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This is VAERS ID 116516

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 116516
VAERS Form:
Age:30.2
Sex:Female
Location:Oklahoma
Vaccinated:1998-09-24
Onset:1998-09-25
Submitted:1998-11-10
Entered:1998-11-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE VHA584A4 / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: DYSPNEA, URTICARIA, LARYNGISMUS

Life Threatening? Yes
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: NONE
Preexisting Conditions: PCN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: onset of hives upon arising-called hlth dept 8AM-told to see pvt MD;traveled to pvt MD 12 miles from work-throat was swelling & had difficulty breathing-meds administered & rxn resolved;


Changed on 12/8/2009

VAERS ID: 116516 Before After
VAERS Form:
Age:30.2 30.0
Sex:Female
Location:Oklahoma
Vaccinated:1998-09-24
Onset:1998-09-25
Submitted:1998-11-10
Entered:1998-11-23 1998-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM VHA584A4 584A4 / 0 LA / IM

Administered by: Other Unknown      Purchased by: Unknown
Symptoms: Dyspnoea, Laryngospasm, Urticaria, DYSPNEA, URTICARIA, LARYNGISMUS

Life Threatening? Yes
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: NONE
Preexisting Conditions: PCN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) OK9843

Write-up: onset of hives upon arising-called hlth dept 8AM-told to see pvt MD;traveled to pvt MD 12 miles from work-throat was swelling & had difficulty breathing-meds administered & rxn resolved;


Changed on 5/14/2017

VAERS ID: 116516 Before After
VAERS Form:
Age:30.0
Sex:Female
Location:Oklahoma
Vaccinated:1998-09-24
Onset:1998-09-25
Submitted:1998-11-10
Entered:1998-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 584A4 / 0 LA / IM

Administered by: Unknown Other      Purchased by: Unknown Public
Symptoms: Dyspnoea, Laryngospasm, Urticaria

Life Threatening? Yes
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: NONE
Preexisting Conditions: PCN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': OK9843

Write-up: onset of hives upon arising-called hlth dept 8AM-told to see pvt MD;traveled to pvt MD 12 miles from work-throat was swelling & had difficulty breathing-meds administered & rxn resolved;


Changed on 9/14/2017

VAERS ID: 116516 Before After
VAERS Form:(blank) 1
Age:30.0
Sex:Female
Location:Oklahoma
Vaccinated:1998-09-24
Onset:1998-09-25
Submitted:1998-11-10
Entered:1998-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 584A4 / 0 1 LA / IM

Administered by: Other      Purchased by: Public
Symptoms: Dyspnoea, Laryngospasm, Urticaria

Life Threatening? Yes
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: NONE
Preexisting Conditions: PCN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': OK9843

Write-up: onset of hives upon arising-called hlth dept 8AM-told to see pvt MD;traveled to pvt MD 12 miles from work-throat was swelling & had difficulty breathing-meds administered & rxn resolved;


Changed on 2/14/2018

VAERS ID: 116516 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:Oklahoma
Vaccinated:1998-09-24
Onset:1998-09-25
Submitted:1998-11-10
Entered:1998-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 584A4 / 1 LA / IM

Administered by: Other      Purchased by: Public
Symptoms: Dyspnoea, Laryngospasm, Urticaria

Life Threatening? Yes
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: NONE
Preexisting Conditions: PCN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': OK9843

Write-up: onset of hives upon arising-called hlth dept 8AM-told to see pvt MD;traveled to pvt MD 12 miles from work-throat was swelling & had difficulty breathing-meds administered & rxn resolved;


Changed on 6/14/2018

VAERS ID: 116516 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:Oklahoma
Vaccinated:1998-09-24
Onset:1998-09-25
Submitted:1998-11-10
Entered:1998-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 584A4 / 1 LA / IM

Administered by: Other      Purchased by: Public
Symptoms: Dyspnoea, Laryngospasm, Urticaria

Life Threatening? Yes
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: NONE
Preexisting Conditions: PCN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': OK9843

Write-up: onset of hives upon arising-called hlth dept 8AM-told to see pvt MD;traveled to pvt MD 12 miles from work-throat was swelling & had difficulty breathing-meds administered & rxn resolved;


Changed on 8/14/2018

VAERS ID: 116516 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:Oklahoma
Vaccinated:1998-09-24
Onset:1998-09-25
Submitted:1998-11-10
Entered:1998-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 584A4 / 1 LA / IM

