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This is VAERS ID 151801

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 151801
VAERS Form:
Age:22.0
Sex:Female
Location:Florida
Vaccinated:2000-04-29
Onset:2000-04-29
Submitted:2000-05-04
Entered:2000-05-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE VHA639A4 / 0 - / IM
MMR: MMR II / MSD 133J / 1 - / SC
TD: TD ADSORBED, ADULTS / CONNAUGHT LABS U0003BA / 1 - / IM

Administered by: Military      Purchased by: Unknown
Symptoms: DYSPNEA, URTICARIA, PALLOR

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Latex, Benadryl
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, dyspnea, pallor, approximately 15 minutes, post vax. Treated with epinephrine, IM, and Atarax, albuterol and Solu-Medrol in ER all in right deltoid. Follow-up with allergist is recommended.


Changed on 12/8/2009

VAERS ID: 151801 Before After
VAERS Form:
Age:22.0
Sex:Female
Location:Florida
Vaccinated:2000-04-29
Onset:2000-04-29
Submitted:2000-05-04
Entered:2000-05-13 2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM VHA639A4 639A4 / 0 - / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 133J / 1 - / SC
TD: TD ADSORBED, ADULTS TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES U0003BA / 1 - / IM

Administered by: Military      Purchased by: Unknown Military
Symptoms: Dyspnoea, Pallor, Urticaria, DYSPNEA, URTICARIA, PALLOR

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Latex, Benadryl
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, dyspnea, pallor, approximately 15 minutes, post vax. Treated with epinephrine, IM, and Atarax, albuterol and Solu-Medrol in ER all in right deltoid. Follow-up with allergist is recommended.


Changed on 6/14/2014

VAERS ID: 151801 Before After
VAERS Form:
Age:22.0
Sex:Female
Location:Florida
Vaccinated:2000-04-29
Onset:2000-04-29
Submitted:2000-05-04
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 639A4 / 0 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 133J / 1 - / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES U0003BA / 1 - / IM

Administered by: Military      Purchased by: Military
Symptoms: Dyspnoea, Pallor, Urticaria

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Latex, Benadryl
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, dyspnea, pallor, approximately 15 minutes, post vax. Treated with epinephrine, IM, and Atarax, albuterol and Solu-Medrol in ER all in right deltoid. Follow-up with allergist is recommended.


Changed on 5/14/2017

VAERS ID: 151801 Before After
VAERS Form:
Age:22.0
Sex:Female
Location:Florida
Vaccinated:2000-04-29
Onset:2000-04-29
Submitted:2000-05-04
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 639A4 / 0 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 133J / 1 - / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES U0003BA / 1 - / IM

Administered by: Military      Purchased by: Military
Symptoms: Dyspnoea, Pallor, Urticaria

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Latex, Benadryl
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, dyspnea, pallor, approximately 15 minutes, post vax. Treated with epinephrine, IM, and Atarax, albuterol and Solu-Medrol in ER all in right deltoid. Follow-up with allergist is recommended.


Changed on 9/14/2017

VAERS ID: 151801 Before After
VAERS Form:(blank) 1
Age:22.0
Sex:Female
Location:Florida
Vaccinated:2000-04-29
Onset:2000-04-29
Submitted:2000-05-04
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 639A4 / 0 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 133J / 1 2 - / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES U0003BA / 1 2 - / IM

Administered by: Military      Purchased by: Military
Symptoms: Dyspnoea, Pallor, Urticaria

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Latex, Benadryl
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, dyspnea, pallor, approximately 15 minutes, post vax. Treated with epinephrine, IM, and Atarax, albuterol and Solu-Medrol in ER all in right deltoid. Follow-up with allergist is recommended.


Changed on 2/14/2018

VAERS ID: 151801 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:Florida
Vaccinated:2000-04-29
Onset:2000-04-29
Submitted:2000-05-04
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 639A4 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 133J / 2 - / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES U0003BA / 2 - / IM

Administered by: Military      Purchased by: Military
Symptoms: Dyspnoea, Pallor, Urticaria

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Latex, Benadryl
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, dyspnea, pallor, approximately 15 minutes, post vax. Treated with epinephrine, IM, and Atarax, albuterol and Solu-Medrol in ER all in right deltoid. Follow-up with allergist is recommended.


Changed on 6/14/2018

VAERS ID: 151801 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:Florida
Vaccinated:2000-04-29
Onset:2000-04-29
Submitted:2000-05-04
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 639A4 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 133J / 2 - / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES U0003BA / 2 - / IM

Administered by: Military      Purchased by: Military
Symptoms: Dyspnoea, Pallor, Urticaria

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Latex, Benadryl
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, dyspnea, pallor, approximately 15 minutes, post vax. Treated with epinephrine, IM, and Atarax, albuterol and Solu-Medrol in ER all in right deltoid. Follow-up with allergist is recommended.


