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This is VAERS ID 77886

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 77886
VAERS Form:
Age:68.0
Sex:Female
Location:Illinois
Vaccinated:1995-07-20
Onset:1995-08-01
Submitted:1995-08-16
Entered:1996-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE VHA420A6 / 1 A / -

Administered by: Private      Purchased by: Unknown
Symptoms: PRURITUS, DIARRHEA, LIVER FUNC ABNORM, JAUNDICE, URIN ABNORM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SGOT 109; SGPT 277; ALKPH 388;
CDC 'Split Type':

Write-up: pt recvd vax;was inadvertently given 2nd dose; w/in 24 to 48 hrs of vax exp itching, d, darker urine & was jaundiced when examined;elev liver enzymes on 1aug95;


Changed on 12/8/2009

VAERS ID: 77886 Before After
VAERS Form:
Age:68.0
Sex:Female
Location:Illinois
Vaccinated:1995-07-20
Onset:1995-08-01 1995-07-21
Submitted:1995-08-16 1995-09-27
Entered:1996-01-24 1995-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM VHA420A6 420A6 / 1 A - / - IM

Administered by: Private Unknown      Purchased by: Unknown
Symptoms: Diarrhoea, Gastrointestinal disorder, Hepatic function abnormal, Jaundice, Neoplasm malignant, Pruritus, Blood alkaline phosphatase increased, Urine analysis abnormal, PRURITUS, DIARRHEA, LIVER FUNC ABNORM, JAUNDICE, URIN ABNORM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SGOT 1AUG95 BilTOT 7.8; SOGT 109; SGPT 277; ALKPH 388; 3AUG95 BILTOT 8.5; SGOT 113; SGPT 293; ALKPH 397; hepatitis screen neg;
CDC 'Split Type': (blank) 950074901

Write-up: pt recvd vax;was inadvertently given 2nd dose; vax 20JUL95 & w/in 24 to 48 hrs of 24-48hrs following vax exp itching, d, diarrhea, darker urine urine, & was jaundiced when examined;elev examined; pt was found to have elevated liver enzymes on 1aug95; 01AUG95;MD demonstrated evidence of bile duct obstruction-bile duct stricture


Changed on 6/11/2011

VAERS ID: 77886 Before After
VAERS Form:
Age:68.0
Sex:Female
Location:Illinois
Vaccinated:1995-07-20
Onset:1995-07-21
Submitted:1995-09-27
Entered:1995-09-22 1995-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 1 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diarrhoea, Gastrointestinal disorder, Hepatic function abnormal, Jaundice, Neoplasm malignant, Pruritus, Blood alkaline phosphatase increased, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 1AUG95 BilTOT 7.8; SOGT 109; SGPT 277; ALKPH 388; 3AUG95 BILTOT 8.5; SGOT 113; SGPT 293; ALKPH 397; hepatitis screen neg;
CDC 'Split Type': 950074901

Write-up: pt recvd vax 20JUL95 & w/in 24-48hrs following vax exp itching, diarrhea, darker urine, & was jaundiced when examined; pt was found to have elevated liver enzymes 01AUG95;MD demonstrated evidence of bile duct obstruction-bile duct stricture


Changed on 5/14/2017

VAERS ID: 77886 Before After
VAERS Form:
Age:68.0
Sex:Female
Location:Illinois
Vaccinated:1995-07-20
Onset:1995-07-21
Submitted:1995-09-27
Entered:1995-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 1 - / IM

Administered by: Unknown Private      Purchased by: Unknown Private
Symptoms: Diarrhoea, Gastrointestinal disorder, Hepatic function abnormal, Jaundice, Neoplasm malignant, Pruritus, Blood alkaline phosphatase increased, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 1AUG95 BilTOT 7.8; SOGT 109; SGPT 277; ALKPH 388; 3AUG95 BILTOT 8.5; SGOT 113; SGPT 293; ALKPH 397; hepatitis screen neg;
CDC 'Split Type': 950074901

Write-up: pt recvd vax 20JUL95 & w/in 24-48hrs following vax exp itching, diarrhea, darker urine, & was jaundiced when examined; pt was found to have elevated liver enzymes 01AUG95;MD demonstrated evidence of bile duct obstruction-bile duct stricture


