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This is VAERS ID 81040

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 81040
VAERS Form:
Age:56.0
Sex:Female
Location:Unknown
Vaccinated:1995-08-31
Onset:1995-08-31
Submitted:1995-09-13
Entered:1996-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE - / 0 RA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: RASH, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: premarin, provera
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax;w/in few hrs exp itching, red welts all over & rash on trunk; to er; tx w/ dph;


Changed on 12/8/2009

VAERS ID: 81040 Before After
VAERS Form:
Age:56.0
Sex:Female
Location:Unknown
Vaccinated:1995-08-31
Onset:1995-08-31
Submitted:1995-09-13
Entered:1996-01-24 1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM - / 0 RA / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Pruritus, Rash, Urticaria, RASH, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: premarin, provera
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 950090971

Write-up: pt recvd vax;w/in few hrs exp itching, red welts all over & rash on trunk; to er; tx w/ dph;


Changed on 5/14/2017

VAERS ID: 81040 Before After
VAERS Form:
Age:56.0
Sex:Female
Location:Unknown
Vaccinated:1995-08-31
Onset:1995-08-31
Submitted:1995-09-13
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: premarin, provera
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950090971

Write-up: pt recvd vax;w/in few hrs exp itching, red welts all over & rash on trunk; to er; tx w/ dph;


Changed on 9/14/2017

VAERS ID: 81040 Before After
VAERS Form:(blank) 1
Age:56.0
Sex:Female
Location:Unknown
Vaccinated:1995-08-31
Onset:1995-08-31
Submitted:1995-09-13
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 0 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: premarin, provera
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950090971

Write-up: pt recvd vax;w/in few hrs exp itching, red welts all over & rash on trunk; to er; tx w/ dph;


Changed on 2/14/2018

VAERS ID: 81040 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:Unknown
Vaccinated:1995-08-31
Onset:1995-08-31
Submitted:1995-09-13
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: premarin, provera
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950090971

Write-up: pt recvd vax;w/in few hrs exp itching, red welts all over & rash on trunk; to er; tx w/ dph;


Changed on 6/14/2018

VAERS ID: 81040 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:Unknown
Vaccinated:1995-08-31
Onset:1995-08-31
Submitted:1995-09-13
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: premarin, provera
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950090971

Write-up: pt recvd vax;w/in few hrs exp itching, red welts all over & rash on trunk; to er; tx w/ dph;


Changed on 8/14/2018

VAERS ID: 81040 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:Unknown
Vaccinated:1995-08-31
Onset:1995-08-31
Submitted:1995-09-13
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: premarin, provera
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950090971

Write-up: pt recvd vax;w/in few hrs exp itching, red welts all over & rash on trunk; to er; tx w/ dph;


Changed on 9/14/2018

VAERS ID: 81040 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:Unknown
Vaccinated:1995-08-31
Onset:1995-08-31
Submitted:1995-09-13
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: premarin, provera
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950090971

Write-up: pt recvd vax;w/in few hrs exp itching, red welts all over & rash on trunk; to er; tx w/ dph;


Changed on 10/14/2018

VAERS ID: 81040 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:Unknown
Vaccinated:1995-08-31
Onset:1995-08-31
Submitted:1995-09-13
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: premarin, provera
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950090971

Write-up: pt recvd vax;w/in few hrs exp itching, red welts all over & rash on trunk; to er; tx w/ dph;


Changed on 12/24/2020

VAERS ID: 81040 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:Unknown
Vaccinated:1995-08-31
Onset:1995-08-31
Submitted:1995-09-13
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: premarin, provera
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950090971

Write-up: pt recvd vax;w/in few hrs exp itching, red welts all over & rash on trunk; to er; tx w/ dph;


Changed on 12/30/2020

VAERS ID: 81040 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:Unknown
Vaccinated:1995-08-31
Onset:1995-08-31
Submitted:1995-09-13
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: premarin, provera
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950090971

Write-up: pt recvd vax;w/in few hrs exp itching, red welts all over & rash on trunk; to er; tx w/ dph;


Changed on 5/7/2021

VAERS ID: 81040 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:Unknown
Vaccinated:1995-08-31
Onset:1995-08-31
Submitted:1995-09-13
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: premarin, provera
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950090971

Write-up: pt recvd vax;w/in few hrs exp itching, red welts all over & rash on trunk; to er; tx w/ dph;


Changed on 5/14/2021

VAERS ID: 81040 Before After
VAERS Form:1
Age:56.0
Sex:Female
Location:Unknown
Vaccinated:1995-08-31
Onset:1995-08-31
Submitted:1995-09-13
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: premarin, provera
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950090971

Write-up: pt recvd vax;w/in few hrs exp itching, red welts all over & rash on trunk; to er; tx w/ dph;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=81040&WAYBACKHISTORY=ON


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