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This is VAERS ID 133789

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 133789
VAERS Form:
Age:82.0
Sex:Male
Location:Florida
Vaccinated:2000-01-26
Onset:2000-01-27
Submitted:2000-02-03
Entered:2000-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: VAQTA / MSD - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: HEART ARREST

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Vitamins
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: No enxyme or EKG evidence of myocardial infarction.
CDC 'Split Type':

Write-up: On 1/26/00, pt was vacinated with Hep A vaccine inactivated. On 1/27/00, pt experienced cardiac arrest, was brought back to life, a code was performed, & he was rushed to the ER. He remained hospitalized at time of report and was


Changed on 12/8/2009

VAERS ID: 133789 Before After
VAERS Form:
Age:82.0
Sex:Male
Location:Florida
Vaccinated:2000-01-26
Onset:2000-01-27
Submitted:2000-02-03
Entered:2000-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: VAQTA HEP A (VAQTA) / MSD MERCK & CO. INC. - 1935H / - - UN / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Cardiac arrest, HEART ARREST

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes 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: Vitamins
Current Illness:
Preexisting Conditions: UNK Unknown
Allergies:
Diagnostic Lab Data: No enxyme or EKG evidence of myocardial infarction.
CDC 'Split Type': (blank) WAES00012633

Write-up: On 1/26/00, pt Information has been received from a physician concerning her father, an 82 year old male who on 26-JAN-2000 was vacinated vaccinated with Hep A VAQTA vaccine inactivated. Concommitant medication included a daily vitamin. On 1/27/00, pt 27-JAN-2000 the patient experienced cardiac arrest, arrest. He was brought ''brought back to life, a code was performed, & and he was rushed to the ER. nearest hospital". He remained hospitalized at the time of the report and was stable. Cardiac arrest was considered life-threatening. No further information is available.


Changed on 6/14/2014

VAERS ID: 133789 Before After
VAERS Form:
Age:82.0
Sex:Male
Location:Florida
Vaccinated:2000-01-26
Onset:2000-01-27
Submitted:2000-02-03
Entered:2000-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1935H / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest

Life Threatening? Yes
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: Vitamins
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: No enxyme or EKG evidence of myocardial infarction.
CDC 'Split Type': WAES00012633

Write-up: Information has been received from a physician concerning her father, an 82 year old male who on 26-JAN-2000 was vaccinated with VAQTA vaccine inactivated. Concommitant medication included a daily vitamin. On 27-JAN-2000 the patient experienced cardiac arrest. He was ''brought back to life, a code was performed, and he was rushed to the nearest hospital". He remained hospitalized at the time of the report and was stable. Cardiac arrest was considered life-threatening. No further information is available.


Changed on 5/14/2017

VAERS ID: 133789 Before After
VAERS Form:
Age:82.0
Sex:Male
Location:Florida
Vaccinated:2000-01-26
Onset:2000-01-27
Submitted:2000-02-03
Entered:2000-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1935H / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest

Life Threatening? Yes
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: Vitamins
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: No enxyme or EKG evidence of myocardial infarction.
CDC 'Split Type': WAES00012633

Write-up: Information has been received from a physician concerning her father, an 82 year old male who on 26-JAN-2000 was vaccinated with VAQTA vaccine inactivated. Concommitant medication included a daily vitamin. On 27-JAN-2000 the patient experienced cardiac arrest. He was ''brought back to life, a code was performed, and he was rushed to the nearest hospital". He remained hospitalized at the time of the report and was stable. Cardiac arrest was considered life-threatening. No further information is available.


Changed on 9/14/2017

VAERS ID: 133789 Before After
VAERS Form:(blank) 1
Age:82.0
Sex:Male
Location:Florida
Vaccinated:2000-01-26
Onset:2000-01-27
Submitted:2000-02-03
Entered:2000-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1935H / - UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest

Life Threatening? Yes
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: Vitamins
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: No enxyme or EKG evidence of myocardial infarction.
CDC 'Split Type': WAES00012633

Write-up: Information has been received from a physician concerning her father, an 82 year old male who on 26-JAN-2000 was vaccinated with VAQTA vaccine inactivated. Concommitant medication included a daily vitamin. On 27-JAN-2000 the patient experienced cardiac arrest. He was ''brought back to life, a code was performed, and he was rushed to the nearest hospital". He remained hospitalized at the time of the report and was stable. Cardiac arrest was considered life-threatening. No further information is available.


