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This is VAERS ID 81055

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 81055
VAERS Form:
Age:16.0
Sex:Male
Location:Nebraska
Vaccinated:1995-10-11
Onset:1995-10-11
Submitted:1995-10-19
Entered:1996-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE VHA460A6 / 0 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: DYSPNEA, MALAISE, RESPIRAT DIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: tuberculin tine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recvd vax 3-4 hrs later felt funny & could get a super deep breath; 3 hrs later seen by MD;dx as resp react; tx w/ dph & poss epi;resolved w/in 48 hrs;


Changed on 12/8/2009

VAERS ID: 81055 Before After
VAERS Form:
Age:16.0
Sex:Male
Location:Nebraska
Vaccinated:1995-10-11
Onset:1995-10-11
Submitted:1995-10-19
Entered:1996-01-24 1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM VHA460A6 / 0 - / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Dyspnoea, Malaise, Respiratory disorder, DYSPNEA, MALAISE, RESPIRAT DIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: tuberculin tine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 950109231

Write-up: pt recvd vax 3-4 hrs later felt funny & could get a super deep breath; 3 hrs later seen by MD;dx as resp react; tx w/ dph & poss epi;resolved w/in 48 hrs;


Changed on 5/14/2017

VAERS ID: 81055 Before After
VAERS Form:
Age:16.0
Sex:Male
Location:Nebraska
Vaccinated:1995-10-11
Onset:1995-10-11
Submitted:1995-10-19
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 0 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Malaise, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: tuberculin tine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950109231

Write-up: pt recvd vax 3-4 hrs later felt funny & could get a super deep breath; 3 hrs later seen by MD;dx as resp react; tx w/ dph & poss epi;resolved w/in 48 hrs;


Changed on 9/14/2017

VAERS ID: 81055 Before After
VAERS Form:(blank) 1
Age:16.0
Sex:Male
Location:Nebraska
Vaccinated:1995-10-11
Onset:1995-10-11
Submitted:1995-10-19
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 0 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Malaise, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: tuberculin tine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950109231

Write-up: pt recvd vax 3-4 hrs later felt funny & could get a super deep breath; 3 hrs later seen by MD;dx as resp react; tx w/ dph & poss epi;resolved w/in 48 hrs;


Changed on 2/14/2018

VAERS ID: 81055 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:Nebraska
Vaccinated:1995-10-11
Onset:1995-10-11
Submitted:1995-10-19
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Malaise, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: tuberculin tine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950109231

Write-up: pt recvd vax 3-4 hrs later felt funny & could get a super deep breath; 3 hrs later seen by MD;dx as resp react; tx w/ dph & poss epi;resolved w/in 48 hrs;


Changed on 6/14/2018

VAERS ID: 81055 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:Nebraska
Vaccinated:1995-10-11
Onset:1995-10-11
Submitted:1995-10-19
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Malaise, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: tuberculin tine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950109231

Write-up: pt recvd vax 3-4 hrs later felt funny & could get a super deep breath; 3 hrs later seen by MD;dx as resp react; tx w/ dph & poss epi;resolved w/in 48 hrs;


Changed on 8/14/2018

VAERS ID: 81055 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:Nebraska
Vaccinated:1995-10-11
Onset:1995-10-11
Submitted:1995-10-19
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Malaise, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: tuberculin tine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950109231

Write-up: pt recvd vax 3-4 hrs later felt funny & could get a super deep breath; 3 hrs later seen by MD;dx as resp react; tx w/ dph & poss epi;resolved w/in 48 hrs;


Changed on 9/14/2018

VAERS ID: 81055 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:Nebraska
Vaccinated:1995-10-11
Onset:1995-10-11
Submitted:1995-10-19
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Malaise, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: tuberculin tine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950109231

Write-up: pt recvd vax 3-4 hrs later felt funny & could get a super deep breath; 3 hrs later seen by MD;dx as resp react; tx w/ dph & poss epi;resolved w/in 48 hrs;


Changed on 10/14/2018

VAERS ID: 81055 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:Nebraska
Vaccinated:1995-10-11
Onset:1995-10-11
Submitted:1995-10-19
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Malaise, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: tuberculin tine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950109231

Write-up: pt recvd vax 3-4 hrs later felt funny & could get a super deep breath; 3 hrs later seen by MD;dx as resp react; tx w/ dph & poss epi;resolved w/in 48 hrs;


Changed on 12/24/2020

VAERS ID: 81055 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:Nebraska
Vaccinated:1995-10-11
Onset:1995-10-11
Submitted:1995-10-19
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Malaise, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: tuberculin tine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950109231

Write-up: pt recvd vax 3-4 hrs later felt funny & could get a super deep breath; 3 hrs later seen by MD;dx as resp react; tx w/ dph & poss epi;resolved w/in 48 hrs;


Changed on 12/30/2020

VAERS ID: 81055 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:Nebraska
Vaccinated:1995-10-11
Onset:1995-10-11
Submitted:1995-10-19
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Malaise, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: tuberculin tine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950109231

Write-up: pt recvd vax 3-4 hrs later felt funny & could get a super deep breath; 3 hrs later seen by MD;dx as resp react; tx w/ dph & poss epi;resolved w/in 48 hrs;


Changed on 5/7/2021

VAERS ID: 81055 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:Nebraska
Vaccinated:1995-10-11
Onset:1995-10-11
Submitted:1995-10-19
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Malaise, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: tuberculin tine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950109231

Write-up: pt recvd vax 3-4 hrs later felt funny & could get a super deep breath; 3 hrs later seen by MD;dx as resp react; tx w/ dph & poss epi;resolved w/in 48 hrs;


Changed on 5/14/2021

VAERS ID: 81055 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:Nebraska
Vaccinated:1995-10-11
Onset:1995-10-11
Submitted:1995-10-19
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA460A6 / 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Dyspnoea, Malaise, Respiratory disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: tuberculin tine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 950109231

Write-up: pt recvd vax 3-4 hrs later felt funny & could get a super deep breath; 3 hrs later seen by MD;dx as resp react; tx w/ dph & poss epi;resolved w/in 48 hrs;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=81055&WAYBACKHISTORY=ON


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