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This is VAERS ID 274618

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 274618    Vaccinated: 2006-11-16
Age: 53.0   Onset: 2006-11-21
Gender: Male   Submitted: 2007-02-13
Location: California   Entered: 2007-03-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had no illness at the time of vaccinations on 16 November 2006. From new information on 15 January 2007, the patient is allergic to Tetracycline.
Diagnostic Lab Data: A CBC, metabolic panel and urinalysis was performed (date not reported). The CBC revealed abnormal lymphocytes at 16% (normal range 26-46%) and WBCs were 7.1. The metabolic panel revealed abnormal BUN at 22 (normal range 7-18) with normal A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX) GLAXOSMITHKLINE BIOLOGICALS AHAVBB050AA 0 IM RA
TDAP: TDAP (ADACEL) AVENTIS PASTEUR C2638AA 0 IM LA
YF: YELLOW FEVER (YF-VAX) AVENTIS PASTEUR UE888AA 0 SC RA
Administered by: Private      Purchased by: Unknown
Symptoms: Alanine aminotransferase normal, Arthralgia, Aspartate aminotransferase normal, Axillary pain, Blood electrolytes normal
Write-up: Initial report received from a health care professional on 22 November 2006. A 53 year old male patient received on 16 November 2006 Adacel (unknown lot number) and YF Vax (corrected) (unknown lot number) and the following concomitant vaccinations: Vaqta,"Engerix B. On 17 November 2006 the patient received Oral Typhoid. Lot numbers, site and side if administration was unknown for all vaccines. On 19 November 2006, three days post initial vaccination, the patient developed pain, swelling of the right fifth

Changed on 12/8/2009

VAERS ID: 274618 Before After   Vaccinated: 2006-11-16
Age: 53.0   Onset: 2006-11-21
Gender: Male   Submitted: 2007-02-13
Location: California   Entered: 2007-03-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had no illness at the time of vaccinations on 16 November 2006. From new information on 15 January 2007, the patient is allergic to Tetracycline.
Diagnostic Lab Data: A CBC, metabolic panel and urinalysis was performed (date not reported). The CBC revealed abnormal lymphocytes at 16% (normal range 26-46%) and WBCs were 7.1. The metabolic panel revealed abnormal BUN at 22 (normal range 7-18) with normal A
CDC 'Split Type':
(blank)
200603243
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX) GLAXOSMITHKLINE BIOLOGICALS AHAVBB050AA 0 IM RA
TDAP: TDAP (ADACEL) AVENTIS PASTEUR C2638AA 0 IM LA
YF: YELLOW FEVER (YF-VAX) AVENTIS PASTEUR UE888AA 0 SC RA
Administered by: Private      Purchased by: Unknown
Symptoms: Alanine aminotransferase normal, Arthralgia, Aspartate aminotransferase normal, Blood urea increased, Erythema multiforme, Full blood count abnormal, Lymphadenopathy, Lymphocyte count decreased, Oedema peripheral, Pain in extremity, Pruritus, Rash erythematous, Rash pruritic, Skin nodule, Tenderness, Urticaria, White blood cell count normal, Axillary pain, Blood electrolytes normal, Urine analysis normal, Metabolic function test
Write-up:
Initial report received from a health care professional on 22 November 2006. A 53 year old male patient received on 16 November 2006 Adacel (unknown lot number) and YF Vax (corrected) (unknown lot number) and the following concomitant vaccinations: Vaqta,"Engerix Vaqta, Engerix B. On 17 November 2006 the patient received Oral Typhoid. Lot numbers, site and side if administration was unknown for all vaccines. On 19 November 2006, three days post initial vaccination, the patient developed pain, swelling of the right fifth finger. The patient moved to the left hip and nodules appeared on hands and feet. The nodules were itchy and tender, visibly noticeable. Corrective treatment was not reported. The patient was not severity ill but the signs and symptoms continued. At the time of this report (22 November 2006), the patient had not recovered. It was unknown if the patient had allergies, but the patient had no egg allergies. No illness at the time of vaccination. Prior exposure to the vaccines was not reported. Upon review of the case on 06 December 2006: a correction of the suspect drug "YF Vax" (formally reported as VF Vax) was made. Follow-up information received on 15 January 2007. Per the reporter, the patient has past medical history of allergy to Tetracycline. The patient was not taking any other medications at the time of the vaccinations on 16 November 2006. The statement in the previous narrative "but the patient had no egg allergies" was crossed out on the follow-up form by the reporter. Regarding the vaccinations on 16 November 2006; the patient received the vaccinations at 12:45 pm. The lot number for the Adacel was reported at C2638AA, and the vaccine was given intramuscularly in the left deltoid. The patient had received in the past a "Td" vaccine on 12 January 2000, and it was not reported whether any adverse events were associated with that vaccination. The lot number for the YF-VAX vaccine was reported as UE888AA, and it was given subcutaneously in the right upper arm. The patient had not received any received any

