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This is VAERS ID 113666

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 113666
VAERS Form:
Age:36.2
Sex:Male
Location:Ohio
Vaccinated:1997-07-01
Onset:0000-00-00
Submitted:1998-08-20
Entered:1998-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B / SMITHKLINE - / 0 - / -
HEPA: HAVRIX / SMITHKLINE - / 0 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: ARTHRALGIA, MYALGIA, AMNESIA, HEPATOMEGALY, BILIRUBINEM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: sore throat-moderate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: lots of blood work indicate abn liver functions;
CDC 'Split Type':

Write-up: joint & muscular pain-severe began w/in a wk of vax;numbness of limbs;swelling of liver-elevated bilirubin-abd pain & short term memory loss, h/a, rash & some itching;


Changed on 12/8/2009

VAERS ID: 113666 Before After
VAERS Form:
Age:36.2
Sex:Male
Location:Ohio
Vaccinated:1997-07-01
Onset:0000-00-00
Submitted:1998-08-20
Entered:1998-08-28 1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B HEP B (ENGERIX-B) / SMITHKLINE SMITHKLINE BEECHAM - / 0 - / -
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM - / 0 - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Abdominal pain, Amnesia, Arthralgia, Hepatomegaly, Hyperbilirubinaemia, Myalgia, Paraesthesia, Rash, ARTHRALGIA, MYALGIA, AMNESIA, HEPATOMEGALY, BILIRUBINEM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: sore throat-moderate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: lots of blood work indicate abn liver functions;
CDC 'Split Type':

Write-up: joint & muscular pain-severe began w/in a wk of vax;numbness of limbs;swelling of liver-elevated bilirubin-abd pain & short term memory loss, h/a, rash & some itching;


Changed on 2/14/2017

VAERS ID: 113666 Before After
VAERS Form:
Age:36.2 36.0
Sex:Male
Location:Ohio
Vaccinated:1997-07-01
Onset:0000-00-00
Submitted:1998-08-20
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 0 - / -
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 0 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Amnesia, Arthralgia, Hepatomegaly, Hyperbilirubinaemia, Myalgia, Paraesthesia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: sore throat-moderate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: lots of blood work indicate abn liver functions;
CDC 'Split Type':

Write-up: joint & muscular pain-severe began w/in a wk of vax;numbness of limbs;swelling of liver-elevated bilirubin-abd pain & short term memory loss, h/a, rash & some itching;


Changed on 5/14/2017

VAERS ID: 113666 Before After
VAERS Form:
Age:36.0
Sex:Male
Location:Ohio
Vaccinated:1997-07-01
Onset:0000-00-00
Submitted:1998-08-20
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 0 - / -
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 0 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Amnesia, Arthralgia, Hepatomegaly, Hyperbilirubinaemia, Myalgia, Paraesthesia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: sore throat-moderate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: lots of blood work indicate abn liver functions;
CDC 'Split Type':

Write-up: joint & muscular pain-severe began w/in a wk of vax;numbness of limbs;swelling of liver-elevated bilirubin-abd pain & short term memory loss, h/a, rash & some itching;


Changed on 9/14/2017

VAERS ID: 113666 Before After
VAERS Form:(blank) 1
Age:36.0
Sex:Male
Location:Ohio
Vaccinated:1997-07-01
Onset:0000-00-00
Submitted:1998-08-20
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 0 1 - / -
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 0 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Amnesia, Arthralgia, Hepatomegaly, Hyperbilirubinaemia, Myalgia, Paraesthesia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: sore throat-moderate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: lots of blood work indicate abn liver functions;
CDC 'Split Type':

Write-up: joint & muscular pain-severe began w/in a wk of vax;numbness of limbs;swelling of liver-elevated bilirubin-abd pain & short term memory loss, h/a, rash & some itching;


Changed on 2/14/2018

VAERS ID: 113666 Before After
VAERS Form:1
Age:36.0
Sex:Male
Location:Ohio
Vaccinated:1997-07-01
Onset:0000-00-00
Submitted:1998-08-20
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 1 - / -
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Amnesia, Arthralgia, Hepatomegaly, Hyperbilirubinaemia, Myalgia, Paraesthesia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: sore throat-moderate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: lots of blood work indicate abn liver functions;
CDC 'Split Type':

Write-up: joint & muscular pain-severe began w/in a wk of vax;numbness of limbs;swelling of liver-elevated bilirubin-abd pain & short term memory loss, h/a, rash & some itching;


Changed on 6/14/2018

VAERS ID: 113666 Before After
VAERS Form:1
Age:36.0
Sex:Male
Location:Ohio
Vaccinated:1997-07-01
Onset:0000-00-00
Submitted:1998-08-20
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 1 - / -
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Amnesia, Arthralgia, Hepatomegaly, Hyperbilirubinaemia, Myalgia, Paraesthesia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: sore throat-moderate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: lots of blood work indicate abn liver functions;
CDC 'Split Type':

