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This is VAERS ID 151884

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 151884
VAERS Form:
Age:44.0
Gender:Male
Location:Pennsylvania
Vaccinated:1999-10-01
Onset:1999-10-14
Submitted:2000-04-21
Entered:2000-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYMERIX / SMITHKLINE - / 1 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: ARTHRALGIA, MOVEMENT DIS

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: Pt received injections of Lymerix in September and October, 1999 and for 2 weeks after 2nd shot, he could not lift his arm. He also experienced constant pain and tightness in his right shoulder and all his joints were sore ""to some extent"". The most re"cent information received on 2/17/2000, indicates he symptoms are ongoing. Additional information has been request.


Changed on 12/30/2006

VAERS ID: 151884 Before After
VAERS Form:
Age:44.0
Gender:Male
Location:Pennsylvania
Vaccinated:1999-10-01
Onset:1999-10-14
Submitted:2000-04-21
Entered:2000-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYMERIX / SMITHKLINE - / 1 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: ARTHRALGIA, MOVEMENT DIS

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: Pt received injections of Lymerix in September and October, 1999 and for 2 weeks after 2nd shot, he could not lift his arm. He also experienced constant pain and tightness in his right shoulder and all his joints were sore ""to /"to some extent"". extent/". The most re"cent information received on 2/17/2000, indicates he symptoms are ongoing. Additional information has been request.


Changed on 12/8/2009

VAERS ID: 151884 Before After
VAERS Form:
Age:44.0
Gender:Male
Location:Pennsylvania
Vaccinated:1999-10-01
Onset:1999-10-14
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 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Arthralgia, Movement disorder, ARTHRALGIA, MOVEMENT DIS

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) 20000055171

Write-up: Pt received injections of Lymerix in September and October, 1999 and for 2 weeks after 2nd shot, he could not lift his arm. He also experienced constant pain and tightness in his right shoulder and all his joints were sore /"to "to some extent/". extent". The most re"cent recent information received on 2/17/2000, indicates he symptoms are ongoing. Additional information has been request.


Changed on 9/14/2017

VAERS ID: 151884 Before After
VAERS Form:(blank) 1
Age:44.0
Gender:Male
Location:Pennsylvania
Vaccinated:1999-10-01
Onset:1999-10-14
Submitted:2000-04-21
Entered:2000-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 1 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Movement disorder

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': 20000055171

Write-up: Pt received injections of Lymerix in September and October, 1999 and for 2 weeks after 2nd shot, he could not lift his arm. He also experienced constant pain and tightness in his right shoulder and all his joints were sore "to some extent". The most recent information received on 2/17/2000, indicates he symptoms are ongoing. Additional information has been request.


Changed on 2/14/2018

VAERS ID: 151884 Before After
VAERS Form:1
Age:44.0
Gender:Male
Location:Pennsylvania
Vaccinated:1999-10-01
Onset:1999-10-14
Submitted:2000-04-21
Entered:2000-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Movement disorder

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': 20000055171

Write-up: Pt received injections of Lymerix in September and October, 1999 and for 2 weeks after 2nd shot, he could not lift his arm. He also experienced constant pain and tightness in his right shoulder and all his joints were sore "to some extent". The most recent information received on 2/17/2000, indicates he symptoms are ongoing. Additional information has been request.


Changed on 6/14/2018

VAERS ID: 151884 Before After
VAERS Form:1
Age:44.0
Gender:Male
Location:Pennsylvania
Vaccinated:1999-10-01
Onset:1999-10-14
Submitted:2000-04-21
Entered:2000-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Movement disorder

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': 20000055171

Write-up: Pt received injections of Lymerix in September and October, 1999 and for 2 weeks after 2nd shot, he could not lift his arm. He also experienced constant pain and tightness in his right shoulder and all his joints were sore "to some extent". The most recent information received on 2/17/2000, indicates he symptoms are ongoing. Additional information has been request.


Changed on 8/14/2018

VAERS ID: 151884 Before After
VAERS Form:1
Age:44.0
Gender:Male
Location:Pennsylvania
Vaccinated:1999-10-01
Onset:1999-10-14
Submitted:2000-04-21
Entered:2000-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Movement disorder

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': 20000055171

Write-up: Pt received injections of Lymerix in September and October, 1999 and for 2 weeks after 2nd shot, he could not lift his arm. He also experienced constant pain and tightness in his right shoulder and all his joints were sore "to some extent". The most recent information received on 2/17/2000, indicates he symptoms are ongoing. Additional information has been request.


Changed on 9/14/2018

VAERS ID: 151884 Before After
VAERS Form:1
Age:44.0
Gender:Male
Location:Pennsylvania
Vaccinated:1999-10-01
Onset:1999-10-14
Submitted:2000-04-21
Entered:2000-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Movement disorder

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': 20000055171

Write-up: Pt received injections of Lymerix in September and October, 1999 and for 2 weeks after 2nd shot, he could not lift his arm. He also experienced constant pain and tightness in his right shoulder and all his joints were sore "to some extent". The most recent information received on 2/17/2000, indicates he symptoms are ongoing. Additional information has been request.


Changed on 10/14/2018

VAERS ID: 151884 Before After
VAERS Form:1
Age:44.0
Gender:Male
Location:Pennsylvania
Vaccinated:1999-10-01
Onset:1999-10-14
Submitted:2000-04-21
Entered:2000-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Movement disorder

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': 20000055171

Write-up: Pt received injections of Lymerix in September and October, 1999 and for 2 weeks after 2nd shot, he could not lift his arm. He also experienced constant pain and tightness in his right shoulder and all his joints were sore "to some extent". The most recent information received on 2/17/2000, indicates he symptoms are ongoing. Additional information has been request.

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