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This is VAERS ID 38681

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 38681
VAERS Form:
Age:0.4
Sex:Male
Location:Michigan
Vaccinated:1991-03-21
Onset:1991-06-27
Submitted:1991-11-18
Entered:1992-02-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B / SMITHKLINE 586A4 / 2 A / IM

Administered by: Other      Purchased by: Unknown
Symptoms: REACT UNEVAL

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


Changed on 12/8/2009

VAERS ID: 38681 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:Michigan
Vaccinated:1991-03-21
Onset:1991-06-27
Submitted:1991-11-18
Entered:1992-02-10 1991-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B HEP B (ENGERIX-B) / SMITHKLINE SMITHKLINE BEECHAM 586A4 / 2 A / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Unevaluable event, REACT UNEVAL

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) EBU911241

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


Changed on 5/14/2017

VAERS ID: 38681 Before After
VAERS Form:
Age:0.4
Sex:Male
Location:Michigan
Vaccinated:1991-03-21
Onset:1991-06-27
Submitted:1991-11-18
Entered:1991-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / 2 A - / IM IM A

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

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: ~ ()~~~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;


Changed on 9/14/2017

VAERS ID: 38681 Before After
VAERS Form:(blank) 1
Age:0.4
Sex:Male
Location:Michigan
Vaccinated:1991-03-21
Onset:1991-06-27
Submitted:1991-11-18
Entered:1991-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / 2 3 - / IM A

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

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: ~ ()~~~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;


Changed on 2/14/2018

VAERS ID: 38681 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Michigan
Vaccinated:1991-03-21
Onset:1991-06-27
Submitted:1991-11-18
Entered:1991-12-23
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

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: ~ ()~~~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;


Changed on 6/14/2018

VAERS ID: 38681 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Michigan
Vaccinated:1991-03-21
Onset:1991-06-27
Submitted:1991-11-18
Entered:1991-12-23
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

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: ~ ()~~~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;


Changed on 8/14/2018

VAERS ID: 38681 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Michigan
Vaccinated:1991-03-21
Onset:1991-06-27
Submitted:1991-11-18
Entered:1991-12-23
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

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: ~ ()~~~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;


Changed on 9/14/2018

VAERS ID: 38681 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Michigan
Vaccinated:1991-03-21
Onset:1991-06-27
Submitted:1991-11-18
Entered:1991-12-23
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

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: ~ ()~~~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;


Changed on 10/14/2018

VAERS ID: 38681 Before After
VAERS Form:1
Age:0.4
Sex:Male
Location:Michigan
Vaccinated:1991-03-21
Onset:1991-06-27
Submitted:1991-11-18
Entered:1991-12-23
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

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: ~ ()~~~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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