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From the 1/14/2022 release of VAERS data:

This is VAERS ID 81647

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Case Details

VAERS ID: 81647 (history)  
Form: Version 1.0  
Age: 32.0  
Sex: Male  
Location: Illinois  
Vaccinated:1996-01-19
Onset:1996-01-20
   Days after vaccination:1
Submitted: 1996-01-21
   Days after onset:1
Entered: 1996-01-31
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Private       Purchased by: Other
Symptoms: Arthralgia, Asthenia, Dizziness, Influenza, Injection site pain, Myalgia, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: pt began to feel weak & dizzy & chills-flu like sx-achiness throughout body;nl body temp;vomit,diarrhea,t103 & soreness of the arm & inj site


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