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This is VAERS ID 151823

Case Details

VAERS ID: 151823 (history)  
Form: Version 1.0  
Age: 50.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2000-01-13
Onset:2000-01-13
   Days after vaccination:0
Submitted: 2000-04-12
   Days after onset:89
Entered: 2000-05-10
   Days after submission:28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM 116A2 / 2 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flovent, Albuterol
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type: 20000011731

Write-up: After receiving dose 2 of Lymerix on 1/13/00, the pt experienced severe arm pain which kept her awake the whole night. No treatment was given. The most recent information received on 1/14/00 it that the condition of the pt is unknown.


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