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This is VAERS ID 85536

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 85536
VAERS Form:
Age:2.7
Sex:Male
Location:Illinois
Vaccinated:1996-04-09
Onset:1996-04-09
Submitted:1996-04-10
Entered:1996-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE VHA178A2 / 1 RL / IM
TYP: TYPHOID / WYETH 4958216 / 1 LL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: CHILLS, FEVER, TREMOR, PHARYNGITIS, POS RECHAL

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: pt exp local inj site pain & t101 for 24hr w/Typhoid, hepatitis A dose 1
Other Medications: NONE
Current Illness: discovered 11APR96 @ f/u visit
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: throat culture-neg for beta strept group A
CDC 'Split Type': NONE

Write-up: pt recv vax 1130AM;mom returned w/pt @ 1:20 w/shaking chills x 5min&temp initially 102.5 tym w/nl BP 107/73;Motrin given;shaking,chills resolved by 1:30;temp rechecked @ 1:50&was 105.6;tonsils erythematous


Changed on 12/8/2009

VAERS ID: 85536 Before After
VAERS Form:
Age:2.7 2.0
Sex:Male
Location:Illinois
Vaccinated:1996-04-09
Onset:1996-04-09
Submitted:1996-04-10
Entered:1996-05-07 1996-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM VHA178A2 178A2 / 1 RL / IM
TYP: TYPHOID TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / WYETH WYETH PHARMACEUTICALS, INC 4958216 / 1 LL / SC

Administered by: Private Unknown      Purchased by: Unknown
Symptoms: Chills, Pharyngitis, Pyrexia, Tremor, CHILLS, FEVER, TREMOR, PHARYNGITIS, POS RECHAL

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: pt exp local inj site pain & t101 for 24hr w/Typhoid, hepatitis A dose 1
Other Medications: NONE
Current Illness: discovered 11APR96 @ f/u visit
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: throat culture-neg for beta strept group A
CDC 'Split Type': NONE (blank)

Write-up: pt recv vax 1130AM;mom returned w/pt @ 1:20 w/shaking chills x 5min&temp initially 102.5 tym w/nl BP 107/73;Motrin given;shaking,chills resolved by 1:30;temp rechecked @ 1:50&was 105.6;tonsils erythematous


Changed on 8/31/2010

VAERS ID: 85536 Before After
VAERS Form:
Age:2.0
Sex:Male
Location:Illinois
Vaccinated:1996-04-09
Onset:1996-04-09
Submitted:1996-04-10
Entered:1996-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 178A2 / 1 RL / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4958216 / 1 LL / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chills, Pharyngitis, Pyrexia, Tremor

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: NONE
Current Illness: discovered 11APR96 @ f/u visit
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: throat culture-neg for beta strept group A
CDC 'Split Type':

Write-up: pt recv vax 1130AM;mom returned w/pt @ 1:20 w/shaking chills x 5min&temp initially 102.5 tym w/nl BP 107/73;Motrin given;shaking,chills resolved by 1:30;temp rechecked @ 1:50&was 105.6;tonsils erythematous


Changed on 5/14/2017

VAERS ID: 85536 Before After
VAERS Form:
Age:2.0
Sex:Male
Location:Illinois
Vaccinated:1996-04-09
Onset:1996-04-09
Submitted:1996-04-10
Entered:1996-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 178A2 / 1 RL / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958216 / 1 LL / SC

Administered by: Unknown Private      Purchased by: Unknown Public
Symptoms: Chills, Pharyngitis, Pyrexia, Tremor

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: NONE
Current Illness: discovered 11APR96 @ f/u visit
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: throat culture-neg for beta strept group A
CDC 'Split Type':

Write-up: pt recv vax 1130AM;mom returned w/pt @ 1:20 w/shaking chills x 5min&temp initially 102.5 tym w/nl BP 107/73;Motrin given;shaking,chills resolved by 1:30;temp rechecked @ 1:50&was 105.6;tonsils erythematous