Changed on 9/14/2017

VAERS ID: 77886 Before After
VAERS Form:(blank) 1
Age:68.0
Sex:Female
Location:Illinois
Vaccinated:1995-07-20
Onset:1995-07-21
Submitted:1995-09-27
Entered:1995-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 1 2 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Diarrhoea, Gastrointestinal disorder, Hepatic function abnormal, Jaundice, Neoplasm malignant, Pruritus, Blood alkaline phosphatase increased, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 1AUG95 BilTOT 7.8; SOGT 109; SGPT 277; ALKPH 388; 3AUG95 BILTOT 8.5; SGOT 113; SGPT 293; ALKPH 397; hepatitis screen neg;
CDC 'Split Type': 950074901

Write-up: pt recvd vax 20JUL95 & w/in 24-48hrs following vax exp itching, diarrhea, darker urine, & was jaundiced when examined; pt was found to have elevated liver enzymes 01AUG95;MD demonstrated evidence of bile duct obstruction-bile duct stricture


Changed on 2/14/2018

VAERS ID: 77886 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Illinois
Vaccinated:1995-07-20
Onset:1995-07-21
Submitted:1995-09-27
Entered:1995-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 2 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Diarrhoea, Gastrointestinal disorder, Hepatic function abnormal, Jaundice, Neoplasm malignant, Pruritus, Blood alkaline phosphatase increased, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 1AUG95 BilTOT 7.8; SOGT 109; SGPT 277; ALKPH 388; 3AUG95 BILTOT 8.5; SGOT 113; SGPT 293; ALKPH 397; hepatitis screen neg;
CDC 'Split Type': 950074901

Write-up: pt recvd vax 20JUL95 & w/in 24-48hrs following vax exp itching, diarrhea, darker urine, & was jaundiced when examined; pt was found to have elevated liver enzymes 01AUG95;MD demonstrated evidence of bile duct obstruction-bile duct stricture


Changed on 6/14/2018

VAERS ID: 77886 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Illinois
Vaccinated:1995-07-20
Onset:1995-07-21
Submitted:1995-09-27
Entered:1995-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 2 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Diarrhoea, Gastrointestinal disorder, Hepatic function abnormal, Jaundice, Neoplasm malignant, Pruritus, Blood alkaline phosphatase increased, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 1AUG95 BilTOT 7.8; SOGT 109; SGPT 277; ALKPH 388; 3AUG95 BILTOT 8.5; SGOT 113; SGPT 293; ALKPH 397; hepatitis screen neg;
CDC 'Split Type': 950074901

Write-up: pt recvd vax 20JUL95 & w/in 24-48hrs following vax exp itching, diarrhea, darker urine, & was jaundiced when examined; pt was found to have elevated liver enzymes 01AUG95;MD demonstrated evidence of bile duct obstruction-bile duct stricture


Changed on 8/14/2018

VAERS ID: 77886 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Illinois
Vaccinated:1995-07-20
Onset:1995-07-21
Submitted:1995-09-27
Entered:1995-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 2 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Diarrhoea, Gastrointestinal disorder, Hepatic function abnormal, Jaundice, Neoplasm malignant, Pruritus, Blood alkaline phosphatase increased, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 1AUG95 BilTOT 7.8; SOGT 109; SGPT 277; ALKPH 388; 3AUG95 BILTOT 8.5; SGOT 113; SGPT 293; ALKPH 397; hepatitis screen neg;
CDC 'Split Type': 950074901

Write-up: pt recvd vax 20JUL95 & w/in 24-48hrs following vax exp itching, diarrhea, darker urine, & was jaundiced when examined; pt was found to have elevated liver enzymes 01AUG95;MD demonstrated evidence of bile duct obstruction-bile duct stricture


Changed on 9/14/2018

VAERS ID: 77886 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Illinois
Vaccinated:1995-07-20
Onset:1995-07-21
Submitted:1995-09-27
Entered:1995-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 2 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Diarrhoea, Gastrointestinal disorder, Hepatic function abnormal, Jaundice, Neoplasm malignant, Pruritus, Blood alkaline phosphatase increased, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 1AUG95 BilTOT 7.8; SOGT 109; SGPT 277; ALKPH 388; 3AUG95 BILTOT 8.5; SGOT 113; SGPT 293; ALKPH 397; hepatitis screen neg;
CDC 'Split Type': 950074901

Write-up: pt recvd vax 20JUL95 & w/in 24-48hrs following vax exp itching, diarrhea, darker urine, & was jaundiced when examined; pt was found to have elevated liver enzymes 01AUG95;MD demonstrated evidence of bile duct obstruction-bile duct stricture


