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This is VAERS ID 119776

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 119776
VAERS Form:
Age:12.1
Sex:Female
Location:Arizona
Vaccinated:1999-02-19
Onset:1999-02-20
Submitted:1999-03-03
Entered:1999-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB / MSD 0599H / 2 - / -
HEPA: VAQTA / MSD 0005H / 1 - / -

Administered by: Public      Purchased by: Unknown
Symptoms: ARTHRITIS, FEVER, SERUM SICK, LAB TEST ABNORM, ESR INC

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imipramine
Current Illness: NONE
Preexisting Conditions: allergy to (Ephalexin (facial swelling));
Allergies:
Diagnostic Lab Data: mildly elevated ESR, negative ANA, negative RF, mildly elevated ASO titer, negative rapid strep test;nl EKG;nl CBC;nl electrolytes & BUN/Cr;nl UA;
CDC 'Split Type':

Write-up: 1 day p/vax had onset of urticarial rash;4 days p/had onset of multiple large joint arthritis (ankle, knees, hips, wrist) sx have persisted for 11 days so far;child has had intermittent fevers-picture is of serum sickness type rxn;


Changed on 12/8/2009

VAERS ID: 119776 Before After
VAERS Form:
Age:12.1
Sex:Female
Location:Arizona
Vaccinated:1999-02-19
Onset:1999-02-20
Submitted:1999-03-03
Entered:1999-03-09 1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB HEP B (RECOMBIVAX HB) / MSD MERCK & CO. INC. 0599H / 2 - / -
HEPA: VAQTA HEP A (VAQTA) / MSD MERCK & CO. INC. 0005H / 1 - / -

Administered by: Public      Purchased by: Unknown Public
Symptoms: Arthritis, Laboratory test abnormal, Pyrexia, Serum sickness, Urticaria, Red blood cell sedimentation rate increased, ARTHRITIS, FEVER, SERUM SICK, LAB TEST ABNORM, ESR INC

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imipramine
Current Illness: NONE
Preexisting Conditions: allergy to (Ephalexin (facial swelling));
Allergies:
Diagnostic Lab Data: mildly elevated ESR, negative ANA, negative RF, mildly elevated ASO titer, negative rapid strep test;nl EKG;nl CBC;nl electrolytes & BUN/Cr;nl UA;
CDC 'Split Type': (blank) AZ9914

Write-up: 1 day p/vax had onset of urticarial rash;4 days p/had onset of multiple large joint arthritis (ankle, knees, hips, wrist) sx have persisted for 11 days so far;child has had intermittent fevers-picture is of serum sickness type rxn;


Changed on 2/14/2017

VAERS ID: 119776 Before After
VAERS Form:
Age:12.1 12.0
Sex:Female
Location:Arizona
Vaccinated:1999-02-19
Onset:1999-02-20
Submitted:1999-03-03
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0599H / 2 - / -
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0005H / 1 - / -

Administered by: Public      Purchased by: Public
Symptoms: Arthritis, Laboratory test abnormal, Pyrexia, Serum sickness, Urticaria, Red blood cell sedimentation rate increased

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imipramine
Current Illness: NONE
Preexisting Conditions: allergy to (Ephalexin (facial swelling));
Allergies:
Diagnostic Lab Data: mildly elevated ESR, negative ANA, negative RF, mildly elevated ASO titer, negative rapid strep test;nl EKG;nl CBC;nl electrolytes & BUN/Cr;nl UA;
CDC 'Split Type': AZ9914

Write-up: 1 day p/vax had onset of urticarial rash;4 days p/had onset of multiple large joint arthritis (ankle, knees, hips, wrist) sx have persisted for 11 days so far;child has had intermittent fevers-picture is of serum sickness type rxn;


Changed on 5/14/2017

VAERS ID: 119776 Before After
VAERS Form:
Age:12.0
Sex:Female
Location:Arizona
Vaccinated:1999-02-19
Onset:1999-02-20
Submitted:1999-03-03
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0599H / 2 - / -
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0005H / 1 - / -

