| VAERS ID: |
81047 (history) |
| Form: |
Version 1.0 |
| Age: |
70.0 |
| Sex: |
Male |
| Location: |
Unknown |
| Vaccinated: | 1995-09-01 |
| Onset: | 1995-09-01 |
| Days after vaccination: | 0 |
| Submitted: |
1995-09-20 |
| Days after onset: | 19 |
| Entered: |
1996-01-03 |
| Days after submission: | 105 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM |
- / 1 |
- / IM |
Administered by: Public Purchased by: Other
Symptoms: Anorexia,
Depression,
Dyspepsia,
Eosinophilia,
Hepatic function abnormal,
Hyperhidrosis,
Nausea,
Pyrexia
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: liver enzymes elev
CDC Split Type: 950094501
Write-up: pt recvd vax;8 days later, elev liver enzymes, fever, n, noc sweats;to hosp; |