Changed on 9/14/2017

VAERS ID: 85536 Before After
VAERS Form:(blank) 1
Age:2.0
Sex:Male
Location:Illinois
Vaccinated:1996-04-09
Onset:1996-04-09
Submitted:1996-04-10
Entered:1996-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 178A2 / 1 2 RL / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958216 / 1 2 LL / SC

Administered by: Private      Purchased by: Public
Symptoms: Chills, Pharyngitis, Pyrexia, Tremor

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: NONE
Current Illness: discovered 11APR96 @ f/u visit
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: throat culture-neg for beta strept group A
CDC 'Split Type':

Write-up: pt recv vax 1130AM;mom returned w/pt @ 1:20 w/shaking chills x 5min&temp initially 102.5 tym w/nl BP 107/73;Motrin given;shaking,chills resolved by 1:30;temp rechecked @ 1:50&was 105.6;tonsils erythematous


Changed on 2/14/2018

VAERS ID: 85536 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Illinois
Vaccinated:1996-04-09
Onset:1996-04-09
Submitted:1996-04-10
Entered:1996-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 178A2 / 2 RL / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958216 / 2 LL / SC

Administered by: Private      Purchased by: Public
Symptoms: Chills, Pharyngitis, Pyrexia, Tremor

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: NONE
Current Illness: discovered 11APR96 @ f/u visit
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: throat culture-neg for beta strept group A
CDC 'Split Type':

Write-up: pt recv vax 1130AM;mom returned w/pt @ 1:20 w/shaking chills x 5min&temp initially 102.5 tym w/nl BP 107/73;Motrin given;shaking,chills resolved by 1:30;temp rechecked @ 1:50&was 105.6;tonsils erythematous


Changed on 6/14/2018

VAERS ID: 85536 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Illinois
Vaccinated:1996-04-09
Onset:1996-04-09
Submitted:1996-04-10
Entered:1996-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 178A2 / 2 RL / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958216 / 2 LL / SC

Administered by: Private      Purchased by: Public
Symptoms: Chills, Pharyngitis, Pyrexia, Tremor

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: NONE
Current Illness: discovered 11APR96 @ f/u visit
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: throat culture-neg for beta strept group A
CDC 'Split Type':

Write-up: pt recv vax 1130AM;mom returned w/pt @ 1:20 w/shaking chills x 5min&temp initially 102.5 tym w/nl BP 107/73;Motrin given;shaking,chills resolved by 1:30;temp rechecked @ 1:50&was 105.6;tonsils erythematous


Changed on 8/14/2018

VAERS ID: 85536 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Illinois
Vaccinated:1996-04-09
Onset:1996-04-09
Submitted:1996-04-10
Entered:1996-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 178A2 / 2 RL / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958216 / 2 LL / SC

Administered by: Private      Purchased by: Public
Symptoms: Chills, Pharyngitis, Pyrexia, Tremor

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: NONE
Current Illness: discovered 11APR96 @ f/u visit
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: throat culture-neg for beta strept group A
CDC 'Split Type':

Write-up: pt recv vax 1130AM;mom returned w/pt @ 1:20 w/shaking chills x 5min&temp initially 102.5 tym w/nl BP 107/73;Motrin given;shaking,chills resolved by 1:30;temp rechecked @ 1:50&was 105.6;tonsils erythematous


Changed on 9/14/2018

VAERS ID: 85536 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Illinois
Vaccinated:1996-04-09
Onset:1996-04-09
Submitted:1996-04-10
Entered:1996-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 178A2 / 2 RL / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958216 / 2 LL / SC

Administered by: Private      Purchased by: Public
Symptoms: Chills, Pharyngitis, Pyrexia, Tremor

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: NONE
Current Illness: discovered 11APR96 @ f/u visit
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: throat culture-neg for beta strept group A
CDC 'Split Type':

Write-up: pt recv vax 1130AM;mom returned w/pt @ 1:20 w/shaking chills x 5min&temp initially 102.5 tym w/nl BP 107/73;Motrin given;shaking,chills resolved by 1:30;temp rechecked @ 1:50&was 105.6;tonsils erythematous


