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This is VAERS ID 133593

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 133593
VAERS Form:
Age:14.3
Sex:Female
Location:California
Vaccinated:2000-01-13
Onset:2000-01-14
Submitted:2000-01-14
Entered:2000-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: VAQTA / MSD 103BJ / 0 LA / IM
IPV: POLIOVAX / CONNAUGHT LTD NO7272 / - LA / SC
VARCEL: VARIVAX / MSD 1014J / 1 RA / SC

Administered by: Other      Purchased by: Unknown
Symptoms: MYELITIS, MYASTHENIA

Life Threatening? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Transverse myelitis with bilateral leg weakness. Developed 12 hrs after vax.


Changed on 12/8/2009

VAERS ID: 133593 Before After
VAERS Form:
Age:14.3
Sex:Female
Location:California
Vaccinated:2000-01-13
Onset:2000-01-14
Submitted:2000-01-14
Entered:2000-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: VAQTA HEP A (VAQTA) / MSD MERCK & CO. INC. 103BJ / 0 LA / IM
IPV: POLIOVAX POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD CONNAUGHT LTD. NO7272 / - LA / SC
VARCEL: VARIVAX VARICELLA (VARIVAX) / MSD MERCK & CO. INC. 1014J / 1 RA / SC

Administered by: Other      Purchased by: Unknown Other
Symptoms: Myasthenic syndrome, Myelitis, MYELITIS, MYASTHENIA

Life Threatening? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) CA000003

Write-up: Transverse myelitis with bilateral leg weakness. Developed 12 hrs after vax.


Changed on 2/14/2017

VAERS ID: 133593 Before After
VAERS Form:
Age:14.3 14.0
Sex:Female
Location:California
Vaccinated:2000-01-13
Onset:2000-01-14
Submitted:2000-01-14
Entered:2000-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 103BJ / 0 LA / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. NO7272 / - LA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1014J / 1 RA / SC

Administered by: Other      Purchased by: Other
Symptoms: Myasthenic syndrome, Myelitis

Life Threatening? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA000003

Write-up: Transverse myelitis with bilateral leg weakness. Developed 12 hrs after vax.


Changed on 5/14/2017

VAERS ID: 133593 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:California
Vaccinated:2000-01-13
Onset:2000-01-14
Submitted:2000-01-14
Entered:2000-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 103BJ / 0 LA / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. NO7272 / - LA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1014J / 1 RA / SC

Administered by: Other Public      Purchased by: Other Public
Symptoms: Myasthenic syndrome, Myelitis

Life Threatening? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA000003

Write-up: Transverse myelitis with bilateral leg weakness. Developed 12 hrs after vax.


Changed on 9/14/2017

VAERS ID: 133593 Before After
VAERS Form:(blank) 1
Age:14.0
Sex:Female
Location:California
Vaccinated:2000-01-13
Onset:2000-01-14
Submitted:2000-01-14
Entered:2000-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 103BJ / 0 1 LA / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. NO7272 / - UNK LA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1014J / 1 2 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Myasthenic syndrome, Myelitis

Life Threatening? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA000003

Write-up: Transverse myelitis with bilateral leg weakness. Developed 12 hrs after vax.


Changed on 2/14/2018

VAERS ID: 133593 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:California
Vaccinated:2000-01-13
Onset:2000-01-14
Submitted:2000-01-14
Entered:2000-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 103BJ / 1 LA / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. NO7272 / UNK LA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1014J / 2 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Myasthenic syndrome, Myelitis

Life Threatening? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA000003

Write-up: Transverse myelitis with bilateral leg weakness. Developed 12 hrs after vax.


Changed on 6/14/2018

VAERS ID: 133593 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:California
Vaccinated:2000-01-13
Onset:2000-01-14
Submitted:2000-01-14
Entered:2000-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 103BJ / 1 LA / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. NO7272 / UNK LA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1014J / 2 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Myasthenic syndrome, Myelitis

Life Threatening? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA000003

Write-up: Transverse myelitis with bilateral leg weakness. Developed 12 hrs after vax.


Changed on 8/14/2018

VAERS ID: 133593 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:California
Vaccinated:2000-01-13
Onset:2000-01-14
Submitted:2000-01-14
Entered:2000-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 103BJ / 1 LA / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. NO7272 / UNK LA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1014J / 2 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Myasthenic syndrome, Myelitis

Life Threatening? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA000003

Write-up: Transverse myelitis with bilateral leg weakness. Developed 12 hrs after vax.


Changed on 9/14/2018

VAERS ID: 133593 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:California
Vaccinated:2000-01-13
Onset:2000-01-14
Submitted:2000-01-14
Entered:2000-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 103BJ / 1 LA / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. NO7272 / UNK LA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1014J / 2 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Myasthenic syndrome, Myelitis

Life Threatening? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA000003

Write-up: Transverse myelitis with bilateral leg weakness. Developed 12 hrs after vax.


Changed on 10/14/2018

VAERS ID: 133593 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:California
Vaccinated:2000-01-13
Onset:2000-01-14
Submitted:2000-01-14
Entered:2000-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 103BJ / 1 LA / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. NO7272 / UNK LA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1014J / 2 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Myasthenic syndrome, Myelitis

Life Threatening? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA000003

Write-up: Transverse myelitis with bilateral leg weakness. Developed 12 hrs after vax.


Changed on 12/24/2020

VAERS ID: 133593 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:California
Vaccinated:2000-01-13
Onset:2000-01-14
Submitted:2000-01-14
Entered:2000-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 103BJ / 1 LA / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. NO7272 / UNK LA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1014J / 2 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Myasthenic syndrome, Myelitis

Life Threatening? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA000003

Write-up: Transverse myelitis with bilateral leg weakness. Developed 12 hrs after vax.


Changed on 12/30/2020

VAERS ID: 133593 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:California
Vaccinated:2000-01-13
Onset:2000-01-14
Submitted:2000-01-14
Entered:2000-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 103BJ / 1 LA / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. NO7272 / UNK LA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1014J / 2 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Myasthenic syndrome, Myelitis

Life Threatening? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA000003

Write-up: Transverse myelitis with bilateral leg weakness. Developed 12 hrs after vax.


Changed on 5/7/2021

VAERS ID: 133593 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:California
Vaccinated:2000-01-13
Onset:2000-01-14
Submitted:2000-01-14
Entered:2000-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 103BJ / 1 LA / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. NO7272 / UNK LA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1014J / 2 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Myasthenic syndrome, Myelitis

Life Threatening? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA000003

Write-up: Transverse myelitis with bilateral leg weakness. Developed 12 hrs after vax.


Changed on 5/21/2021

VAERS ID: 133593 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:California
Vaccinated:2000-01-13
Onset:2000-01-14
Submitted:2000-01-14
Entered:2000-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 103BJ / 1 LA / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. NO7272 / UNK LA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1014J / 2 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Myasthenic syndrome, Myelitis

Life Threatening? No
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': CA000003

Write-up: Transverse myelitis with bilateral leg weakness. Developed 12 hrs after vax.

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