Administered by: Public      Purchased by: Public
Symptoms: Arthritis, Laboratory test abnormal, Pyrexia, Serum sickness, Urticaria, Red blood cell sedimentation rate increased

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imipramine
Current Illness: NONE
Preexisting Conditions: allergy to (Ephalexin (facial swelling));
Allergies:
Diagnostic Lab Data: mildly elevated ESR, negative ANA, negative RF, mildly elevated ASO titer, negative rapid strep test;nl EKG;nl CBC;nl electrolytes & BUN/Cr;nl UA;
CDC 'Split Type': AZ9914

Write-up: 1 day p/vax had onset of urticarial rash;4 days p/had onset of multiple large joint arthritis (ankle, knees, hips, wrist) sx have persisted for 11 days so far;child has had intermittent fevers-picture is of serum sickness type rxn; rxn;Annual follow-up received on 11/08/00 provided no additional data.


Changed on 9/14/2017

VAERS ID: 119776 Before After
VAERS Form:(blank) 1
Age:12.0
Sex:Female
Location:Arizona
Vaccinated:1999-02-19
Onset:1999-02-20
Submitted:1999-03-03
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0599H / 2 3 - / -
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0005H / 1 2 - / -

Administered by: Public      Purchased by: Public
Symptoms: Arthritis, Laboratory test abnormal, Pyrexia, Serum sickness, Urticaria, Red blood cell sedimentation rate increased

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imipramine
Current Illness: NONE
Preexisting Conditions: allergy to (Ephalexin (facial swelling));
Allergies:
Diagnostic Lab Data: mildly elevated ESR, negative ANA, negative RF, mildly elevated ASO titer, negative rapid strep test;nl EKG;nl CBC;nl electrolytes & BUN/Cr;nl UA;
CDC 'Split Type': AZ9914

Write-up: 1 day p/vax had onset of urticarial rash;4 days p/had onset of multiple large joint arthritis (ankle, knees, hips, wrist) sx have persisted for 11 days so far;child has had intermittent fevers-picture is of serum sickness type rxn;Annual follow-up received on 11/08/00 provided no additional data.


Changed on 2/14/2018

VAERS ID: 119776 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Arizona
Vaccinated:1999-02-19
Onset:1999-02-20
Submitted:1999-03-03
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0599H / 3 - / -
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0005H / 2 - / -

Administered by: Public      Purchased by: Public
Symptoms: Arthritis, Laboratory test abnormal, Pyrexia, Serum sickness, Urticaria, Red blood cell sedimentation rate increased

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imipramine
Current Illness: NONE
Preexisting Conditions: allergy to (Ephalexin (facial swelling));
Allergies:
Diagnostic Lab Data: mildly elevated ESR, negative ANA, negative RF, mildly elevated ASO titer, negative rapid strep test;nl EKG;nl CBC;nl electrolytes & BUN/Cr;nl UA;
CDC 'Split Type': AZ9914

Write-up: 1 day p/vax had onset of urticarial rash;4 days p/had onset of multiple large joint arthritis (ankle, knees, hips, wrist) sx have persisted for 11 days so far;child has had intermittent fevers-picture is of serum sickness type rxn;Annual follow-up received on 11/08/00 provided no additional data.


Changed on 6/14/2018

VAERS ID: 119776 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Arizona
Vaccinated:1999-02-19
Onset:1999-02-20
Submitted:1999-03-03
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0599H / 3 - / -
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0005H / 2 - / -

Administered by: Public      Purchased by: Public
Symptoms: Arthritis, Laboratory test abnormal, Pyrexia, Serum sickness, Urticaria, Red blood cell sedimentation rate increased

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imipramine
Current Illness: NONE
Preexisting Conditions: allergy to (Ephalexin (facial swelling));
Allergies:
Diagnostic Lab Data: mildly elevated ESR, negative ANA, negative RF, mildly elevated ASO titer, negative rapid strep test;nl EKG;nl CBC;nl electrolytes & BUN/Cr;nl UA;
CDC 'Split Type': AZ9914

Write-up: 1 day p/vax had onset of urticarial rash;4 days p/had onset of multiple large joint arthritis (ankle, knees, hips, wrist) sx have persisted for 11 days so far;child has had intermittent fevers-picture is of serum sickness type rxn;Annual follow-up received on 11/08/00 provided no additional data.