Administered by: Other      Purchased by: Public
Symptoms: Dyspnoea, Laryngospasm, Urticaria

Life Threatening? Yes
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: NONE
Preexisting Conditions: PCN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': OK9843

Write-up: onset of hives upon arising-called hlth dept 8AM-told to see pvt MD;traveled to pvt MD 12 miles from work-throat was swelling & had difficulty breathing-meds administered & rxn resolved;


Changed on 9/14/2018

VAERS ID: 116516 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:Oklahoma
Vaccinated:1998-09-24
Onset:1998-09-25
Submitted:1998-11-10
Entered:1998-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 584A4 / 1 LA / IM

Administered by: Other      Purchased by: Public
Symptoms: Dyspnoea, Laryngospasm, Urticaria

Life Threatening? Yes
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: NONE
Preexisting Conditions: PCN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': OK9843

Write-up: onset of hives upon arising-called hlth dept 8AM-told to see pvt MD;traveled to pvt MD 12 miles from work-throat was swelling & had difficulty breathing-meds administered & rxn resolved;


Changed on 10/14/2018

VAERS ID: 116516 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:Oklahoma
Vaccinated:1998-09-24
Onset:1998-09-25
Submitted:1998-11-10
Entered:1998-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 584A4 / 1 LA / IM

Administered by: Other      Purchased by: Public
Symptoms: Dyspnoea, Laryngospasm, Urticaria

Life Threatening? Yes
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: NONE
Preexisting Conditions: PCN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': OK9843

Write-up: onset of hives upon arising-called hlth dept 8AM-told to see pvt MD;traveled to pvt MD 12 miles from work-throat was swelling & had difficulty breathing-meds administered & rxn resolved;


Changed on 12/24/2020

VAERS ID: 116516 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:Oklahoma
Vaccinated:1998-09-24
Onset:1998-09-25
Submitted:1998-11-10
Entered:1998-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 584A4 / 1 LA / IM

Administered by: Other      Purchased by: Public
Symptoms: Dyspnoea, Laryngospasm, Urticaria

Life Threatening? Yes
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: NONE
Preexisting Conditions: PCN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': OK9843

Write-up: onset of hives upon arising-called hlth dept 8AM-told to see pvt MD;traveled to pvt MD 12 miles from work-throat was swelling & had difficulty breathing-meds administered & rxn resolved;


Changed on 12/30/2020

VAERS ID: 116516 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:Oklahoma
Vaccinated:1998-09-24
Onset:1998-09-25
Submitted:1998-11-10
Entered:1998-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 584A4 / 1 LA / IM

Administered by: Other      Purchased by: Public
Symptoms: Dyspnoea, Laryngospasm, Urticaria

Life Threatening? Yes
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: NONE
Preexisting Conditions: PCN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': OK9843

Write-up: onset of hives upon arising-called hlth dept 8AM-told to see pvt MD;traveled to pvt MD 12 miles from work-throat was swelling & had difficulty breathing-meds administered & rxn resolved;


Changed on 5/7/2021

VAERS ID: 116516 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:Oklahoma
Vaccinated:1998-09-24
Onset:1998-09-25
Submitted:1998-11-10
Entered:1998-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 584A4 / 1 LA / IM

Administered by: Other      Purchased by: Public
Symptoms: Dyspnoea, Laryngospasm, Urticaria

Life Threatening? Yes
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: NONE
Preexisting Conditions: PCN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': OK9843

Write-up: onset of hives upon arising-called hlth dept 8AM-told to see pvt MD;traveled to pvt MD 12 miles from work-throat was swelling & had difficulty breathing-meds administered & rxn resolved;


Changed on 5/21/2021

VAERS ID: 116516 Before After
VAERS Form:1
Age:30.0
Sex:Female
Location:Oklahoma
Vaccinated:1998-09-24
Onset:1998-09-25
Submitted:1998-11-10
Entered:1998-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 584A4 / 1 LA / IM

Administered by: Other      Purchased by: Public
Symptoms: Dyspnoea, Laryngospasm, Urticaria

Life Threatening? Yes
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: NONE
Preexisting Conditions: PCN
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': OK9843

Write-up: onset of hives upon arising-called hlth dept 8AM-told to see pvt MD;traveled to pvt MD 12 miles from work-throat was swelling & had difficulty breathing-meds administered & rxn resolved;

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