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This is VAERS ID 38681

Case Details

VAERS ID: 38681 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: Male  
Location: Michigan  
Vaccinated:1991-03-21
Onset:1991-06-27
   Days after vaccination:98
Submitted: 1991-11-18
   Days after onset:144
Entered: 1991-12-23
   Days after submission:35
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / 3 - / IM A

Administered by: Other       Purchased by: Other
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: EBU911241

Write-up: Pt recvd Engerix-B on 26APR90, 1JUN90, & 23OCT90 subsequently found neg anti-HBS p/3 doses @ 1mo, 2mo, & 6mo intervals;


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