National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

This is VAERS ID 114730

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 114730
VAERS Form:
Age:28.1
Sex:Male
Location:Unknown
Vaccinated:1998-09-29
Onset:1998-09-30
Submitted:0000-00-00
Entered:1998-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE VHA553A6 / - RA / IM
MEN: MENOMUNE A/C/Y/W / CONNAUGHT LABS 0937650 / - LA / SC
OPV: ORIMUNE / LEDERLE 0777A / - - / -
YF: YELLOW FEVER / CONNAUGHT LABS 090540 / - RA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: CHILLS, NAUSEA, HEADACHE, PAIN BACK, FLU SYND

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: approx 10-15min p/vax noted stuffy nose, h/a, & drainage down the back of throat;itchiness & watering rt eye & tingling along top of rt hand & along fingertips of rt hand;chills,nausea;throbbing pain of skull & spine & shoulder;flu like sx;


Changed on 12/8/2009

VAERS ID: 114730 Before After
VAERS Form:
Age:28.1 28.0
Sex:Male
Location:Unknown
Vaccinated:1998-09-29
Onset:1998-09-30
Submitted:0000-00-00
Entered:1998-10-06 1998-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM VHA553A6 553A6 / - RA / IM
MEN: MENOMUNE A/C/Y/W MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0937650 / - LA / SC
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0777A / - - / -
YF: YELLOW FEVER YELLOW FEVER (YF-VAX) / CONNAUGHT LABS CONNAUGHT LABORATORIES 090540 / - RA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Back pain, Chills, Headache, Influenza, Nausea, Neck pain, Paraesthesia, Pruritus, CHILLS, NAUSEA, HEADACHE, PAIN BACK, FLU SYND

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: approx 10-15min p/vax noted stuffy nose, h/a, & drainage down the back of throat;itchiness & watering rt eye & tingling along top of rt hand & along fingertips of rt hand;chills,nausea;throbbing pain of skull & spine & shoulder;flu like sx;


Changed on 5/14/2017

VAERS ID: 114730 Before After
VAERS Form:
Age:28.0
Sex:Male
Location:Unknown
Vaccinated:1998-09-29
Onset:1998-09-30
Submitted:0000-00-00
Entered:1998-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 553A6 / - RA / IM
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0937650 / - LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0777A / - - / -
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 090540 / - RA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Back pain, Chills, Headache, Influenza, Nausea, Neck pain, Paraesthesia, Pruritus

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: approx 10-15min p/vax noted stuffy nose, h/a, & drainage down the back of throat;itchiness & watering rt eye & tingling along top of rt hand & along fingertips of rt hand;chills,nausea;throbbing pain of skull & spine & shoulder;flu like sx;


Changed on 9/14/2017

VAERS ID: 114730 Before After
VAERS Form:(blank) 1
Age:28.0
Sex:Male
Location:Unknown
Vaccinated:1998-09-29
Onset:1998-09-30
Submitted:0000-00-00
Entered:1998-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 553A6 / - UNK RA / IM
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0937650 / - UNK LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0777A / - UNK - / -
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 090540 / - UNK RA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Back pain, Chills, Headache, Influenza, Nausea, Neck pain, Paraesthesia, Pruritus

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: approx 10-15min p/vax noted stuffy nose, h/a, & drainage down the back of throat;itchiness & watering rt eye & tingling along top of rt hand & along fingertips of rt hand;chills,nausea;throbbing pain of skull & spine & shoulder;flu like sx;


Changed on 2/14/2018

VAERS ID: 114730 Before After
VAERS Form:1
Age:28.0
Sex:Male
Location:Unknown
Vaccinated:1998-09-29
Onset:1998-09-30
Submitted:0000-00-00
Entered:1998-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 553A6 / UNK RA / IM
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0937650 / UNK LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0777A / UNK - / -
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 090540 / UNK RA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Back pain, Chills, Headache, Influenza, Nausea, Neck pain, Paraesthesia, Pruritus

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: approx 10-15min p/vax noted stuffy nose, h/a, & drainage down the back of throat;itchiness & watering rt eye & tingling along top of rt hand & along fingertips of rt hand;chills,nausea;throbbing pain of skull & spine & shoulder;flu like sx;


Changed on 6/14/2018

VAERS ID: 114730 Before After
VAERS Form:1
Age:28.0
Sex:Male
Location:Unknown
Vaccinated:1998-09-29
Onset:1998-09-30
Submitted:0000-00-00
Entered:1998-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 553A6 / UNK RA / IM
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0937650 / UNK LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0777A / UNK - / -
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 090540 / UNK RA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Back pain, Chills, Headache, Influenza, Nausea, Neck pain, Paraesthesia, Pruritus

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: approx 10-15min p/vax noted stuffy nose, h/a, & drainage down the back of throat;itchiness & watering rt eye & tingling along top of rt hand & along fingertips of rt hand;chills,nausea;throbbing pain of skull & spine & shoulder;flu like sx;


