Already in VAERS on 12/31/2003 |
| VAERS ID: |
41955
|
Vaccinated: |
1992-04-02 |
| Age: |
53.6 |
Onset: |
1992-04-13 |
| Gender: |
Female |
Submitted: |
1992-05-08 |
| Location: |
New Hampshire |
Entered: |
1992-05-18 |
|
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes |
| ER or Doctor Visit? No |
| Hospitalized? No |
| Previous Vaccinations: |
| Other Medications: |
| Current Illness: NONE |
| Preexisting Conditions: splenectomy |
| Diagnostic Lab Data: NONE |
| CDC 'Split Type': |
|
| Vaccination |
Manufacturer |
Lot |
Dose |
Route |
Site |
| HIBV: UNK. HAEMOPHILUS B |
UNCLASSIFIED |
|
|
IM |
LA |
| MEN: UNK. MENINGOCOCCAL POLYSACCHARIDE |
UNCLASSIFIED |
|
|
SC |
RA |
|
| Administered by: Private
Purchased by: Unknown |
| Symptoms: VOMIT, PAIN ABDO, DIARRHEA |
| Write-up: vomitting, diarrhea, abd pain reported to MD on 13APR92; |
|
|
Changed on 12/8/2009 |
| VAERS ID: |
41955 Before
After
|
Vaccinated: |
1992-04-02 |
| Age: |
53.6 |
Onset: |
1992-04-13 |
| Gender: |
Female |
Submitted: |
1992-05-08 |
| Location: |
New Hampshire |
Entered: |
1992-05-18/1992-05-14 |
|
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes |
| ER or Doctor Visit? No |
| Hospitalized? No |
| Previous Vaccinations: |
| Other Medications: |
| Current Illness: NONE |
| Preexisting Conditions: splenectomy |
| Diagnostic Lab Data: NONE |
| CDC 'Split Type': |
|
| Vaccination |
Manufacturer |
Lot |
Dose |
Route |
Site |
| HIBV: UNK. HAEMOPHILUS B/HIB (NO BRAND NAME) |
UNCLASSIFIED/UNKNOWN MANUFACTURER |
|
|
IM |
LA |
| MEN: UNK. MENINGOCOCCAL POLYSACCHARIDE/MENINGOCOCCAL (NO BRAND NAME) |
UNCLASSIFIED/UNKNOWN MANUFACTURER |
|
|
SC |
RA |
|
| Administered by: Private
Purchased by: Unknown/Other |
| Symptoms: Abdominal pain, Diarrhoea, Vomiting, VOMIT, PAIN ABDO, DIARRHEA |
| Write-up: vomitting, diarrhea, abd pain reported to MD on 13APR92; |
|
|
