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This is VAERS ID 85904

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 85904
VAERS Form:
Age:49.2
Sex:Male
Location:Washington
Vaccinated:1996-03-22
Onset:1996-03-22
Submitted:1996-05-01
Entered:1996-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE VHA478B6 / 1 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: PAIN INJECT SITE, MYALGIA, PAIN, MYASTHENIA, ATROPHY MUSCLE

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electromyography on 26APR96 shows denervation & early reinervation of lt supraspinatious muscle
CDC 'Split Type':

Write-up: local pain,aching lt deltoid for 1 wk following vax,no redness or swelling;subsided approx 6 days p/inj;28MAR96 abrupt onset of extreme deep,burning anterolateral shoulder pain;weakness of lt shoulder 8APR96;atrophy of biceps muscle;


Changed on 12/8/2009

VAERS ID: 85904 Before After
VAERS Form:
Age:49.2
Sex:Male
Location:Washington
Vaccinated:1996-03-22
Onset:1996-03-22
Submitted:1996-05-01
Entered:1996-05-14 1996-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM VHA478B6 / 1 LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Injection site pain, Muscle atrophy, Myalgia, Myasthenic syndrome, Pain, PAIN INJECT SITE, MYALGIA, PAIN, MYASTHENIA, ATROPHY MUSCLE

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electromyography on 26APR96 shows denervation & early reinervation of lt supraspinatious muscle
CDC 'Split Type': (blank) WA961226

Write-up: local pain,aching lt deltoid for 1 wk following vax,no redness or swelling;subsided approx 6 days p/inj;28MAR96 abrupt onset of extreme deep,burning anterolateral shoulder pain;weakness of lt shoulder 8APR96;atrophy of biceps muscle;


Changed on 2/14/2017

VAERS ID: 85904 Before After
VAERS Form:
Age:49.2 49.0
Sex:Male
Location:Washington
Vaccinated:1996-03-22
Onset:1996-03-22
Submitted:1996-05-01
Entered:1996-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA478B6 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain, Muscle atrophy, Myalgia, Myasthenic syndrome, Pain

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electromyography on 26APR96 shows denervation & early reinervation of lt supraspinatious muscle
CDC 'Split Type': WA961226

Write-up: local pain,aching lt deltoid for 1 wk following vax,no redness or swelling;subsided approx 6 days p/inj;28MAR96 abrupt onset of extreme deep,burning anterolateral shoulder pain;weakness of lt shoulder 8APR96;atrophy of biceps muscle;


Changed on 5/14/2017

VAERS ID: 85904 Before After
VAERS Form:
Age:49.0
Sex:Male
Location:Washington
Vaccinated:1996-03-22
Onset:1996-03-22
Submitted:1996-05-01
Entered:1996-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA478B6 / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain, Muscle atrophy, Myalgia, Myasthenic syndrome, Pain

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electromyography on 26APR96 shows denervation & early reinervation of lt supraspinatious muscle
CDC 'Split Type': WA961226

Write-up: local pain,aching lt deltoid for 1 wk following vax,no redness or swelling;subsided approx 6 days p/inj;28MAR96 abrupt onset of extreme deep,burning anterolateral shoulder pain;weakness of lt shoulder 8APR96;atrophy of biceps muscle;


Changed on 9/14/2017

VAERS ID: 85904 Before After
VAERS Form:(blank) 1
Age:49.0
Sex:Male
Location:Washington
Vaccinated:1996-03-22
Onset:1996-03-22
Submitted:1996-05-01
Entered:1996-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA478B6 / 1 2 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain, Muscle atrophy, Myalgia, Myasthenic syndrome, Pain

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electromyography on 26APR96 shows denervation & early reinervation of lt supraspinatious muscle
CDC 'Split Type': WA961226

Write-up: local pain,aching lt deltoid for 1 wk following vax,no redness or swelling;subsided approx 6 days p/inj;28MAR96 abrupt onset of extreme deep,burning anterolateral shoulder pain;weakness of lt shoulder 8APR96;atrophy of biceps muscle;


Changed on 2/14/2018

VAERS ID: 85904 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:Washington
Vaccinated:1996-03-22
Onset:1996-03-22
Submitted:1996-05-01
Entered:1996-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA478B6 / 2 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain, Muscle atrophy, Myalgia, Myasthenic syndrome, Pain

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electromyography on 26APR96 shows denervation & early reinervation of lt supraspinatious muscle
CDC 'Split Type': WA961226

Write-up: local pain,aching lt deltoid for 1 wk following vax,no redness or swelling;subsided approx 6 days p/inj;28MAR96 abrupt onset of extreme deep,burning anterolateral shoulder pain;weakness of lt shoulder 8APR96;atrophy of biceps muscle;


Changed on 6/14/2018

VAERS ID: 85904 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:Washington
Vaccinated:1996-03-22
Onset:1996-03-22
Submitted:1996-05-01
Entered:1996-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA478B6 / 2 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain, Muscle atrophy, Myalgia, Myasthenic syndrome, Pain

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electromyography on 26APR96 shows denervation & early reinervation of lt supraspinatious muscle
CDC 'Split Type': WA961226

