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This is VAERS ID 151879

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 151879
VAERS Form:
Age:65.0
Sex:Male
Location:New York
Vaccinated:1999-05-01
Onset:1999-05-14
Submitted:2000-04-21
Entered:2000-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYMERIX / SMITHKLINE - / 1 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: ARTHRITIS, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Two weeks post 2nd dose of vax, the pt experienced arthritic-type symptoms in his shoulders and hips. Treatment included prednisone and cortisone.


Changed on 12/8/2009

VAERS ID: 151879 Before After
VAERS Form:
Age:65.0
Sex:Male
Location:New York
Vaccinated:1999-05-01
Onset:1999-05-14
Submitted:2000-04-21
Entered:2000-06-13 2000-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYMERIX LYME (LYMERIX) / SMITHKLINE SMITHKLINE BEECHAM - / 1 - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Arthritis, Pain, ARTHRITIS, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 20000055101

Write-up: Two weeks post 2nd dose of vax, the pt experienced arthritic-type symptoms in his shoulders and hips. Treatment included prednisone and cortisone.


Changed on 5/14/2017

VAERS ID: 151879 Before After
VAERS Form:
Age:65.0
Sex:Male
Location:New York
Vaccinated:1999-05-01
Onset:1999-05-14
Submitted:2000-04-21
Entered:2000-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Other      Purchased by: Other Unknown
Symptoms: Arthritis, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000055101

Write-up: Two weeks post 2nd dose of vax, the pt experienced arthritic-type symptoms in his shoulders and hips. Treatment included prednisone and cortisone.


Changed on 9/14/2017

VAERS ID: 151879 Before After
VAERS Form:(blank) 1
Age:65.0
Sex:Male
Location:New York
Vaccinated:1999-05-01
Onset:1999-05-14
Submitted:2000-04-21
Entered:2000-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 1 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Arthritis, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000055101

Write-up: Two weeks post 2nd dose of vax, the pt experienced arthritic-type symptoms in his shoulders and hips. Treatment included prednisone and cortisone.


Changed on 2/14/2018

VAERS ID: 151879 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:New York
Vaccinated:1999-05-01
Onset:1999-05-14
Submitted:2000-04-21
Entered:2000-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Arthritis, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000055101

Write-up: Two weeks post 2nd dose of vax, the pt experienced arthritic-type symptoms in his shoulders and hips. Treatment included prednisone and cortisone.


Changed on 6/14/2018

VAERS ID: 151879 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:New York
Vaccinated:1999-05-01
Onset:1999-05-14
Submitted:2000-04-21
Entered:2000-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Arthritis, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000055101

Write-up: Two weeks post 2nd dose of vax, the pt experienced arthritic-type symptoms in his shoulders and hips. Treatment included prednisone and cortisone.


Changed on 8/14/2018

VAERS ID: 151879 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:New York
Vaccinated:1999-05-01
Onset:1999-05-14
Submitted:2000-04-21
Entered:2000-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Arthritis, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000055101

Write-up: Two weeks post 2nd dose of vax, the pt experienced arthritic-type symptoms in his shoulders and hips. Treatment included prednisone and cortisone.


Changed on 9/14/2018

VAERS ID: 151879 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:New York
Vaccinated:1999-05-01
Onset:1999-05-14
Submitted:2000-04-21
Entered:2000-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Arthritis, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000055101

Write-up: Two weeks post 2nd dose of vax, the pt experienced arthritic-type symptoms in his shoulders and hips. Treatment included prednisone and cortisone.


Changed on 10/14/2018

VAERS ID: 151879 Before After
VAERS Form:1
Age:65.0
Sex:Male
Location:New York
Vaccinated:1999-05-01
Onset:1999-05-14
Submitted:2000-04-21
Entered:2000-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Arthritis, 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 20000055101

Write-up: Two weeks post 2nd dose of vax, the pt experienced arthritic-type symptoms in his shoulders and hips. Treatment included prednisone and cortisone.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=151879&WAYBACKHISTORY=ON


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