Changed on 8/31/2010

VAERS ID: 274618 Before After   Vaccinated: 2006-11-16
Age: 53.0   Onset: 2006-11-21
Gender: Male   Submitted: 2007-02-13
Location: California   Entered: 2007-03-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had no illness at the time of vaccinations on 16 November 2006. From new information on 15 January 2007, the patient is allergic to Tetracycline.
Diagnostic Lab Data: A CBC, metabolic panel and urinalysis was performed (date not reported). The CBC revealed abnormal lymphocytes at 16% (normal range 26-46%) and WBCs were 7.1. The metabolic panel revealed abnormal BUN at 22 (normal range 7-18) with normal A
CDC 'Split Type': 200603243
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX) GLAXOSMITHKLINE BIOLOGICALS AHAVBB050AA 0 IM RA
TDAP: TDAP (ADACEL) AVENTIS PASTEUR C2638AA 0 IM LA
YF: YELLOW FEVER (YF-VAX) AVENTIS PASTEUR UE888AA 0 SC RA
Administered by: Private      Purchased by: Unknown
Symptoms: Alanine aminotransferase normal, Arthralgia, Aspartate aminotransferase normal, Blood urea increased, Erythema multiforme, Full blood count abnormal, Lymphadenopathy, Lymphocyte count decreased, Oedema peripheral, Pain in extremity, Pruritus, Rash erythematous, Rash pruritic, Skin nodule, Tenderness, Urticaria, White blood cell count normal, Axillary pain, Blood electrolytes normal, Urine analysis normal, Metabolic function test
Write-up: Initial report received from a health care professional on 22 November 2006. A 53 year old male patient received on 16 November 2006 Adacel (unknown lot number) and YF Vax (corrected) (unknown lot number) and the following concomitant vaccinations: Vaqta, Engerix B. On 17 November 2006 the patient received Oral Typhoid. Lot numbers, site and side if administration was unknown for all vaccines. On 19 November 2006, three days post initial vaccination, the patient developed pain, swelling of the right fifth finger. The patient moved to the left hip and nodules appeared on hands and feet. The nodules were itchy and tender, visibly noticeable. Corrective treatment was not reported. The patient was not severity ill but the signs and symptoms continued. At the time of this report (22 November 2006), the patient had not recovered. It was unknown if the patient had allergies, but the patient had no egg allergies. No illness at the time of vaccination. Prior exposure to the vaccines was not reported. Upon review of the case on 06 December 2006: a correction of the suspect drug "YF Vax" (formally reported as VF Vax) was made. Follow-up information received on 15 January 2007. Per the reporter, the patient has past medical history of allergy to Tetracycline. The patient was not taking any other medications at the time of the vaccinations on 16 November 2006. The statement in the previous narrative "but the patient had no egg allergies" was crossed out on the follow-up form by the reporter. Regarding the vaccinations on 16 November 2006; the patient received the vaccinations at 12:45 pm. The lot number for the Adacel was reported at C2638AA, and the vaccine was given intramuscularly in the left deltoid. The patient had received in the past a "Td" vaccine on 12 January 2000, and it was not reported whether any adverse events were associated with that vaccination. The lot number for the YF-VAX vaccine was reported as UE888AA, and it was given subcutaneously in the right upper arm. The patient had not received any received any