Changed on 10/14/2018

VAERS ID: 77886 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Illinois
Vaccinated:1995-07-20
Onset:1995-07-21
Submitted:1995-09-27
Entered:1995-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 2 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Diarrhoea, Gastrointestinal disorder, Hepatic function abnormal, Jaundice, Neoplasm malignant, Pruritus, Blood alkaline phosphatase increased, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 1AUG95 BilTOT 7.8; SOGT 109; SGPT 277; ALKPH 388; 3AUG95 BILTOT 8.5; SGOT 113; SGPT 293; ALKPH 397; hepatitis screen neg;
CDC 'Split Type': 950074901

Write-up: pt recvd vax 20JUL95 & w/in 24-48hrs following vax exp itching, diarrhea, darker urine, & was jaundiced when examined; pt was found to have elevated liver enzymes 01AUG95;MD demonstrated evidence of bile duct obstruction-bile duct stricture


Changed on 12/24/2020

VAERS ID: 77886 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Illinois
Vaccinated:1995-07-20
Onset:1995-07-21
Submitted:1995-09-27
Entered:1995-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 2 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Diarrhoea, Gastrointestinal disorder, Hepatic function abnormal, Jaundice, Neoplasm malignant, Pruritus, Blood alkaline phosphatase increased, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 1AUG95 BilTOT 7.8; SOGT 109; SGPT 277; ALKPH 388; 3AUG95 BILTOT 8.5; SGOT 113; SGPT 293; ALKPH 397; hepatitis screen neg;
CDC 'Split Type': 950074901

Write-up: pt recvd vax 20JUL95 & w/in 24-48hrs following vax exp itching, diarrhea, darker urine, & was jaundiced when examined; pt was found to have elevated liver enzymes 01AUG95;MD demonstrated evidence of bile duct obstruction-bile duct stricture


Changed on 12/30/2020

VAERS ID: 77886 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Illinois
Vaccinated:1995-07-20
Onset:1995-07-21
Submitted:1995-09-27
Entered:1995-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 2 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Diarrhoea, Gastrointestinal disorder, Hepatic function abnormal, Jaundice, Neoplasm malignant, Pruritus, Blood alkaline phosphatase increased, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 1AUG95 BilTOT 7.8; SOGT 109; SGPT 277; ALKPH 388; 3AUG95 BILTOT 8.5; SGOT 113; SGPT 293; ALKPH 397; hepatitis screen neg;
CDC 'Split Type': 950074901

Write-up: pt recvd vax 20JUL95 & w/in 24-48hrs following vax exp itching, diarrhea, darker urine, & was jaundiced when examined; pt was found to have elevated liver enzymes 01AUG95;MD demonstrated evidence of bile duct obstruction-bile duct stricture


Changed on 5/7/2021

VAERS ID: 77886 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Illinois
Vaccinated:1995-07-20
Onset:1995-07-21
Submitted:1995-09-27
Entered:1995-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 2 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Diarrhoea, Gastrointestinal disorder, Hepatic function abnormal, Jaundice, Neoplasm malignant, Pruritus, Blood alkaline phosphatase increased, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 1AUG95 BilTOT 7.8; SOGT 109; SGPT 277; ALKPH 388; 3AUG95 BILTOT 8.5; SGOT 113; SGPT 293; ALKPH 397; hepatitis screen neg;
CDC 'Split Type': 950074901

Write-up: pt recvd vax 20JUL95 & w/in 24-48hrs following vax exp itching, diarrhea, darker urine, & was jaundiced when examined; pt was found to have elevated liver enzymes 01AUG95;MD demonstrated evidence of bile duct obstruction-bile duct stricture


Changed on 5/14/2021

VAERS ID: 77886 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Illinois
Vaccinated:1995-07-20
Onset:1995-07-21
Submitted:1995-09-27
Entered:1995-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 420A6 / 2 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Diarrhoea, Gastrointestinal disorder, Hepatic function abnormal, Jaundice, Neoplasm malignant, Pruritus, Blood alkaline phosphatase increased, Urine analysis abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 1AUG95 BilTOT 7.8; SOGT 109; SGPT 277; ALKPH 388; 3AUG95 BILTOT 8.5; SGOT 113; SGPT 293; ALKPH 397; hepatitis screen neg;
CDC 'Split Type': 950074901

Write-up: pt recvd vax 20JUL95 & w/in 24-48hrs following vax exp itching, diarrhea, darker urine, & was jaundiced when examined; pt was found to have elevated liver enzymes 01AUG95;MD demonstrated evidence of bile duct obstruction-bile duct stricture

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