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This is VAERS ID 151824

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 151824
VAERS Form:
Age:56.0
Sex:Male
Location:Minnesota
Vaccinated:2000-01-13
Onset:2000-01-13
Submitted:2000-04-21
Entered:2000-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYMERIX / SMITHKLINE LY126A2 / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: PAIN

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: Contac, acetylasalicysic acid, Advil
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: On 1/13/00, the pt received his first right arm dose of Lymerix. Following the first dose on 1/13/00, the pt experienced severe arm pain which kept his awake all night. No treatment was given.The most recent information received on 1/14/00, reported the c"ondition of the pt as unknown.


Changed on 12/8/2009

VAERS ID: 151824 Before After
VAERS Form:
Age:56.0
Sex:Male
Location:Minnesota
Vaccinated:2000-01-13
Onset:2000-01-13
Submitted:2000-04-21
Entered:2000-06-13 2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYMERIX LYME (LYMERIX) / SMITHKLINE SMITHKLINE BEECHAM LY126A2 / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Pain, PAIN

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: Contac, acetylasalicysic acid, Advil
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 20000011991

Write-up: On 1/13/00, the pt received his first right arm dose of Lymerix. Following the first dose on 1/13/00, the pt experienced severe arm pain which kept his awake all night. No treatment was given.The given. The most recent information received on 1/14/00, reported the c"ondition condition of the pt as unknown.


Changed on 5/14/2017

VAERS ID: 151824 Before After
VAERS Form:
Age:56.0
Sex:Male
Location:Minnesota
Vaccinated:2000-01-13
Onset:2000-01-13
Submitted:2000-04-21
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM LY126A2 / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: Contac, acetylasalicysic acid, Advil
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000011991

Write-up: On 1/13/00, the pt received his first right arm dose of Lymerix. Following the first dose on 1/13/00, the pt experienced severe arm pain which kept his awake all night. No treatment was given. The most recent information received on 1/14/00, reported the condition of the pt as unknown.


Changed on 9/14/2017

VAERS ID: 151824 Before After
VAERS Form:(blank) 1
Age:56.0
Sex:Male
Location:Minnesota
Vaccinated:2000-01-13
Onset:2000-01-13
Submitted:2000-04-21
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM LY126A2 / 0 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: Contac, acetylasalicysic acid, Advil
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000011991

Write-up: On 1/13/00, the pt received his first right arm dose of Lymerix. Following the first dose on 1/13/00, the pt experienced severe arm pain which kept his awake all night. No treatment was given. The most recent information received on 1/14/00, reported the condition of the pt as unknown.


Changed on 2/14/2018

VAERS ID: 151824 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:Minnesota
Vaccinated:2000-01-13
Onset:2000-01-13
Submitted:2000-04-21
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM LY126A2 / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: Contac, acetylasalicysic acid, Advil
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000011991

Write-up: On 1/13/00, the pt received his first right arm dose of Lymerix. Following the first dose on 1/13/00, the pt experienced severe arm pain which kept his awake all night. No treatment was given. The most recent information received on 1/14/00, reported the condition of the pt as unknown.


Changed on 6/14/2018

VAERS ID: 151824 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:Minnesota
Vaccinated:2000-01-13
Onset:2000-01-13
Submitted:2000-04-21
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM LY126A2 / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: Contac, acetylasalicysic acid, Advil
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000011991

Write-up: On 1/13/00, the pt received his first right arm dose of Lymerix. Following the first dose on 1/13/00, the pt experienced severe arm pain which kept his awake all night. No treatment was given. The most recent information received on 1/14/00, reported the condition of the pt as unknown.


Changed on 8/14/2018

VAERS ID: 151824 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:Minnesota
Vaccinated:2000-01-13
Onset:2000-01-13
Submitted:2000-04-21
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM LY126A2 / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: Contac, acetylasalicysic acid, Advil
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000011991

Write-up: On 1/13/00, the pt received his first right arm dose of Lymerix. Following the first dose on 1/13/00, the pt experienced severe arm pain which kept his awake all night. No treatment was given. The most recent information received on 1/14/00, reported the condition of the pt as unknown.


Changed on 9/14/2018

VAERS ID: 151824 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:Minnesota
Vaccinated:2000-01-13
Onset:2000-01-13
Submitted:2000-04-21
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM LY126A2 / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: Contac, acetylasalicysic acid, Advil
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000011991

Write-up: On 1/13/00, the pt received his first right arm dose of Lymerix. Following the first dose on 1/13/00, the pt experienced severe arm pain which kept his awake all night. No treatment was given. The most recent information received on 1/14/00, reported the condition of the pt as unknown.


Changed on 10/14/2018

VAERS ID: 151824 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:Minnesota
Vaccinated:2000-01-13
Onset:2000-01-13
Submitted:2000-04-21
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM LY126A2 / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: Contac, acetylasalicysic acid, Advil
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000011991

Write-up: On 1/13/00, the pt received his first right arm dose of Lymerix. Following the first dose on 1/13/00, the pt experienced severe arm pain which kept his awake all night. No treatment was given. The most recent information received on 1/14/00, reported the condition of the pt as unknown.

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