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This is VAERS ID 81017

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 81017
VAERS Form:
Age:2.0
Sex:Female
Location:Florida
Vaccinated:1995-06-14
Onset:1995-06-15
Submitted:1995-06-21
Entered:1996-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE - / 0 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: CONVULS, FEVER

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; exp high fever & sz; reporter believes pt exp sz but not 100 percent sure


Changed on 12/8/2009

VAERS ID: 81017 Before After
VAERS Form:
Age:2.0
Sex:Female
Location:Florida
Vaccinated:1995-06-14
Onset:1995-06-15
Submitted:1995-06-21
Entered:1996-01-24 1995-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM - / 0 - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Convulsion, Pyrexia, CONVULS, FEVER

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 950056821

Write-up: pt recvd vax; exp high fever & sz; reporter believes pt exp sz but not 100 percent sure


Changed on 5/14/2017

VAERS ID: 81017 Before After
VAERS Form:
Age:2.0
Sex:Female
Location:Florida
Vaccinated:1995-06-14
Onset:1995-06-15
Submitted:1995-06-21
Entered:1995-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 0 - / -

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950056821

Write-up: pt recvd vax; exp high fever & sz; reporter believes pt exp sz but not 100 percent sure


Changed on 9/14/2017

VAERS ID: 81017 Before After
VAERS Form:(blank) 1
Age:2.0
Sex:Female
Location:Florida
Vaccinated:1995-06-14
Onset:1995-06-15
Submitted:1995-06-21
Entered:1995-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 0 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950056821

Write-up: pt recvd vax; exp high fever & sz; reporter believes pt exp sz but not 100 percent sure


Changed on 2/14/2018

VAERS ID: 81017 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Florida
Vaccinated:1995-06-14
Onset:1995-06-15
Submitted:1995-06-21
Entered:1995-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950056821

Write-up: pt recvd vax; exp high fever & sz; reporter believes pt exp sz but not 100 percent sure


Changed on 6/14/2018

VAERS ID: 81017 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Florida
Vaccinated:1995-06-14
Onset:1995-06-15
Submitted:1995-06-21
Entered:1995-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950056821

Write-up: pt recvd vax; exp high fever & sz; reporter believes pt exp sz but not 100 percent sure


Changed on 8/14/2018

VAERS ID: 81017 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Florida
Vaccinated:1995-06-14
Onset:1995-06-15
Submitted:1995-06-21
Entered:1995-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950056821

Write-up: pt recvd vax; exp high fever & sz; reporter believes pt exp sz but not 100 percent sure


Changed on 9/14/2018

VAERS ID: 81017 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Florida
Vaccinated:1995-06-14
Onset:1995-06-15
Submitted:1995-06-21
Entered:1995-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950056821

Write-up: pt recvd vax; exp high fever & sz; reporter believes pt exp sz but not 100 percent sure


Changed on 10/14/2018

VAERS ID: 81017 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Florida
Vaccinated:1995-06-14
Onset:1995-06-15
Submitted:1995-06-21
Entered:1995-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950056821

Write-up: pt recvd vax; exp high fever & sz; reporter believes pt exp sz but not 100 percent sure


Changed on 12/24/2020

VAERS ID: 81017 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Florida
Vaccinated:1995-06-14
Onset:1995-06-15
Submitted:1995-06-21
Entered:1995-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950056821

Write-up: pt recvd vax; exp high fever & sz; reporter believes pt exp sz but not 100 percent sure


Changed on 12/30/2020

VAERS ID: 81017 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Florida
Vaccinated:1995-06-14
Onset:1995-06-15
Submitted:1995-06-21
Entered:1995-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950056821

Write-up: pt recvd vax; exp high fever & sz; reporter believes pt exp sz but not 100 percent sure


Changed on 5/7/2021

VAERS ID: 81017 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Florida
Vaccinated:1995-06-14
Onset:1995-06-15
Submitted:1995-06-21
Entered:1995-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950056821

Write-up: pt recvd vax; exp high fever & sz; reporter believes pt exp sz but not 100 percent sure


Changed on 5/14/2021

VAERS ID: 81017 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Florida
Vaccinated:1995-06-14
Onset:1995-06-15
Submitted:1995-06-21
Entered:1995-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Convulsion, Pyrexia

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950056821

Write-up: pt recvd vax; exp high fever & sz; reporter believes pt exp sz but not 100 percent sure

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=81017&WAYBACKHISTORY=ON


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