised to put ice on it&go to ER if diff breathing;27NOV95 pt concerned w/yellow circle w/4 10" purple specks


Changed on 5/14/2017

VAERS ID: 80357 Before After
VAERS Form:
Age:72.0
Sex:Female
Location:Florida
Vaccinated:1995-11-13
Onset:1995-11-13
Submitted:1995-11-27
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 0 RA / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958185 / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Ecchymosis, Myalgia, Oedema peripheral, Pain

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: NONE NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FL95091

Write-up: 13NOV95 pt devel 2" swelling in rt delt-IM w/in 1 min of vax;pt didn''t know of having prev rxn to any components of vax;pt advised to put ice on it&go to ER if diff breathing;27NOV95 pt concerned w/yellow circle w/4 10" purple specks


Changed on 9/14/2017

VAERS ID: 80357 Before After
VAERS Form:(blank) 1
Age:72.0
Sex:Female
Location:Florida
Vaccinated:1995-11-13
Onset:1995-11-13
Submitted:1995-11-27
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 0 1 RA / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958185 / 1 2 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Ecchymosis, Myalgia, Oedema peripheral, Pain

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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FL95091

Write-up: 13NOV95 pt devel 2" swelling in rt delt-IM w/in 1 min of vax;pt didn''t know of having prev rxn to any components of vax;pt advised to put ice on it&go to ER if diff breathing;27NOV95 pt concerned w/yellow circle w/4 10" purple specks


Changed on 2/14/2018

VAERS ID: 80357 Before After
VAERS Form:1
Age:72.0
Sex:Female
Location:Florida
Vaccinated:1995-11-13
Onset:1995-11-13
Submitted:1995-11-27
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 RA / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958185 / 2 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Ecchymosis, Myalgia, Oedema peripheral, Pain

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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FL95091

Write-up: 13NOV95 pt devel 2" swelling in rt delt-IM w/in 1 min of vax;pt didn''t know of having prev rxn to any components of vax;pt advised to put ice on it&go to ER if diff breathing;27NOV95 pt concerned w/yellow circle w/4 10" purple specks


Changed on 6/14/2018

VAERS ID: 80357 Before After
VAERS Form:1
Age:72.0
Sex:Female
Location:Florida
Vaccinated:1995-11-13
Onset:1995-11-13
Submitted:1995-11-27
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 RA / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958185 / 2 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Ecchymosis, Myalgia, Oedema peripheral, Pain

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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FL95091

Write-up: 13NOV95 pt devel 2" swelling in rt delt-IM w/in 1 min of vax;pt didn''t know of having prev rxn to any components of vax;pt advised to put ice on it&go to ER if diff breathing;27NOV95 pt concerned w/yellow circle w/4 10" purple specks


Changed on 8/14/2018

VAERS ID: 80357 Before After
VAERS Form:1
Age:72.0
Sex:Female
Location:Florida
Vaccinated:1995-11-13
Onset:1995-11-13
Submitted:1995-11-27
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 RA / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958185 / 2 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Ecchymosis, Myalgia, Oedema peripheral, Pain

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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FL95091

Write-up: 13NOV95 pt devel 2" swelling in rt delt-IM w/in 1 min of vax;pt didn''t know of having prev rxn to any components of vax;pt advised to put ice on it&go to ER if diff breathing;27NOV95 pt concerned w/yellow circle w/4 10" purple specks


Changed on 9/14/2018

VAERS ID: 80357 Before After
VAERS Form:1
Age:72.0
Sex:Female
Location:Florida
Vaccinated:1995-11-13
Onset:1995-11-13
Submitted:1995-11-27
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 RA / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958185 / 2 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Ecchymosis, Myalgia, Oedema peripheral, Pain

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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FL95091

Write-up: 13NOV95 pt devel 2" swelling in rt delt-IM w/in 1 min of vax;pt didn''t know of having prev rxn to any components of vax;pt advised to put ice on it&go to ER if diff breathing;27NOV95 pt concerned w/yellow circle w/4 10" purple specks


Changed on 10/14/2018

VAERS ID: 80357 Before After
VAERS Form:1
Age:72.0
Sex:Female
Location:Florida
Vaccinated:1995-11-13
Onset:1995-11-13
Submitted:1995-11-27
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 RA / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958185 / 2 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Ecchymosis, Myalgia, Oedema peripheral, Pain

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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FL95091

Write-up: 13NOV95 pt devel 2" swelling in rt delt-IM w/in 1 min of vax;pt didn''t know of having prev rxn to any components of vax;pt advised to put ice on it&go to ER if diff breathing;27NOV95 pt concerned w/yellow circle w/4 10" purple specks


Changed on 12/24/2020

VAERS ID: 80357 Before After
VAERS Form:1
Age:72.0
Sex:Female
Location:Florida
Vaccinated:1995-11-13
Onset:1995-11-13
Submitted:1995-11-27
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 RA / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958185 / 2 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Ecchymosis, Myalgia, Oedema peripheral, Pain

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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FL95091

Write-up: 13NOV95 pt devel 2" swelling in rt delt-IM w/in 1 min of vax;pt didn''t know of having prev rxn to any components of vax;pt advised to put ice on it&go to ER if diff breathing;27NOV95 pt concerned w/yellow circle w/4 10" purple specks


Changed on 12/30/2020

VAERS ID: 80357 Before After
VAERS Form:1
Age:72.0
Sex:Female
Location:Florida
Vaccinated:1995-11-13
Onset:1995-11-13
Submitted:1995-11-27
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 RA / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958185 / 2 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Ecchymosis, Myalgia, Oedema peripheral, Pain

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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FL95091

Write-up: 13NOV95 pt devel 2" swelling in rt delt-IM w/in 1 min of vax;pt didn''t know of having prev rxn to any components of vax;pt advised to put ice on it&go to ER if diff breathing;27NOV95 pt concerned w/yellow circle w/4 10" purple specks


Changed on 5/7/2021

VAERS ID: 80357 Before After
VAERS Form:1
Age:72.0
Sex:Female
Location:Florida
Vaccinated:1995-11-13
Onset:1995-11-13
Submitted:1995-11-27
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 RA / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958185 / 2 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Ecchymosis, Myalgia, Oedema peripheral, Pain

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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FL95091

Write-up: 13NOV95 pt devel 2" swelling in rt delt-IM w/in 1 min of vax;pt didn''t know of having prev rxn to any components of vax;pt advised to put ice on it&go to ER if diff breathing;27NOV95 pt concerned w/yellow circle w/4 10" purple specks


Changed on 5/14/2021

VAERS ID: 80357 Before After
VAERS Form:1
Age:72.0
Sex:Female
Location:Florida
Vaccinated:1995-11-13
Onset:1995-11-13
Submitted:1995-11-27
Entered:1995-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 RA / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958185 / 2 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Ecchymosis, Myalgia, Oedema peripheral, Pain

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: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: rx 20yrs ago lymphosarroma, allergies to PCN, eggs, cats, doxycycline, milk, & iodine
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': FL95091

Write-up: 13NOV95 pt devel 2" swelling in rt delt-IM w/in 1 min of vax;pt didn''t know of having prev rxn to any components of vax;pt advised to put ice on it&go to ER if diff breathing;27NOV95 pt concerned w/yellow circle w/4 10" purple specks

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=80357&WAYBACKHISTORY=ON


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