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This is VAERS ID 81047

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 81047
VAERS Form:
Age:70.0
Sex:Male
Location:Unknown
Vaccinated:1995-09-01
Onset:1995-09-01
Submitted:1995-09-20
Entered:1996-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE - / 0 - / IM

Administered by: Public      Purchased by: Unknown
Symptoms: FEVER, ANOREXIA, DYSPEPSIA, DEPRESSION, EOSINOPHILIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: liver enzymes elev
CDC 'Split Type':

Write-up: pt recvd vax;8 days later, elev liver enzymes, fever, n, noc sweats;to hosp;


Changed on 12/8/2009

VAERS ID: 81047 Before After
VAERS Form:
Age:70.0
Sex:Male
Location:Unknown
Vaccinated:1995-09-01
Onset:1995-09-01
Submitted:1995-09-20
Entered:1996-01-24 1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM - / 0 - / IM

Administered by: Public      Purchased by: Unknown Other
Symptoms: Anorexia, Depression, Dyspepsia, Eosinophilia, Hepatic function abnormal, Hyperhidrosis, Nausea, Pyrexia, FEVER, ANOREXIA, DYSPEPSIA, DEPRESSION, EOSINOPHILIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: liver enzymes elev
CDC 'Split Type': (blank) 950094501

Write-up: pt recvd vax;8 days later, elev liver enzymes, fever, n, noc sweats;to hosp;


Changed on 5/14/2017

VAERS ID: 81047 Before After
VAERS Form:
Age:70.0
Sex:Male
Location:Unknown
Vaccinated:1995-09-01
Onset:1995-09-01
Submitted:1995-09-20
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 0 - / IM

Administered by: Public      Purchased by: Other
Symptoms: Anorexia, Depression, Dyspepsia, Eosinophilia, Hepatic function abnormal, Hyperhidrosis, Nausea, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;


Changed on 9/14/2017

VAERS ID: 81047 Before After
VAERS Form:(blank) 1
Age:70.0
Sex:Male
Location:Unknown
Vaccinated:1995-09-01
Onset:1995-09-01
Submitted:1995-09-20
Entered:1996-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 0 1 - / IM

Administered by: Public      Purchased by: Other
Symptoms: Anorexia, Depression, Dyspepsia, Eosinophilia, Hepatic function abnormal, Hyperhidrosis, Nausea, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;


Changed on 2/14/2018

VAERS ID: 81047 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:Unknown
Vaccinated:1995-09-01
Onset:1995-09-01
Submitted:1995-09-20
Entered:1996-01-03
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;


Changed on 6/14/2018

VAERS ID: 81047 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:Unknown
Vaccinated:1995-09-01
Onset:1995-09-01
Submitted:1995-09-20
Entered:1996-01-03
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;


Changed on 8/14/2018

VAERS ID: 81047 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:Unknown
Vaccinated:1995-09-01
Onset:1995-09-01
Submitted:1995-09-20
Entered:1996-01-03
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;


Changed on 9/14/2018

VAERS ID: 81047 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:Unknown
Vaccinated:1995-09-01
Onset:1995-09-01
Submitted:1995-09-20
Entered:1996-01-03
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;


Changed on 10/14/2018

VAERS ID: 81047 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:Unknown
Vaccinated:1995-09-01
Onset:1995-09-01
Submitted:1995-09-20
Entered:1996-01-03
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;


Changed on 12/24/2020

VAERS ID: 81047 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:Unknown
Vaccinated:1995-09-01
Onset:1995-09-01
Submitted:1995-09-20
Entered:1996-01-03
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;


Changed on 12/30/2020

VAERS ID: 81047 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:Unknown
Vaccinated:1995-09-01
Onset:1995-09-01
Submitted:1995-09-20
Entered:1996-01-03
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;


Changed on 5/7/2021

VAERS ID: 81047 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:Unknown
Vaccinated:1995-09-01
Onset:1995-09-01
Submitted:1995-09-20
Entered:1996-01-03
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;


Changed on 5/14/2021

VAERS ID: 81047 Before After
VAERS Form:1
Age:70.0
Sex:Male
Location:Unknown
Vaccinated:1995-09-01
Onset:1995-09-01
Submitted:1995-09-20
Entered:1996-01-03
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=81047&WAYBACKHISTORY=ON


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