Write-up: joint & muscular pain-severe began w/in a wk of vax;numbness of limbs;swelling of liver-elevated bilirubin-abd pain & short term memory loss, h/a, rash & some itching;


Changed on 8/14/2018

VAERS ID: 113666 Before After
VAERS Form:1
Age:36.0
Sex:Male
Location:Ohio
Vaccinated:1997-07-01
Onset:0000-00-00
Submitted:1998-08-20
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 1 - / -
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Amnesia, Arthralgia, Hepatomegaly, Hyperbilirubinaemia, Myalgia, Paraesthesia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: sore throat-moderate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: lots of blood work indicate abn liver functions;
CDC 'Split Type':

Write-up: joint & muscular pain-severe began w/in a wk of vax;numbness of limbs;swelling of liver-elevated bilirubin-abd pain & short term memory loss, h/a, rash & some itching;


Changed on 9/14/2018

VAERS ID: 113666 Before After
VAERS Form:1
Age:36.0
Sex:Male
Location:Ohio
Vaccinated:1997-07-01
Onset:0000-00-00
Submitted:1998-08-20
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 1 - / -
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Amnesia, Arthralgia, Hepatomegaly, Hyperbilirubinaemia, Myalgia, Paraesthesia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: sore throat-moderate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: lots of blood work indicate abn liver functions;
CDC 'Split Type':

Write-up: joint & muscular pain-severe began w/in a wk of vax;numbness of limbs;swelling of liver-elevated bilirubin-abd pain & short term memory loss, h/a, rash & some itching;


Changed on 10/14/2018

VAERS ID: 113666 Before After
VAERS Form:1
Age:36.0
Sex:Male
Location:Ohio
Vaccinated:1997-07-01
Onset:0000-00-00
Submitted:1998-08-20
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 1 - / -
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Amnesia, Arthralgia, Hepatomegaly, Hyperbilirubinaemia, Myalgia, Paraesthesia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: sore throat-moderate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: lots of blood work indicate abn liver functions;
CDC 'Split Type':

Write-up: joint & muscular pain-severe began w/in a wk of vax;numbness of limbs;swelling of liver-elevated bilirubin-abd pain & short term memory loss, h/a, rash & some itching;


Changed on 12/24/2020

VAERS ID: 113666 Before After
VAERS Form:1
Age:36.0
Sex:Male
Location:Ohio
Vaccinated:1997-07-01
Onset:0000-00-00
Submitted:1998-08-20
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 1 - / -
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Amnesia, Arthralgia, Hepatomegaly, Hyperbilirubinaemia, Myalgia, Paraesthesia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: sore throat-moderate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: lots of blood work indicate abn liver functions;
CDC 'Split Type':

Write-up: joint & muscular pain-severe began w/in a wk of vax;numbness of limbs;swelling of liver-elevated bilirubin-abd pain & short term memory loss, h/a, rash & some itching;


Changed on 12/30/2020

VAERS ID: 113666 Before After
VAERS Form:1
Age:36.0
Sex:Male
Location:Ohio
Vaccinated:1997-07-01
Onset:0000-00-00
Submitted:1998-08-20
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 1 - / -
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Amnesia, Arthralgia, Hepatomegaly, Hyperbilirubinaemia, Myalgia, Paraesthesia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: sore throat-moderate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: lots of blood work indicate abn liver functions;
CDC 'Split Type':

Write-up: joint & muscular pain-severe began w/in a wk of vax;numbness of limbs;swelling of liver-elevated bilirubin-abd pain & short term memory loss, h/a, rash & some itching;


Changed on 5/7/2021

VAERS ID: 113666 Before After
VAERS Form:1
Age:36.0
Sex:Male
Location:Ohio
Vaccinated:1997-07-01
Onset:0000-00-00
Submitted:1998-08-20
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 1 - / -
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Amnesia, Arthralgia, Hepatomegaly, Hyperbilirubinaemia, Myalgia, Paraesthesia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: sore throat-moderate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: lots of blood work indicate abn liver functions;
CDC 'Split Type':

Write-up: joint & muscular pain-severe began w/in a wk of vax;numbness of limbs;swelling of liver-elevated bilirubin-abd pain & short term memory loss, h/a, rash & some itching;


Changed on 5/21/2021

VAERS ID: 113666 Before After
VAERS Form:1
Age:36.0
Sex:Male
Location:Ohio
Vaccinated:1997-07-01
Onset:0000-00-00
Submitted:1998-08-20
Entered:1998-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / 1 - / -
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Amnesia, Arthralgia, Hepatomegaly, Hyperbilirubinaemia, Myalgia, Paraesthesia, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: sore throat-moderate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: lots of blood work indicate abn liver functions;
CDC 'Split Type':

Write-up: joint & muscular pain-severe began w/in a wk of vax;numbness of limbs;swelling of liver-elevated bilirubin-abd pain & short term memory loss, h/a, rash & some itching;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=113666&WAYBACKHISTORY=ON


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