Changed on 10/14/2018

VAERS ID: 85536 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Illinois
Vaccinated:1996-04-09
Onset:1996-04-09
Submitted:1996-04-10
Entered:1996-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 178A2 / 2 RL / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958216 / 2 LL / SC

Administered by: Private      Purchased by: Public
Symptoms: Chills, Pharyngitis, Pyrexia, Tremor

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: NONE
Current Illness: discovered 11APR96 @ f/u visit
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: throat culture-neg for beta strept group A
CDC 'Split Type':

Write-up: pt recv vax 1130AM;mom returned w/pt @ 1:20 w/shaking chills x 5min&temp initially 102.5 tym w/nl BP 107/73;Motrin given;shaking,chills resolved by 1:30;temp rechecked @ 1:50&was 105.6;tonsils erythematous


Changed on 12/24/2020

VAERS ID: 85536 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Illinois
Vaccinated:1996-04-09
Onset:1996-04-09
Submitted:1996-04-10
Entered:1996-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 178A2 / 2 RL / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958216 / 2 LL / SC

Administered by: Private      Purchased by: Public
Symptoms: Chills, Pharyngitis, Pyrexia, Tremor

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: NONE
Current Illness: discovered 11APR96 @ f/u visit
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: throat culture-neg for beta strept group A
CDC 'Split Type':

Write-up: pt recv vax 1130AM;mom returned w/pt @ 1:20 w/shaking chills x 5min&temp initially 102.5 tym w/nl BP 107/73;Motrin given;shaking,chills resolved by 1:30;temp rechecked @ 1:50&was 105.6;tonsils erythematous


Changed on 12/30/2020

VAERS ID: 85536 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Illinois
Vaccinated:1996-04-09
Onset:1996-04-09
Submitted:1996-04-10
Entered:1996-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 178A2 / 2 RL / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958216 / 2 LL / SC

Administered by: Private      Purchased by: Public
Symptoms: Chills, Pharyngitis, Pyrexia, Tremor

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: NONE
Current Illness: discovered 11APR96 @ f/u visit
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: throat culture-neg for beta strept group A
CDC 'Split Type':

Write-up: pt recv vax 1130AM;mom returned w/pt @ 1:20 w/shaking chills x 5min&temp initially 102.5 tym w/nl BP 107/73;Motrin given;shaking,chills resolved by 1:30;temp rechecked @ 1:50&was 105.6;tonsils erythematous


Changed on 5/7/2021

VAERS ID: 85536 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Illinois
Vaccinated:1996-04-09
Onset:1996-04-09
Submitted:1996-04-10
Entered:1996-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 178A2 / 2 RL / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958216 / 2 LL / SC

Administered by: Private      Purchased by: Public
Symptoms: Chills, Pharyngitis, Pyrexia, Tremor

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: NONE
Current Illness: discovered 11APR96 @ f/u visit
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: throat culture-neg for beta strept group A
CDC 'Split Type':

Write-up: pt recv vax 1130AM;mom returned w/pt @ 1:20 w/shaking chills x 5min&temp initially 102.5 tym w/nl BP 107/73;Motrin given;shaking,chills resolved by 1:30;temp rechecked @ 1:50&was 105.6;tonsils erythematous


Changed on 5/21/2021

VAERS ID: 85536 Before After
VAERS Form:1
Age:2.0
Sex:Male
Location:Illinois
Vaccinated:1996-04-09
Onset:1996-04-09
Submitted:1996-04-10
Entered:1996-05-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 178A2 / 2 RL / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4958216 / 2 LL / SC

Administered by: Private      Purchased by: Public
Symptoms: Chills, Pharyngitis, Pyrexia, Tremor

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: NONE
Current Illness: discovered 11APR96 @ f/u visit
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: throat culture-neg for beta strept group A
CDC 'Split Type':

Write-up: pt recv vax 1130AM;mom returned w/pt @ 1:20 w/shaking chills x 5min&temp initially 102.5 tym w/nl BP 107/73;Motrin given;shaking,chills resolved by 1:30;temp rechecked @ 1:50&was 105.6;tonsils erythematous

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