Changed on 8/14/2018

VAERS ID: 151801 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:Florida
Vaccinated:2000-04-29
Onset:2000-04-29
Submitted:2000-05-04
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 639A4 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 133J / 2 - / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES U0003BA / 2 - / IM

Administered by: Military      Purchased by: Military
Symptoms: Dyspnoea, Pallor, Urticaria

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Latex, Benadryl
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, dyspnea, pallor, approximately 15 minutes, post vax. Treated with epinephrine, IM, and Atarax, albuterol and Solu-Medrol in ER all in right deltoid. Follow-up with allergist is recommended.


Changed on 9/14/2018

VAERS ID: 151801 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:Florida
Vaccinated:2000-04-29
Onset:2000-04-29
Submitted:2000-05-04
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 639A4 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 133J / 2 - / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES U0003BA / 2 - / IM

Administered by: Military      Purchased by: Military
Symptoms: Dyspnoea, Pallor, Urticaria

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Latex, Benadryl
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, dyspnea, pallor, approximately 15 minutes, post vax. Treated with epinephrine, IM, and Atarax, albuterol and Solu-Medrol in ER all in right deltoid. Follow-up with allergist is recommended.


Changed on 10/14/2018

VAERS ID: 151801 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:Florida
Vaccinated:2000-04-29
Onset:2000-04-29
Submitted:2000-05-04
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 639A4 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 133J / 2 - / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES U0003BA / 2 - / IM

Administered by: Military      Purchased by: Military
Symptoms: Dyspnoea, Pallor, Urticaria

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Latex, Benadryl
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, dyspnea, pallor, approximately 15 minutes, post vax. Treated with epinephrine, IM, and Atarax, albuterol and Solu-Medrol in ER all in right deltoid. Follow-up with allergist is recommended.


Changed on 12/24/2020

VAERS ID: 151801 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:Florida
Vaccinated:2000-04-29
Onset:2000-04-29
Submitted:2000-05-04
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 639A4 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 133J / 2 - / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES U0003BA / 2 - / IM

Administered by: Military      Purchased by: Military
Symptoms: Dyspnoea, Pallor, Urticaria

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Latex, Benadryl
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, dyspnea, pallor, approximately 15 minutes, post vax. Treated with epinephrine, IM, and Atarax, albuterol and Solu-Medrol in ER all in right deltoid. Follow-up with allergist is recommended.


Changed on 12/30/2020

VAERS ID: 151801 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:Florida
Vaccinated:2000-04-29
Onset:2000-04-29
Submitted:2000-05-04
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 639A4 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 133J / 2 - / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES U0003BA / 2 - / IM

Administered by: Military      Purchased by: Military
Symptoms: Dyspnoea, Pallor, Urticaria

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Latex, Benadryl
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, dyspnea, pallor, approximately 15 minutes, post vax. Treated with epinephrine, IM, and Atarax, albuterol and Solu-Medrol in ER all in right deltoid. Follow-up with allergist is recommended.


Changed on 5/7/2021

VAERS ID: 151801 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:Florida
Vaccinated:2000-04-29
Onset:2000-04-29
Submitted:2000-05-04
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 639A4 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 133J / 2 - / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES U0003BA / 2 - / IM

Administered by: Military      Purchased by: Military
Symptoms: Dyspnoea, Pallor, Urticaria

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Latex, Benadryl
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, dyspnea, pallor, approximately 15 minutes, post vax. Treated with epinephrine, IM, and Atarax, albuterol and Solu-Medrol in ER all in right deltoid. Follow-up with allergist is recommended.


Changed on 5/21/2021

VAERS ID: 151801 Before After
VAERS Form:1
Age:22.0
Sex:Female
Location:Florida
Vaccinated:2000-04-29
Onset:2000-04-29
Submitted:2000-05-04
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 639A4 / 1 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 133J / 2 - / SC
TD: TD ADSORBED (NO BRAND NAME) / CONNAUGHT LABORATORIES U0003BA / 2 - / IM

Administered by: Military      Purchased by: Military
Symptoms: Dyspnoea, Pallor, Urticaria

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Latex, Benadryl
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Urticaria, dyspnea, pallor, approximately 15 minutes, post vax. Treated with epinephrine, IM, and Atarax, albuterol and Solu-Medrol in ER all in right deltoid. Follow-up with allergist is recommended.

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