Changed on 8/14/2018

VAERS ID: 114730 Before After
VAERS Form:1
Age:28.0
Sex:Male
Location:Unknown
Vaccinated:1998-09-29
Onset:1998-09-30
Submitted:0000-00-00
Entered:1998-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 553A6 / UNK RA / IM
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0937650 / UNK LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0777A / UNK - / -
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 090540 / UNK RA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Back pain, Chills, Headache, Influenza, Nausea, Neck pain, Paraesthesia, Pruritus

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: approx 10-15min p/vax noted stuffy nose, h/a, & drainage down the back of throat;itchiness & watering rt eye & tingling along top of rt hand & along fingertips of rt hand;chills,nausea;throbbing pain of skull & spine & shoulder;flu like sx;


Changed on 9/14/2018

VAERS ID: 114730 Before After
VAERS Form:1
Age:28.0
Sex:Male
Location:Unknown
Vaccinated:1998-09-29
Onset:1998-09-30
Submitted:0000-00-00
Entered:1998-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 553A6 / UNK RA / IM
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0937650 / UNK LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0777A / UNK - / -
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 090540 / UNK RA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Back pain, Chills, Headache, Influenza, Nausea, Neck pain, Paraesthesia, Pruritus

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: approx 10-15min p/vax noted stuffy nose, h/a, & drainage down the back of throat;itchiness & watering rt eye & tingling along top of rt hand & along fingertips of rt hand;chills,nausea;throbbing pain of skull & spine & shoulder;flu like sx;


Changed on 10/14/2018

VAERS ID: 114730 Before After
VAERS Form:1
Age:28.0
Sex:Male
Location:Unknown
Vaccinated:1998-09-29
Onset:1998-09-30
Submitted:0000-00-00
Entered:1998-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 553A6 / UNK RA / IM
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0937650 / UNK LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0777A / UNK - / -
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 090540 / UNK RA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Back pain, Chills, Headache, Influenza, Nausea, Neck pain, Paraesthesia, Pruritus

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: approx 10-15min p/vax noted stuffy nose, h/a, & drainage down the back of throat;itchiness & watering rt eye & tingling along top of rt hand & along fingertips of rt hand;chills,nausea;throbbing pain of skull & spine & shoulder;flu like sx;


Changed on 12/24/2020

VAERS ID: 114730 Before After
VAERS Form:1
Age:28.0
Sex:Male
Location:Unknown
Vaccinated:1998-09-29
Onset:1998-09-30
Submitted:0000-00-00
Entered:1998-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 553A6 / UNK RA / IM
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0937650 / UNK LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0777A / UNK - / -
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 090540 / UNK RA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Back pain, Chills, Headache, Influenza, Nausea, Neck pain, Paraesthesia, Pruritus

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: approx 10-15min p/vax noted stuffy nose, h/a, & drainage down the back of throat;itchiness & watering rt eye & tingling along top of rt hand & along fingertips of rt hand;chills,nausea;throbbing pain of skull & spine & shoulder;flu like sx;


Changed on 12/30/2020

VAERS ID: 114730 Before After
VAERS Form:1
Age:28.0
Sex:Male
Location:Unknown
Vaccinated:1998-09-29
Onset:1998-09-30
Submitted:0000-00-00
Entered:1998-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 553A6 / UNK RA / IM
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0937650 / UNK LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0777A / UNK - / -
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 090540 / UNK RA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Back pain, Chills, Headache, Influenza, Nausea, Neck pain, Paraesthesia, Pruritus

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: approx 10-15min p/vax noted stuffy nose, h/a, & drainage down the back of throat;itchiness & watering rt eye & tingling along top of rt hand & along fingertips of rt hand;chills,nausea;throbbing pain of skull & spine & shoulder;flu like sx;


Changed on 5/7/2021

VAERS ID: 114730 Before After
VAERS Form:1
Age:28.0
Sex:Male
Location:Unknown
Vaccinated:1998-09-29
Onset:1998-09-30
Submitted:0000-00-00
Entered:1998-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 553A6 / UNK RA / IM
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0937650 / UNK LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0777A / UNK - / -
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 090540 / UNK RA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Back pain, Chills, Headache, Influenza, Nausea, Neck pain, Paraesthesia, Pruritus

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: approx 10-15min p/vax noted stuffy nose, h/a, & drainage down the back of throat;itchiness & watering rt eye & tingling along top of rt hand & along fingertips of rt hand;chills,nausea;throbbing pain of skull & spine & shoulder;flu like sx;


Changed on 5/21/2021

VAERS ID: 114730 Before After
VAERS Form:1
Age:28.0
Sex:Male
Location:Unknown
Vaccinated:1998-09-29
Onset:1998-09-30
Submitted:0000-00-00
Entered:1998-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 553A6 / UNK RA / IM
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 0937650 / UNK LA / SC
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0777A / UNK - / -
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 090540 / UNK RA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Back pain, Chills, Headache, Influenza, Nausea, Neck pain, Paraesthesia, Pruritus

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: approx 10-15min p/vax noted stuffy nose, h/a, & drainage down the back of throat;itchiness & watering rt eye & tingling along top of rt hand & along fingertips of rt hand;chills,nausea;throbbing pain of skull & spine & shoulder;flu like sx;

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=114730&WAYBACKHISTORY=ON


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166