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This is VAERS ID 151825

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 151825
VAERS Form:
Age:26.0
Sex:Male
Location:Maryland
Vaccinated:1999-10-29
Onset:0000-00-00
Submitted:2000-04-21
Entered:2000-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYMERIX / SMITHKLINE - / 0 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: EDEMA INJECT SITE, PAIN INJECT SITE, HYSN INJECT SITE

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

Write-up: On 10/29/99, the pt received his first IM-deltoid dose of Lymerix.A few days later, he experienced redness, swelling, and pain on the entire deltoid. Symptoms worsened over a couple of days, and then resolved within a few days. No treatment was given.The"most recent information received on 1/17/00 reports the condition of the pt is resolved.


Changed on 12/8/2009

VAERS ID: 151825 Before After
VAERS Form:
Age:26.0
Sex:Male
Location:Maryland
Vaccinated:1999-10-29
Onset:0000-00-00
Submitted:2000-04-21
Entered:2000-06-13 2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYMERIX LYME (LYMERIX) / SMITHKLINE SMITHKLINE BEECHAM - / 0 - / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, EDEMA INJECT SITE, PAIN INJECT SITE, HYSN INJECT SITE

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 20000013491

Write-up: On 10/29/99, the pt received his first IM-deltoid dose of Lymerix.A Lymerix. A few days later, he experienced redness, swelling, and pain on the entire deltoid. Symptoms worsened over a couple of days, and then resolved within a few days. No treatment was given.The"most given. The most recent information received on 1/17/00 reports the condition of the pt is resolved.


Changed on 5/14/2017

VAERS ID: 151825 Before After
VAERS Form:
Age:26.0
Sex:Male
Location:Maryland
Vaccinated:1999-10-29
Onset:0000-00-00
Submitted:2000-04-21
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 0 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site pain

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000013491

Write-up: On 10/29/99, the pt received his first IM-deltoid dose of Lymerix. A few days later, he experienced redness, swelling, and pain on the entire deltoid. Symptoms worsened over a couple of days, and then resolved within a few days. No treatment was given. The most recent information received on 1/17/00 reports the condition of the pt is resolved.


Changed on 9/14/2017

VAERS ID: 151825 Before After
VAERS Form:(blank) 1
Age:26.0
Sex:Male
Location:Maryland
Vaccinated:1999-10-29
Onset:0000-00-00
Submitted:2000-04-21
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 0 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site pain

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000013491

Write-up: On 10/29/99, the pt received his first IM-deltoid dose of Lymerix. A few days later, he experienced redness, swelling, and pain on the entire deltoid. Symptoms worsened over a couple of days, and then resolved within a few days. No treatment was given. The most recent information received on 1/17/00 reports the condition of the pt is resolved.


Changed on 2/14/2018

VAERS ID: 151825 Before After
VAERS Form:1
Age:26.0
Sex:Male
Location:Maryland
Vaccinated:1999-10-29
Onset:0000-00-00
Submitted:2000-04-21
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site pain

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000013491

Write-up: On 10/29/99, the pt received his first IM-deltoid dose of Lymerix. A few days later, he experienced redness, swelling, and pain on the entire deltoid. Symptoms worsened over a couple of days, and then resolved within a few days. No treatment was given. The most recent information received on 1/17/00 reports the condition of the pt is resolved.


Changed on 6/14/2018

VAERS ID: 151825 Before After
VAERS Form:1
Age:26.0
Sex:Male
Location:Maryland
Vaccinated:1999-10-29
Onset:0000-00-00
Submitted:2000-04-21
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site pain

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000013491

Write-up: On 10/29/99, the pt received his first IM-deltoid dose of Lymerix. A few days later, he experienced redness, swelling, and pain on the entire deltoid. Symptoms worsened over a couple of days, and then resolved within a few days. No treatment was given. The most recent information received on 1/17/00 reports the condition of the pt is resolved.


Changed on 8/14/2018

VAERS ID: 151825 Before After
VAERS Form:1
Age:26.0
Sex:Male
Location:Maryland
Vaccinated:1999-10-29
Onset:0000-00-00
Submitted:2000-04-21
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site pain

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000013491

Write-up: On 10/29/99, the pt received his first IM-deltoid dose of Lymerix. A few days later, he experienced redness, swelling, and pain on the entire deltoid. Symptoms worsened over a couple of days, and then resolved within a few days. No treatment was given. The most recent information received on 1/17/00 reports the condition of the pt is resolved.


Changed on 9/14/2018

VAERS ID: 151825 Before After
VAERS Form:1
Age:26.0
Sex:Male
Location:Maryland
Vaccinated:1999-10-29
Onset:0000-00-00
Submitted:2000-04-21
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site pain

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000013491

Write-up: On 10/29/99, the pt received his first IM-deltoid dose of Lymerix. A few days later, he experienced redness, swelling, and pain on the entire deltoid. Symptoms worsened over a couple of days, and then resolved within a few days. No treatment was given. The most recent information received on 1/17/00 reports the condition of the pt is resolved.


Changed on 10/14/2018

VAERS ID: 151825 Before After
VAERS Form:1
Age:26.0
Sex:Male
Location:Maryland
Vaccinated:1999-10-29
Onset:0000-00-00
Submitted:2000-04-21
Entered:2000-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site pain

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000013491

Write-up: On 10/29/99, the pt received his first IM-deltoid dose of Lymerix. A few days later, he experienced redness, swelling, and pain on the entire deltoid. Symptoms worsened over a couple of days, and then resolved within a few days. No treatment was given. The most recent information received on 1/17/00 reports the condition of the pt is resolved.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=151825&WAYBACKHISTORY=ON


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