Changed on 2/14/2018

VAERS ID: 133789 Before After
VAERS Form:1
Age:82.0
Sex:Male
Location:Florida
Vaccinated:2000-01-26
Onset:2000-01-27
Submitted:2000-02-03
Entered:2000-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1935H / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest

Life Threatening? Yes
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: Vitamins
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: No enxyme or EKG evidence of myocardial infarction.
CDC 'Split Type': WAES00012633

Write-up: Information has been received from a physician concerning her father, an 82 year old male who on 26-JAN-2000 was vaccinated with VAQTA vaccine inactivated. Concommitant medication included a daily vitamin. On 27-JAN-2000 the patient experienced cardiac arrest. He was ''brought back to life, a code was performed, and he was rushed to the nearest hospital". He remained hospitalized at the time of the report and was stable. Cardiac arrest was considered life-threatening. No further information is available.


Changed on 6/14/2018

VAERS ID: 133789 Before After
VAERS Form:1
Age:82.0
Sex:Male
Location:Florida
Vaccinated:2000-01-26
Onset:2000-01-27
Submitted:2000-02-03
Entered:2000-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1935H / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest

Life Threatening? Yes
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: Vitamins
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: No enxyme or EKG evidence of myocardial infarction.
CDC 'Split Type': WAES00012633

Write-up: Information has been received from a physician concerning her father, an 82 year old male who on 26-JAN-2000 was vaccinated with VAQTA vaccine inactivated. Concommitant medication included a daily vitamin. On 27-JAN-2000 the patient experienced cardiac arrest. He was ''brought back to life, a code was performed, and he was rushed to the nearest hospital". He remained hospitalized at the time of the report and was stable. Cardiac arrest was considered life-threatening. No further information is available.


Changed on 8/14/2018

VAERS ID: 133789 Before After
VAERS Form:1
Age:82.0
Sex:Male
Location:Florida
Vaccinated:2000-01-26
Onset:2000-01-27
Submitted:2000-02-03
Entered:2000-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1935H / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest

Life Threatening? Yes
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: Vitamins
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: No enxyme or EKG evidence of myocardial infarction.
CDC 'Split Type': WAES00012633

Write-up: Information has been received from a physician concerning her father, an 82 year old male who on 26-JAN-2000 was vaccinated with VAQTA vaccine inactivated. Concommitant medication included a daily vitamin. On 27-JAN-2000 the patient experienced cardiac arrest. He was ''brought back to life, a code was performed, and he was rushed to the nearest hospital". He remained hospitalized at the time of the report and was stable. Cardiac arrest was considered life-threatening. No further information is available.


Changed on 9/14/2018

VAERS ID: 133789 Before After
VAERS Form:1
Age:82.0
Sex:Male
Location:Florida
Vaccinated:2000-01-26
Onset:2000-01-27
Submitted:2000-02-03
Entered:2000-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1935H / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest

Life Threatening? Yes
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: Vitamins
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: No enxyme or EKG evidence of myocardial infarction.
CDC 'Split Type': WAES00012633

Write-up: Information has been received from a physician concerning her father, an 82 year old male who on 26-JAN-2000 was vaccinated with VAQTA vaccine inactivated. Concommitant medication included a daily vitamin. On 27-JAN-2000 the patient experienced cardiac arrest. He was ''brought back to life, a code was performed, and he was rushed to the nearest hospital". He remained hospitalized at the time of the report and was stable. Cardiac arrest was considered life-threatening. No further information is available.


