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This is VAERS ID 81647

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 81647
VAERS Form:
Age:32.5
Sex:Male
Location:Illinois
Vaccinated:1996-01-19
Onset:1996-01-20
Submitted:1996-01-21
Entered:1996-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE - / - - / -

Administered by: Private      Purchased by: Unknown
Symptoms: DIZZINESS, FEVER, ARTHRALGIA, FLU SYND, ASTHENIA

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


Changed on 12/8/2009

VAERS ID: 81647 Before After
VAERS Form:
Age:32.5
Sex:Male
Location:Illinois
Vaccinated:1996-01-19
Onset:1996-01-20
Submitted:1996-01-21
Entered:1996-02-01 1996-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM - / - - / -

Administered by: Private      Purchased by: Unknown Other
Symptoms: Arthralgia, Asthenia, Dizziness, Influenza, Injection site pain, Myalgia, Pyrexia, Vomiting, DIZZINESS, FEVER, ARTHRALGIA, FLU SYND, ASTHENIA

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


Changed on 2/14/2017

VAERS ID: 81647 Before After
VAERS Form:
Age:32.5 32.0
Sex:Male
Location:Illinois
Vaccinated:1996-01-19
Onset:1996-01-20
Submitted:1996-01-21
Entered:1996-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / - - / -

Administered by: Private      Purchased by: Other
Symptoms: Arthralgia, Asthenia, Dizziness, Influenza, Injection site pain, Myalgia, Pyrexia, Vomiting

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


Changed on 5/14/2017

VAERS ID: 81647 Before After
VAERS Form:
Age:32.0
Sex:Male
Location:Illinois
Vaccinated:1996-01-19
Onset:1996-01-20
Submitted:1996-01-21
Entered:1996-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / - - / -

Administered by: Private      Purchased by: Other
Symptoms: Arthralgia, Asthenia, Dizziness, Influenza, Injection site pain, Myalgia, Pyrexia, Vomiting

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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


Changed on 9/14/2017

VAERS ID: 81647 Before After
VAERS Form:(blank) 1
Age:32.0
Sex:Male
Location:Illinois
Vaccinated:1996-01-19
Onset:1996-01-20
Submitted:1996-01-21
Entered:1996-01-31
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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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


Changed on 2/14/2018

VAERS ID: 81647 Before After
VAERS Form:1
Age:32.0
Sex:Male
Location:Illinois
Vaccinated:1996-01-19
Onset:1996-01-20
Submitted:1996-01-21
Entered:1996-01-31
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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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


Changed on 6/14/2018

VAERS ID: 81647 Before After
VAERS Form:1
Age:32.0
Sex:Male
Location:Illinois
Vaccinated:1996-01-19
Onset:1996-01-20
Submitted:1996-01-21
Entered:1996-01-31
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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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


Changed on 8/14/2018

VAERS ID: 81647 Before After
VAERS Form:1
Age:32.0
Sex:Male
Location:Illinois
Vaccinated:1996-01-19
Onset:1996-01-20
Submitted:1996-01-21
Entered:1996-01-31
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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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


Changed on 9/14/2018

VAERS ID: 81647 Before After
VAERS Form:1
Age:32.0
Sex:Male
Location:Illinois
Vaccinated:1996-01-19
Onset:1996-01-20
Submitted:1996-01-21
Entered:1996-01-31
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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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


Changed on 10/14/2018

VAERS ID: 81647 Before After
VAERS Form:1
Age:32.0
Sex:Male
Location:Illinois
Vaccinated:1996-01-19
Onset:1996-01-20
Submitted:1996-01-21
Entered:1996-01-31
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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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


Changed on 12/24/2020

VAERS ID: 81647 Before After
VAERS Form:1
Age:32.0
Sex:Male
Location:Illinois
Vaccinated:1996-01-19
Onset:1996-01-20
Submitted:1996-01-21
Entered:1996-01-31
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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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


Changed on 12/30/2020

VAERS ID: 81647 Before After
VAERS Form:1
Age:32.0
Sex:Male
Location:Illinois
Vaccinated:1996-01-19
Onset:1996-01-20
Submitted:1996-01-21
Entered:1996-01-31
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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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


Changed on 5/7/2021

VAERS ID: 81647 Before After
VAERS Form:1
Age:32.0
Sex:Male
Location:Illinois
Vaccinated:1996-01-19
Onset:1996-01-20
Submitted:1996-01-21
Entered:1996-01-31
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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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


Changed on 5/21/2021

VAERS ID: 81647 Before After
VAERS Form:1
Age:32.0
Sex:Male
Location:Illinois
Vaccinated:1996-01-19
Onset:1996-01-20
Submitted:1996-01-21
Entered:1996-01-31
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

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=81647&WAYBACKHISTORY=ON


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