Changed on 4/13/2011

VAERS ID: 274618 Before After   Vaccinated: 2006-11-16
Age: 53.0   Onset: 2006-11-21
Gender: Male   Submitted: 2007-02-13
Location: California   Entered: 2007-03-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had no illness at the time of vaccinations on 16 November 2006. From new information on 15 January 2007, the patient is allergic to Tetracycline.
Diagnostic Lab Data: A CBC, metabolic panel and urinalysis was performed (date not reported). The CBC revealed abnormal lymphocytes at 16% (normal range 26-46%) and WBCs were 7.1. The metabolic panel revealed abnormal BUN at 22 (normal range 7-18) with normal A
CDC 'Split Type': 200603243
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX) GLAXOSMITHKLINE BIOLOGICALS AHAVBB050AA 0 IM RA
TDAP: TDAP (ADACEL) AVENTIS PASTEUR C2638AA 0 IM LA
YF: YELLOW FEVER (YF-VAX) AVENTIS PASTEUR UE888AA 0 SC RA
Administered by: Private      Purchased by: Unknown
Symptoms: Alanine aminotransferase normal, Arthralgia, Aspartate aminotransferase normal, Blood urea increased, Erythema multiforme, Full blood count abnormal, Lymphadenopathy, Lymphocyte count decreased, Oedema peripheral, Pain in extremity, Pruritus, Rash erythematous, Rash pruritic, Skin nodule, Tenderness, Urticaria, White blood cell count normal, Axillary pain, Blood electrolytes normal, Urine analysis normal, Metabolic function test
Write-up: Initial report received from a health care professional on 22 November 2006. A 53 year old male patient received on 16 November 2006 Adacel (unknown lot number) and YF Vax (corrected) (unknown lot number) and the following concomitant vaccinations: Vaqta, Engerix B. On 17 November 2006 the patient received Oral Typhoid. Lot numbers, site and side if administration was unknown for all vaccines. On 19 November 2006, three days post initial vaccination, the patient developed pain, swelling of the right fifth finger. The patient moved to the left hip and nodules appeared on hands and feet. The nodules were itchy and tender, visibly noticeable. Corrective treatment was not reported. The patient was not severity ill but the signs and symptoms continued. At the time of this report (22 November 2006), the patient had not recovered. It was unknown if the patient had allergies, but the patient had no egg allergies. No illness at the time of vaccination. Prior exposure to the vaccines was not reported. Upon review of the case on 06 December 2006: a correction of the suspect drug "YF Vax" (formally reported as VF Vax) was made. Follow-up information received on 15 January 2007. Per the reporter, the patient has past medical history of allergy to Tetracycline. The patient was not taking any other medications at the time of the vaccinations on 16 November 2006. The statement in the previous narrative "but the patient had no egg allergies" was crossed out on the follow-up form by the reporter. Regarding the vaccinations on 16 November 2006; the patient received the vaccinations at 12:45 pm. The lot number for the Adacel was reported at C2638AA, and the vaccine was given intramuscularly in the left deltoid. The patient had received in the past a "Td" vaccine on 12 January 2000, and it was not reported whether any adverse events were associated with that vaccination. The lot number for the YF-VAX vaccine was reported as UE888AA, and it was given subcutaneously in the right upper arm. The patient had not received any received any

Changed on 5/13/2011

VAERS ID: 274618 Before After   Vaccinated: 2006-11-16
Age: 53.0   Onset: 2006-11-21
Gender: Male   Submitted: 2007-02-13
Location: California   Entered: 2007-03-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had no illness at the time of vaccinations on 16 November 2006. From new information on 15 January 2007, the patient is allergic to Tetracycline.
Diagnostic Lab Data: A CBC, metabolic panel and urinalysis was performed (date not reported). The CBC revealed abnormal lymphocytes at 16% (normal range 26-46%) and WBCs were 7.1. The metabolic panel revealed abnormal BUN at 22 (normal range 7-18) with normal A
CDC 'Split Type': 200603243
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX) GLAXOSMITHKLINE BIOLOGICALS AHAVBB050AA 0 IM RA
TDAP: TDAP (ADACEL) AVENTIS PASTEUR C2638AA 0 IM LA
YF: YELLOW FEVER (YF-VAX) AVENTIS PASTEUR UE888AA 0 SC RA
Administered by: Private      Purchased by: Unknown
Symptoms: Alanine aminotransferase normal, Arthralgia, Aspartate aminotransferase normal, Blood urea increased, Erythema multiforme, Full blood count abnormal, Lymphadenopathy, Lymphocyte count decreased, Oedema peripheral, Pain in extremity, Pruritus, Rash erythematous, Rash pruritic, Skin nodule, Tenderness, Urticaria, White blood cell count normal, Axillary pain, Blood electrolytes normal, Urine analysis normal, Metabolic function test
Write-up: Initial report received from a health care professional on 22 November 2006. A 53 year old male patient received on 16 November 2006 Adacel (unknown lot number) and YF Vax (corrected) (unknown lot number) and the following concomitant vaccinations: Vaqta, Engerix B. On 17 November 2006 the patient received Oral Typhoid. Lot numbers, site and side if administration was unknown for all vaccines. On 19 November 2006, three days post initial vaccination, the patient developed pain, swelling of the right fifth finger. The patient moved to the left hip and nodules appeared on hands and feet. The nodules were itchy and tender, visibly noticeable. Corrective treatment was not reported. The patient was not severity ill but the signs and symptoms continued. At the time of this report (22 November 2006), the patient had not recovered. It was unknown if the patient had allergies, but the patient had no egg allergies. No illness at the time of vaccination. Prior exposure to the vaccines was not reported. Upon review of the case on 06 December 2006: a correction of the suspect drug "YF Vax" (formally reported as VF Vax) was made. Follow-up information received on 15 January 2007. Per the reporter, the patient has past medical history of allergy to Tetracycline. The patient was not taking any other medications at the time of the vaccinations on 16 November 2006. The statement in the previous narrative "but the patient had no egg allergies" was crossed out on the follow-up form by the reporter. Regarding the vaccinations on 16 November 2006; the patient received the vaccinations at 12:45 pm. The lot number for the Adacel was reported at C2638AA, and the vaccine was given intramuscularly in the left deltoid. The patient had received in the past a "Td" vaccine on 12 January 2000, and it was not reported whether any adverse events were associated with that vaccination. The lot number for the YF-VAX vaccine was reported as UE888AA, and it was given subcutaneously in the right upper arm. The patient had not received any received any

