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This is VAERS ID 861839

History of Changes from the VAERS Wayback Machine

First Appeared on 3/14/2020

VAERS ID: 861839
VAERS Form:2
Age:80.0
Sex:Male
Location:Pennsylvania
Vaccinated:2020-01-14
Onset:2020-02-08
Submitted:0000-00-00
Entered:2020-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (SHINGRIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 AR / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Seizure

Life Threatening? Yes
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)? Yes
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cellcept, pyridistigmine, omeprazole, Levo dopa, carbidopa
Current Illness: Week previous to incident, stomach illness, vomiting
Preexisting Conditions: Parkinsons, Myasthenia Gravis
Allergies: penicillin, levaquin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Onset of seizure, hospitalized, stabilized, seizure return, given Keppra, stabilized, returned again


Changed on 12/24/2020

VAERS ID: 861839 Before After
VAERS Form:2
Age:80.0
Sex:Male
Location:Pennsylvania
Vaccinated:2020-01-14
Onset:2020-02-08
Submitted:0000-00-00
Entered:2020-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (SHINGRIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 AR / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Seizure

Life Threatening? Yes
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)? Yes
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cellcept, pyridistigmine, omeprazole, Levo dopa, carbidopa
Current Illness: Week previous to incident, stomach illness, vomiting
Preexisting Conditions: Parkinsons, Myasthenia Gravis
Allergies: penicillin, levaquin levaquin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Onset of seizure, hospitalized, stabilized, seizure return, given Keppra, stabilized, returned again


Changed on 12/30/2020

VAERS ID: 861839 Before After
VAERS Form:2
Age:80.0
Sex:Male
Location:Pennsylvania
Vaccinated:2020-01-14
Onset:2020-02-08
Submitted:0000-00-00
Entered:2020-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (SHINGRIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 AR / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Seizure

Life Threatening? Yes
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)? Yes
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cellcept, pyridistigmine, omeprazole, Levo dopa, carbidopa
Current Illness: Week previous to incident, stomach illness, vomiting
Preexisting Conditions: Parkinsons, Myasthenia Gravis
Allergies: penicillin, levaquin levaquin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Onset of seizure, hospitalized, stabilized, seizure return, given Keppra, stabilized, returned again


Changed on 5/7/2021

VAERS ID: 861839 Before After
VAERS Form:2
Age:80.0
Sex:Male
Location:Pennsylvania
Vaccinated:2020-01-14
Onset:2020-02-08
Submitted:0000-00-00
Entered:2020-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (SHINGRIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 AR / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Seizure

Life Threatening? Yes
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)? Yes
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cellcept, pyridistigmine, omeprazole, Levo dopa, carbidopa
Current Illness: Week previous to incident, stomach illness, vomiting
Preexisting Conditions: Parkinsons, Myasthenia Gravis
Allergies: penicillin, levaquin levaquin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Onset of seizure, hospitalized, stabilized, seizure return, given Keppra, stabilized, returned again


Changed on 5/14/2021

VAERS ID: 861839 Before After
VAERS Form:2
Age:80.0
Sex:Male
Location:Pennsylvania
Vaccinated:2020-01-14
Onset:2020-02-08
Submitted:0000-00-00
Entered:2020-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (SHINGRIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 AR / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Seizure

Life Threatening? Yes
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)? Yes
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cellcept, pyridistigmine, omeprazole, Levo dopa, carbidopa
Current Illness: Week previous to incident, stomach illness, vomiting
Preexisting Conditions: Parkinsons, Myasthenia Gravis
Allergies: penicillin, levaquin levaquin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Onset of seizure, hospitalized, stabilized, seizure return, given Keppra, stabilized, returned again


Changed on 7/16/2021

VAERS ID: 861839 Before After
VAERS Form:2
Age:80.0
Sex:Male
Location:Pennsylvania
Vaccinated:2020-01-14
Onset:2020-02-08
Submitted:0000-00-00
Entered:2020-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (SHINGRIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 AR / SYR

Administered by: Pharmacy      Purchased by: ??
Symptoms: Seizure

Life Threatening? Yes
Birth Defect? No
Died? No Yes
   Date died:0000-00-00 2020-03-29
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cellcept, pyridistigmine, omeprazole, Levo dopa, carbidopa
Current Illness: Week previous to incident, stomach illness, vomiting
Preexisting Conditions: Parkinsons, Myasthenia Gravis
Allergies: penicillin, levaquin
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Onset of seizure, hospitalized, stabilized, seizure return, given Keppra, stabilized, returned again

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