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This is VAERS ID 81036

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 81036
VAERS Form:
Age:38.0
Sex:Male
Location:Ohio
Vaccinated:1995-08-08
Onset:1995-08-25
Submitted:1995-09-07
Entered:1996-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE VHA426A6 / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: LIVER FUNC ABNORM, PHARYNGITIS, SGPT INC, SGOT INC, BILIRUBINEM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SGOT elev, GGTP elev; BILTOT elev;
CDC 'Split Type':

Write-up: pt recvd vax; exp elev LFTs & pharyngitis;


Changed on 12/8/2009

VAERS ID: 81036 Before After
VAERS Form:
Age:38.0
Sex:Male
Location:Ohio
Vaccinated:1995-08-08
Onset:1995-08-25
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 VHA426A6 / 0 LA / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatic function abnormal, Hyperbilirubinaemia, Pharyngitis, LIVER FUNC ABNORM, PHARYNGITIS, SGPT INC, SGOT INC, BILIRUBINEM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SGOT elev, GGTP elev; BILTOT elev;
CDC 'Split Type': (blank) 950088201

Write-up: pt recvd vax; exp elev LFTs & pharyngitis;


Changed on 5/14/2017

VAERS ID: 81036 Before After
VAERS Form:
Age:38.0
Sex:Male
Location:Ohio
Vaccinated:1995-08-08
Onset:1995-08-25
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA426A6 / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatic function abnormal, Hyperbilirubinaemia, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SGOT elev, GGTP elev; BILTOT elev;
CDC 'Split Type': 950088201

Write-up: pt recvd vax; exp elev LFTs & pharyngitis;


Changed on 9/14/2017

VAERS ID: 81036 Before After
VAERS Form:(blank) 1
Age:38.0
Sex:Male
Location:Ohio
Vaccinated:1995-08-08
Onset:1995-08-25
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA426A6 / 0 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatic function abnormal, Hyperbilirubinaemia, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SGOT elev, GGTP elev; BILTOT elev;
CDC 'Split Type': 950088201

Write-up: pt recvd vax; exp elev LFTs & pharyngitis;


Changed on 2/14/2018

VAERS ID: 81036 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:Ohio
Vaccinated:1995-08-08
Onset:1995-08-25
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA426A6 / 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatic function abnormal, Hyperbilirubinaemia, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SGOT elev, GGTP elev; BILTOT elev;
CDC 'Split Type': 950088201

Write-up: pt recvd vax; exp elev LFTs & pharyngitis;


Changed on 6/14/2018

VAERS ID: 81036 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:Ohio
Vaccinated:1995-08-08
Onset:1995-08-25
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA426A6 / 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatic function abnormal, Hyperbilirubinaemia, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SGOT elev, GGTP elev; BILTOT elev;
CDC 'Split Type': 950088201

Write-up: pt recvd vax; exp elev LFTs & pharyngitis;


Changed on 8/14/2018

VAERS ID: 81036 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:Ohio
Vaccinated:1995-08-08
Onset:1995-08-25
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA426A6 / 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatic function abnormal, Hyperbilirubinaemia, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SGOT elev, GGTP elev; BILTOT elev;
CDC 'Split Type': 950088201

Write-up: pt recvd vax; exp elev LFTs & pharyngitis;


Changed on 9/14/2018

VAERS ID: 81036 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:Ohio
Vaccinated:1995-08-08
Onset:1995-08-25
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA426A6 / 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatic function abnormal, Hyperbilirubinaemia, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SGOT elev, GGTP elev; BILTOT elev;
CDC 'Split Type': 950088201

Write-up: pt recvd vax; exp elev LFTs & pharyngitis;


Changed on 10/14/2018

VAERS ID: 81036 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:Ohio
Vaccinated:1995-08-08
Onset:1995-08-25
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA426A6 / 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatic function abnormal, Hyperbilirubinaemia, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SGOT elev, GGTP elev; BILTOT elev;
CDC 'Split Type': 950088201

Write-up: pt recvd vax; exp elev LFTs & pharyngitis;


Changed on 12/24/2020

VAERS ID: 81036 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:Ohio
Vaccinated:1995-08-08
Onset:1995-08-25
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA426A6 / 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatic function abnormal, Hyperbilirubinaemia, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SGOT elev, GGTP elev; BILTOT elev;
CDC 'Split Type': 950088201

Write-up: pt recvd vax; exp elev LFTs & pharyngitis;


Changed on 12/30/2020

VAERS ID: 81036 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:Ohio
Vaccinated:1995-08-08
Onset:1995-08-25
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA426A6 / 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatic function abnormal, Hyperbilirubinaemia, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SGOT elev, GGTP elev; BILTOT elev;
CDC 'Split Type': 950088201

Write-up: pt recvd vax; exp elev LFTs & pharyngitis;


Changed on 5/7/2021

VAERS ID: 81036 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:Ohio
Vaccinated:1995-08-08
Onset:1995-08-25
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA426A6 / 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatic function abnormal, Hyperbilirubinaemia, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SGOT elev, GGTP elev; BILTOT elev;
CDC 'Split Type': 950088201

Write-up: pt recvd vax; exp elev LFTs & pharyngitis;


Changed on 5/14/2021

VAERS ID: 81036 Before After
VAERS Form:1
Age:38.0
Sex:Male
Location:Ohio
Vaccinated:1995-08-08
Onset:1995-08-25
Submitted:1995-09-07
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA426A6 / 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Hepatic function abnormal, Hyperbilirubinaemia, Pharyngitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SGOT elev, GGTP elev; BILTOT elev;
CDC 'Split Type': 950088201

Write-up: pt recvd vax; exp elev LFTs & pharyngitis;

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