Changed on 8/14/2018

VAERS ID: 119776 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Arizona
Vaccinated:1999-02-19
Onset:1999-02-20
Submitted:1999-03-03
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0599H / 3 - / -
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0005H / 2 - / -

Administered by: Public      Purchased by: Public
Symptoms: Arthritis, Laboratory test abnormal, Pyrexia, Serum sickness, Urticaria, Red blood cell sedimentation rate increased

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imipramine
Current Illness: NONE
Preexisting Conditions: allergy to (Ephalexin (facial swelling));
Allergies:
Diagnostic Lab Data: mildly elevated ESR, negative ANA, negative RF, mildly elevated ASO titer, negative rapid strep test;nl EKG;nl CBC;nl electrolytes & BUN/Cr;nl UA;
CDC 'Split Type': AZ9914

Write-up: 1 day p/vax had onset of urticarial rash;4 days p/had onset of multiple large joint arthritis (ankle, knees, hips, wrist) sx have persisted for 11 days so far;child has had intermittent fevers-picture is of serum sickness type rxn;Annual follow-up received on 11/08/00 provided no additional data.


Changed on 9/14/2018

VAERS ID: 119776 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Arizona
Vaccinated:1999-02-19
Onset:1999-02-20
Submitted:1999-03-03
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0599H / 3 - / -
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0005H / 2 - / -

Administered by: Public      Purchased by: Public
Symptoms: Arthritis, Laboratory test abnormal, Pyrexia, Serum sickness, Urticaria, Red blood cell sedimentation rate increased

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imipramine
Current Illness: NONE
Preexisting Conditions: allergy to (Ephalexin (facial swelling));
Allergies:
Diagnostic Lab Data: mildly elevated ESR, negative ANA, negative RF, mildly elevated ASO titer, negative rapid strep test;nl EKG;nl CBC;nl electrolytes & BUN/Cr;nl UA;
CDC 'Split Type': AZ9914

Write-up: 1 day p/vax had onset of urticarial rash;4 days p/had onset of multiple large joint arthritis (ankle, knees, hips, wrist) sx have persisted for 11 days so far;child has had intermittent fevers-picture is of serum sickness type rxn;Annual follow-up received on 11/08/00 provided no additional data.


Changed on 10/14/2018

VAERS ID: 119776 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Arizona
Vaccinated:1999-02-19
Onset:1999-02-20
Submitted:1999-03-03
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0599H / 3 - / -
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0005H / 2 - / -

Administered by: Public      Purchased by: Public
Symptoms: Arthritis, Laboratory test abnormal, Pyrexia, Serum sickness, Urticaria, Red blood cell sedimentation rate increased

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imipramine
Current Illness: NONE
Preexisting Conditions: allergy to (Ephalexin (facial swelling));
Allergies:
Diagnostic Lab Data: mildly elevated ESR, negative ANA, negative RF, mildly elevated ASO titer, negative rapid strep test;nl EKG;nl CBC;nl electrolytes & BUN/Cr;nl UA;
CDC 'Split Type': AZ9914

Write-up: 1 day p/vax had onset of urticarial rash;4 days p/had onset of multiple large joint arthritis (ankle, knees, hips, wrist) sx have persisted for 11 days so far;child has had intermittent fevers-picture is of serum sickness type rxn;Annual follow-up received on 11/08/00 provided no additional data.


