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This is VAERS ID 85209

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 85209
VAERS Form:
Age:52.0
Sex:Male
Location:Illinois
Vaccinated:1995-09-19
Onset:1995-10-30
Submitted:1996-02-09
Entered:1996-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE VHA440A6 / 0 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: NO DRUG EFFECT

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: HAV-6 = .662 30oct95 and .669 on 12jan96;
CDC 'Split Type':

Write-up: pt recv vax;pt found to be a nonresponder;


Changed on 12/8/2009

VAERS ID: 85209 Before After
VAERS Form:
Age:52.0
Sex:Male
Location:Illinois
Vaccinated:1995-09-19
Onset:1995-10-30
Submitted:1996-02-09
Entered:1996-05-01 1996-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM VHA440A6 / 0 - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Drug ineffective, NO DRUG EFFECT

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: HAV-6 = .662 30oct95 and .669 on 12jan96;
CDC 'Split Type': (blank) 960016551

Write-up: pt recv vax;pt found to be a nonresponder;


Changed on 5/14/2017

VAERS ID: 85209 Before After
VAERS Form:
Age:52.0
Sex:Male
Location:Illinois
Vaccinated:1995-09-19
Onset:1995-10-30
Submitted:1996-02-09
Entered:1996-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA440A6 / 0 - / -

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective

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: HAV-6 = .662 30oct95 and .669 on 12jan96;
CDC 'Split Type': 960016551

Write-up: pt recv vax;pt found to be a nonresponder;


Changed on 9/14/2017

VAERS ID: 85209 Before After
VAERS Form:(blank) 1
Age:52.0
Sex:Male
Location:Illinois
Vaccinated:1995-09-19
Onset:1995-10-30
Submitted:1996-02-09
Entered:1996-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA440A6 / 0 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective

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: HAV-6 = .662 30oct95 and .669 on 12jan96;
CDC 'Split Type': 960016551

Write-up: pt recv vax;pt found to be a nonresponder;


Changed on 2/14/2018

VAERS ID: 85209 Before After
VAERS Form:1
Age:52.0
Sex:Male
Location:Illinois
Vaccinated:1995-09-19
Onset:1995-10-30
Submitted:1996-02-09
Entered:1996-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA440A6 / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective

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: HAV-6 = .662 30oct95 and .669 on 12jan96;
CDC 'Split Type': 960016551

Write-up: pt recv vax;pt found to be a nonresponder;


Changed on 6/14/2018

VAERS ID: 85209 Before After
VAERS Form:1
Age:52.0
Sex:Male
Location:Illinois
Vaccinated:1995-09-19
Onset:1995-10-30
Submitted:1996-02-09
Entered:1996-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA440A6 / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective

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: HAV-6 = .662 30oct95 and .669 on 12jan96;
CDC 'Split Type': 960016551

Write-up: pt recv vax;pt found to be a nonresponder;


Changed on 8/14/2018

VAERS ID: 85209 Before After
VAERS Form:1
Age:52.0
Sex:Male
Location:Illinois
Vaccinated:1995-09-19
Onset:1995-10-30
Submitted:1996-02-09
Entered:1996-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA440A6 / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective

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: HAV-6 = .662 30oct95 and .669 on 12jan96;
CDC 'Split Type': 960016551

Write-up: pt recv vax;pt found to be a nonresponder;


Changed on 9/14/2018

VAERS ID: 85209 Before After
VAERS Form:1
Age:52.0
Sex:Male
Location:Illinois
Vaccinated:1995-09-19
Onset:1995-10-30
Submitted:1996-02-09
Entered:1996-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA440A6 / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective

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: HAV-6 = .662 30oct95 and .669 on 12jan96;
CDC 'Split Type': 960016551

Write-up: pt recv vax;pt found to be a nonresponder;


Changed on 10/14/2018

VAERS ID: 85209 Before After
VAERS Form:1
Age:52.0
Sex:Male
Location:Illinois
Vaccinated:1995-09-19
Onset:1995-10-30
Submitted:1996-02-09
Entered:1996-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA440A6 / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective

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: HAV-6 = .662 30oct95 and .669 on 12jan96;
CDC 'Split Type': 960016551

Write-up: pt recv vax;pt found to be a nonresponder;


Changed on 12/24/2020

VAERS ID: 85209 Before After
VAERS Form:1
Age:52.0
Sex:Male
Location:Illinois
Vaccinated:1995-09-19
Onset:1995-10-30
Submitted:1996-02-09
Entered:1996-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA440A6 / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective

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: HAV-6 = .662 30oct95 and .669 on 12jan96;
CDC 'Split Type': 960016551

Write-up: pt recv vax;pt found to be a nonresponder;


Changed on 12/30/2020

VAERS ID: 85209 Before After
VAERS Form:1
Age:52.0
Sex:Male
Location:Illinois
Vaccinated:1995-09-19
Onset:1995-10-30
Submitted:1996-02-09
Entered:1996-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA440A6 / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective

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: HAV-6 = .662 30oct95 and .669 on 12jan96;
CDC 'Split Type': 960016551

Write-up: pt recv vax;pt found to be a nonresponder;


Changed on 5/7/2021

VAERS ID: 85209 Before After
VAERS Form:1
Age:52.0
Sex:Male
Location:Illinois
Vaccinated:1995-09-19
Onset:1995-10-30
Submitted:1996-02-09
Entered:1996-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA440A6 / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective

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: HAV-6 = .662 30oct95 and .669 on 12jan96;
CDC 'Split Type': 960016551

Write-up: pt recv vax;pt found to be a nonresponder;


Changed on 5/21/2021

VAERS ID: 85209 Before After
VAERS Form:1
Age:52.0
Sex:Male
Location:Illinois
Vaccinated:1995-09-19
Onset:1995-10-30
Submitted:1996-02-09
Entered:1996-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA440A6 / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Drug ineffective

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: HAV-6 = .662 30oct95 and .669 on 12jan96;
CDC 'Split Type': 960016551

Write-up: pt recv vax;pt found to be a nonresponder;

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