Changed on 10/14/2018

VAERS ID: 133789 Before After
VAERS Form:1
Age:82.0
Sex:Male
Location:Florida
Vaccinated:2000-01-26
Onset:2000-01-27
Submitted:2000-02-03
Entered:2000-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1935H / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest

Life Threatening? Yes
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: Vitamins
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: No enxyme or EKG evidence of myocardial infarction.
CDC 'Split Type': WAES00012633

Write-up: Information has been received from a physician concerning her father, an 82 year old male who on 26-JAN-2000 was vaccinated with VAQTA vaccine inactivated. Concommitant medication included a daily vitamin. On 27-JAN-2000 the patient experienced cardiac arrest. He was ''brought back to life, a code was performed, and he was rushed to the nearest hospital". He remained hospitalized at the time of the report and was stable. Cardiac arrest was considered life-threatening. No further information is available.


Changed on 12/24/2020

VAERS ID: 133789 Before After
VAERS Form:1
Age:82.0
Sex:Male
Location:Florida
Vaccinated:2000-01-26
Onset:2000-01-27
Submitted:2000-02-03
Entered:2000-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1935H / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest

Life Threatening? Yes
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: Vitamins
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: No enxyme or EKG evidence of myocardial infarction.
CDC 'Split Type': WAES00012633

Write-up: Information has been received from a physician concerning her father, an 82 year old male who on 26-JAN-2000 was vaccinated with VAQTA vaccine inactivated. Concommitant medication included a daily vitamin. On 27-JAN-2000 the patient experienced cardiac arrest. He was ''brought back to life, a code was performed, and he was rushed to the nearest hospital". He remained hospitalized at the time of the report and was stable. Cardiac arrest was considered life-threatening. No further information is available.


Changed on 12/30/2020

VAERS ID: 133789 Before After
VAERS Form:1
Age:82.0
Sex:Male
Location:Florida
Vaccinated:2000-01-26
Onset:2000-01-27
Submitted:2000-02-03
Entered:2000-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1935H / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest

Life Threatening? Yes
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: Vitamins
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: No enxyme or EKG evidence of myocardial infarction.
CDC 'Split Type': WAES00012633

Write-up: Information has been received from a physician concerning her father, an 82 year old male who on 26-JAN-2000 was vaccinated with VAQTA vaccine inactivated. Concommitant medication included a daily vitamin. On 27-JAN-2000 the patient experienced cardiac arrest. He was ''brought back to life, a code was performed, and he was rushed to the nearest hospital". He remained hospitalized at the time of the report and was stable. Cardiac arrest was considered life-threatening. No further information is available.


Changed on 5/7/2021

VAERS ID: 133789 Before After
VAERS Form:1
Age:82.0
Sex:Male
Location:Florida
Vaccinated:2000-01-26
Onset:2000-01-27
Submitted:2000-02-03
Entered:2000-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1935H / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest

Life Threatening? Yes
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: Vitamins
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: No enxyme or EKG evidence of myocardial infarction.
CDC 'Split Type': WAES00012633

Write-up: Information has been received from a physician concerning her father, an 82 year old male who on 26-JAN-2000 was vaccinated with VAQTA vaccine inactivated. Concommitant medication included a daily vitamin. On 27-JAN-2000 the patient experienced cardiac arrest. He was ''brought back to life, a code was performed, and he was rushed to the nearest hospital". He remained hospitalized at the time of the report and was stable. Cardiac arrest was considered life-threatening. No further information is available.


Changed on 5/21/2021

VAERS ID: 133789 Before After
VAERS Form:1
Age:82.0
Sex:Male
Location:Florida
Vaccinated:2000-01-26
Onset:2000-01-27
Submitted:2000-02-03
Entered:2000-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1935H / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Cardiac arrest

Life Threatening? Yes
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: Vitamins
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: No enxyme or EKG evidence of myocardial infarction.
CDC 'Split Type': WAES00012633

Write-up: Information has been received from a physician concerning her father, an 82 year old male who on 26-JAN-2000 was vaccinated with VAQTA vaccine inactivated. Concommitant medication included a daily vitamin. On 27-JAN-2000 the patient experienced cardiac arrest. He was ''brought back to life, a code was performed, and he was rushed to the nearest hospital". He remained hospitalized at the time of the report and was stable. Cardiac arrest was considered life-threatening. No further information is available.

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