Changed on 12/24/2020

VAERS ID: 119776 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Arizona
Vaccinated:1999-02-19
Onset:1999-02-20
Submitted:1999-03-03
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0599H / 3 - / -
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0005H / 2 - / -

Administered by: Public      Purchased by: Public
Symptoms: Arthritis, Laboratory test abnormal, Pyrexia, Serum sickness, Urticaria, Red blood cell sedimentation rate increased

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imipramine
Current Illness: NONE
Preexisting Conditions: allergy to (Ephalexin (facial swelling));
Allergies:
Diagnostic Lab Data: mildly elevated ESR, negative ANA, negative RF, mildly elevated ASO titer, negative rapid strep test;nl EKG;nl CBC;nl electrolytes & BUN/Cr;nl UA;
CDC 'Split Type': AZ9914

Write-up: 1 day p/vax had onset of urticarial rash;4 days p/had onset of multiple large joint arthritis (ankle, knees, hips, wrist) sx have persisted for 11 days so far;child has had intermittent fevers-picture is of serum sickness type rxn;Annual follow-up received on 11/08/00 provided no additional data.


Changed on 12/30/2020

VAERS ID: 119776 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Arizona
Vaccinated:1999-02-19
Onset:1999-02-20
Submitted:1999-03-03
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0599H / 3 - / -
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0005H / 2 - / -

Administered by: Public      Purchased by: Public
Symptoms: Arthritis, Laboratory test abnormal, Pyrexia, Serum sickness, Urticaria, Red blood cell sedimentation rate increased

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imipramine
Current Illness: NONE
Preexisting Conditions: allergy to (Ephalexin (facial swelling));
Allergies:
Diagnostic Lab Data: mildly elevated ESR, negative ANA, negative RF, mildly elevated ASO titer, negative rapid strep test;nl EKG;nl CBC;nl electrolytes & BUN/Cr;nl UA;
CDC 'Split Type': AZ9914

Write-up: 1 day p/vax had onset of urticarial rash;4 days p/had onset of multiple large joint arthritis (ankle, knees, hips, wrist) sx have persisted for 11 days so far;child has had intermittent fevers-picture is of serum sickness type rxn;Annual follow-up received on 11/08/00 provided no additional data.


Changed on 5/7/2021

VAERS ID: 119776 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Arizona
Vaccinated:1999-02-19
Onset:1999-02-20
Submitted:1999-03-03
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0599H / 3 - / -
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0005H / 2 - / -

Administered by: Public      Purchased by: Public
Symptoms: Arthritis, Laboratory test abnormal, Pyrexia, Serum sickness, Urticaria, Red blood cell sedimentation rate increased

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imipramine
Current Illness: NONE
Preexisting Conditions: allergy to (Ephalexin (facial swelling));
Allergies:
Diagnostic Lab Data: mildly elevated ESR, negative ANA, negative RF, mildly elevated ASO titer, negative rapid strep test;nl EKG;nl CBC;nl electrolytes & BUN/Cr;nl UA;
CDC 'Split Type': AZ9914

Write-up: 1 day p/vax had onset of urticarial rash;4 days p/had onset of multiple large joint arthritis (ankle, knees, hips, wrist) sx have persisted for 11 days so far;child has had intermittent fevers-picture is of serum sickness type rxn;Annual follow-up received on 11/08/00 provided no additional data.


Changed on 5/21/2021

VAERS ID: 119776 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Arizona
Vaccinated:1999-02-19
Onset:1999-02-20
Submitted:1999-03-03
Entered:1999-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0599H / 3 - / -
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0005H / 2 - / -

Administered by: Public      Purchased by: Public
Symptoms: Arthritis, Laboratory test abnormal, Pyrexia, Serum sickness, Urticaria, Red blood cell sedimentation rate increased

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Imipramine
Current Illness: NONE
Preexisting Conditions: allergy to (Ephalexin (facial swelling));
Allergies:
Diagnostic Lab Data: mildly elevated ESR, negative ANA, negative RF, mildly elevated ASO titer, negative rapid strep test;nl EKG;nl CBC;nl electrolytes & BUN/Cr;nl UA;
CDC 'Split Type': AZ9914

Write-up: 1 day p/vax had onset of urticarial rash;4 days p/had onset of multiple large joint arthritis (ankle, knees, hips, wrist) sx have persisted for 11 days so far;child has had intermittent fevers-picture is of serum sickness type rxn;Annual follow-up received on 11/08/00 provided no additional data.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=119776&WAYBACKHISTORY=ON


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