Write-up: local pain,aching lt deltoid for 1 wk following vax,no redness or swelling;subsided approx 6 days p/inj;28MAR96 abrupt onset of extreme deep,burning anterolateral shoulder pain;weakness of lt shoulder 8APR96;atrophy of biceps muscle;


Changed on 8/14/2018

VAERS ID: 85904 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:Washington
Vaccinated:1996-03-22
Onset:1996-03-22
Submitted:1996-05-01
Entered:1996-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA478B6 / 2 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain, Muscle atrophy, Myalgia, Myasthenic syndrome, Pain

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electromyography on 26APR96 shows denervation & early reinervation of lt supraspinatious muscle
CDC 'Split Type': WA961226

Write-up: local pain,aching lt deltoid for 1 wk following vax,no redness or swelling;subsided approx 6 days p/inj;28MAR96 abrupt onset of extreme deep,burning anterolateral shoulder pain;weakness of lt shoulder 8APR96;atrophy of biceps muscle;


Changed on 9/14/2018

VAERS ID: 85904 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:Washington
Vaccinated:1996-03-22
Onset:1996-03-22
Submitted:1996-05-01
Entered:1996-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA478B6 / 2 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain, Muscle atrophy, Myalgia, Myasthenic syndrome, Pain

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electromyography on 26APR96 shows denervation & early reinervation of lt supraspinatious muscle
CDC 'Split Type': WA961226

Write-up: local pain,aching lt deltoid for 1 wk following vax,no redness or swelling;subsided approx 6 days p/inj;28MAR96 abrupt onset of extreme deep,burning anterolateral shoulder pain;weakness of lt shoulder 8APR96;atrophy of biceps muscle;


Changed on 10/14/2018

VAERS ID: 85904 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:Washington
Vaccinated:1996-03-22
Onset:1996-03-22
Submitted:1996-05-01
Entered:1996-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA478B6 / 2 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain, Muscle atrophy, Myalgia, Myasthenic syndrome, Pain

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electromyography on 26APR96 shows denervation & early reinervation of lt supraspinatious muscle
CDC 'Split Type': WA961226

Write-up: local pain,aching lt deltoid for 1 wk following vax,no redness or swelling;subsided approx 6 days p/inj;28MAR96 abrupt onset of extreme deep,burning anterolateral shoulder pain;weakness of lt shoulder 8APR96;atrophy of biceps muscle;


Changed on 12/24/2020

VAERS ID: 85904 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:Washington
Vaccinated:1996-03-22
Onset:1996-03-22
Submitted:1996-05-01
Entered:1996-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA478B6 / 2 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain, Muscle atrophy, Myalgia, Myasthenic syndrome, Pain

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electromyography on 26APR96 shows denervation & early reinervation of lt supraspinatious muscle
CDC 'Split Type': WA961226

Write-up: local pain,aching lt deltoid for 1 wk following vax,no redness or swelling;subsided approx 6 days p/inj;28MAR96 abrupt onset of extreme deep,burning anterolateral shoulder pain;weakness of lt shoulder 8APR96;atrophy of biceps muscle;


Changed on 12/30/2020

VAERS ID: 85904 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:Washington
Vaccinated:1996-03-22
Onset:1996-03-22
Submitted:1996-05-01
Entered:1996-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA478B6 / 2 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain, Muscle atrophy, Myalgia, Myasthenic syndrome, Pain

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electromyography on 26APR96 shows denervation & early reinervation of lt supraspinatious muscle
CDC 'Split Type': WA961226

Write-up: local pain,aching lt deltoid for 1 wk following vax,no redness or swelling;subsided approx 6 days p/inj;28MAR96 abrupt onset of extreme deep,burning anterolateral shoulder pain;weakness of lt shoulder 8APR96;atrophy of biceps muscle;


Changed on 5/7/2021

VAERS ID: 85904 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:Washington
Vaccinated:1996-03-22
Onset:1996-03-22
Submitted:1996-05-01
Entered:1996-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA478B6 / 2 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain, Muscle atrophy, Myalgia, Myasthenic syndrome, Pain

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electromyography on 26APR96 shows denervation & early reinervation of lt supraspinatious muscle
CDC 'Split Type': WA961226

Write-up: local pain,aching lt deltoid for 1 wk following vax,no redness or swelling;subsided approx 6 days p/inj;28MAR96 abrupt onset of extreme deep,burning anterolateral shoulder pain;weakness of lt shoulder 8APR96;atrophy of biceps muscle;


Changed on 5/21/2021

VAERS ID: 85904 Before After
VAERS Form:1
Age:49.0
Sex:Male
Location:Washington
Vaccinated:1996-03-22
Onset:1996-03-22
Submitted:1996-05-01
Entered:1996-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA478B6 / 2 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site pain, Muscle atrophy, Myalgia, Myasthenic syndrome, Pain

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: electromyography on 26APR96 shows denervation & early reinervation of lt supraspinatious muscle
CDC 'Split Type': WA961226

Write-up: local pain,aching lt deltoid for 1 wk following vax,no redness or swelling;subsided approx 6 days p/inj;28MAR96 abrupt onset of extreme deep,burning anterolateral shoulder pain;weakness of lt shoulder 8APR96;atrophy of biceps muscle;

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