Changed on 6/11/2011

VAERS ID: 274618 Before After   Vaccinated: 2006-11-16
Age: 53.0   Onset: 2006-11-21
Gender: Male   Submitted: 2007-02-13
Location: California   Entered: 2007-03-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had no illness at the time of vaccinations on 16 November 2006. From new information on 15 January 2007, the patient is allergic to Tetracycline.
Diagnostic Lab Data: A CBC, metabolic panel and urinalysis was performed (date not reported). The CBC revealed abnormal lymphocytes at 16% (normal range 26-46%) and WBCs were 7.1. The metabolic panel revealed abnormal BUN at 22 (normal range 7-18) with normal A
CDC 'Split Type': 200603243
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX) GLAXOSMITHKLINE BIOLOGICALS AHAVBB050AA 0 IM RA
TDAP: TDAP (ADACEL) AVENTIS PASTEUR C2638AA 0 IM LA
YF: YELLOW FEVER (YF-VAX) AVENTIS PASTEUR UE888AA 0 SC RA
Administered by: Private      Purchased by: Unknown
Symptoms: Alanine aminotransferase normal, Arthralgia, Aspartate aminotransferase normal, Blood urea increased, Erythema multiforme, Full blood count abnormal, Lymphadenopathy, Lymphocyte count decreased, Oedema peripheral, Pain in extremity, Pruritus, Rash erythematous, Rash pruritic, Skin nodule, Tenderness, Urticaria, White blood cell count normal, Axillary pain, Blood electrolytes normal, Urine analysis normal, Metabolic function test
Write-up: Initial report received from a health care professional on 22 November 2006. A 53 year old male patient received on 16 November 2006 Adacel (unknown lot number) and YF Vax (corrected) (unknown lot number) and the following concomitant vaccinations: Vaqta, Engerix B. On 17 November 2006 the patient received Oral Typhoid. Lot numbers, site and side if administration was unknown for all vaccines. On 19 November 2006, three days post initial vaccination, the patient developed pain, swelling of the right fifth finger. The patient moved to the left hip and nodules appeared on hands and feet. The nodules were itchy and tender, visibly noticeable. Corrective treatment was not reported. The patient was not severity ill but the signs and symptoms continued. At the time of this report (22 November 2006), the patient had not recovered. It was unknown if the patient had allergies, but the patient had no egg allergies. No illness at the time of vaccination. Prior exposure to the vaccines was not reported. Upon review of the case on 06 December 2006: a correction of the suspect drug "YF Vax" (formally reported as VF Vax) was made. Follow-up information received on 15 January 2007. Per the reporter, the patient has past medical history of allergy to Tetracycline. The patient was not taking any other medications at the time of the vaccinations on 16 November 2006. The statement in the previous narrative "but the patient had no egg allergies" was crossed out on the follow-up form by the reporter. Regarding the vaccinations on 16 November 2006; the patient received the vaccinations at 12:45 pm. The lot number for the Adacel was reported at C2638AA, and the vaccine was given intramuscularly in the left deltoid. The patient had received in the past a "Td" vaccine on 12 January 2000, and it was not reported whether any adverse events were associated with that vaccination. The lot number for the YF-VAX vaccine was reported as UE888AA, and it was given subcutaneously in the right upper arm. The patient had not received any received any

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