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From the 1/14/2022 release of VAERS data:

This is VAERS ID 150477

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Case Details

VAERS ID: 150477 (history)  
Form: Version 1.0  
Age: 44.0  
Sex: Female  
Location: Colorado  
Vaccinated:1999-12-15
Onset:2000-01-25
   Days after vaccination:41
Submitted: 2000-03-24
   Days after onset:59
Entered: 2000-03-28
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 570B6 / 1 - / IM

Administered by: Public       Purchased by: Other
Symptoms: Anaemia, Anorexia, Blood albumin decreased, Dehydration, Enzyme abnormality, Erythema multiforme, Hepatomegaly, Hepatosplenomegaly, Hyperplasia, Lymphadenopathy, Pain, Pyrexia, Rash, Rash macular, Red blood cell sedimentation rate increased, Splenomegaly, Thrombocytopenia, Viral infection
SMQs:, Liver related investigations, signs and symptoms (narrow), Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Dehydration (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Paxil
Current Illness: NONE
Preexisting Conditions: Mild depression. No additional past medically or allergy history.
Allergies:
Diagnostic Lab Data: CBC - mild anemia, AST-8xnml , decreased albumin, skin biopsy, sedimentation rate of 39, Liver function test-10xnml,
CDC Split Type: 20000044082

Write-up: Possible viral infection, possible drug reaction, erythema multiforme. January, 2000 pt developed some posterior cervical adenopathy that was painless. One lymph node from back of neck was subsequently and showed reactive hyperplasia. 01/25 lymphadenopathy reported became widespread and painful. She experienced anorexia, and developed rash on trunk and arms, a fever of 102. 01/29 pt admitted to hospital due to dehydration, continued fevers, generalized severe painful lymphadenopathy, mildly enlarged and tender liver and spleen, elevated liver enzymes, decreased albumin, and macular rash - confluent over 80% of body, face and feet. Skin biopsy revealed erythema multiforme. Also mild thrombocytopenia. Husband noted that she was improving. She completely recovery around 02/15. Discharge diagnosis was rash, fever, lymphadenopathy, and hepatosplenomegaly of unknown etiology, possibly viral infection although drug reaction is possible. During hospital stay, pt received fluids and medications for pain and itching.


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