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This is VAERS ID 81034

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 81034
VAERS Form:
Age:22.0
Sex:Female
Location:California
Vaccinated:1995-08-22
Onset:1995-08-23
Submitted:1995-09-07
Entered:1996-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE - / 0 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: ARTHRALGIA, MYALGIA

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: oral contraceptives
Current Illness:
Preexisting Conditions: chronic bronchitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax; exp arthralgia, myalgia in legs;


Changed on 12/8/2009

VAERS ID: 81034 Before After
VAERS Form:
Age:22.0
Sex:Female
Location:California
Vaccinated:1995-08-22
Onset:1995-08-23
Submitted:1995-09-07
Entered:1996-01-24 1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM - / 0 - / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Arthralgia, Myalgia, ARTHRALGIA, MYALGIA

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: oral contraceptives
Current Illness:
Preexisting Conditions: chronic bronchitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 950088121

Write-up: pt recvd vax; exp arthralgia, myalgia in legs;


Changed on 5/14/2017

VAERS ID: 81034 Before After
VAERS Form:
Age:22.0
Sex:Female
Location:California
Vaccinated:1995-08-22
Onset:1995-08-23
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Myalgia

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: oral contraceptives
Current Illness:
Preexisting Conditions: chronic bronchitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950088121

Write-up: pt recvd vax; exp arthralgia, myalgia in legs;


Changed on 9/14/2017

VAERS ID: 81034 Before After
VAERS Form:(blank) 1
Age:22.0
Sex:Female
Location:California
Vaccinated:1995-08-22
Onset:1995-08-23
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 0 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Myalgia

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: oral contraceptives
Current Illness:
Preexisting Conditions: chronic bronchitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950088121

Write-up: pt recvd vax; exp arthralgia, myalgia in legs;


Changed on 2/14/2018

VAERS ID: 81034 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:California
Vaccinated:1995-08-22
Onset:1995-08-23
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Myalgia

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: oral contraceptives
Current Illness:
Preexisting Conditions: chronic bronchitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950088121

Write-up: pt recvd vax; exp arthralgia, myalgia in legs;


Changed on 6/14/2018

VAERS ID: 81034 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:California
Vaccinated:1995-08-22
Onset:1995-08-23
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Myalgia

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: oral contraceptives
Current Illness:
Preexisting Conditions: chronic bronchitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950088121

Write-up: pt recvd vax; exp arthralgia, myalgia in legs;


Changed on 8/14/2018

VAERS ID: 81034 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:California
Vaccinated:1995-08-22
Onset:1995-08-23
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Myalgia

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: oral contraceptives
Current Illness:
Preexisting Conditions: chronic bronchitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950088121

Write-up: pt recvd vax; exp arthralgia, myalgia in legs;


Changed on 9/14/2018

VAERS ID: 81034 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:California
Vaccinated:1995-08-22
Onset:1995-08-23
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Myalgia

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: oral contraceptives
Current Illness:
Preexisting Conditions: chronic bronchitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950088121

Write-up: pt recvd vax; exp arthralgia, myalgia in legs;


Changed on 10/14/2018

VAERS ID: 81034 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:California
Vaccinated:1995-08-22
Onset:1995-08-23
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Myalgia

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: oral contraceptives
Current Illness:
Preexisting Conditions: chronic bronchitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950088121

Write-up: pt recvd vax; exp arthralgia, myalgia in legs;


Changed on 12/24/2020

VAERS ID: 81034 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:California
Vaccinated:1995-08-22
Onset:1995-08-23
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Myalgia

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: oral contraceptives
Current Illness:
Preexisting Conditions: chronic bronchitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950088121

Write-up: pt recvd vax; exp arthralgia, myalgia in legs;


Changed on 12/30/2020

VAERS ID: 81034 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:California
Vaccinated:1995-08-22
Onset:1995-08-23
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Myalgia

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: oral contraceptives
Current Illness:
Preexisting Conditions: chronic bronchitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950088121

Write-up: pt recvd vax; exp arthralgia, myalgia in legs;


Changed on 5/7/2021

VAERS ID: 81034 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:California
Vaccinated:1995-08-22
Onset:1995-08-23
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Myalgia

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: oral contraceptives
Current Illness:
Preexisting Conditions: chronic bronchitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950088121

Write-up: pt recvd vax; exp arthralgia, myalgia in legs;


Changed on 5/14/2021

VAERS ID: 81034 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:California
Vaccinated:1995-08-22
Onset:1995-08-23
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Myalgia

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: oral contraceptives
Current Illness:
Preexisting Conditions: chronic bronchitis
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950088121

Write-up: pt recvd vax; exp arthralgia, myalgia in legs;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=81034&WAYBACKHISTORY=ON


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