National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

This is VAERS ID 87758

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 87758
VAERS Form:
Age:
Sex:Male
Location:D.C.
Vaccinated:1995-06-21
Onset:1995-07-12
Submitted:1996-05-30
Entered:1996-07-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE - / 0 - / -

Administered by: Military      Purchased by: Unknown
Symptoms: NAUSEA, EYES GAZE UPWARD, ASTHENIA, LAB TEST ABNORM, EYE DIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: 23SEP96-Mfr f/u-lab results reported-CSF & MRI-consistent with Demyelinating Disease.
CDC 'Split Type':

Write-up: pt recv vax & 2.5 wk later pt exp neurological sx, weakness, & poss multiple sclerosis-like signs & sx;sx lasted a couple days & then resolved;


Changed on 12/8/2009

VAERS ID: 87758 Before After
VAERS Form:
Age:
Sex:Male
Location:D.C.
Vaccinated:1995-06-21
Onset:1995-07-12
Submitted:1996-05-30
Entered:1996-07-15 1996-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM - / 0 - / -

Administered by: Military      Purchased by: Unknown Military
Symptoms: Asthenia, Eye disorder, Laboratory test abnormal, Multiple sclerosis, Nausea, Neuropathy, Vomiting, Gaze palsy, NAUSEA, EYES GAZE UPWARD, ASTHENIA, LAB TEST ABNORM, EYE DIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: 23SEP96-Mfr f/u-lab results reported-CSF & MRI-consistent with Demyelinating Disease.
CDC 'Split Type': (blank) 960070861

Write-up: pt recv vax & 2.5 wk later pt exp neurological sx, weakness, & poss multiple sclerosis-like signs & sx;sx lasted a couple days & then resolved;


Changed on 5/14/2017

VAERS ID: 87758 Before After
VAERS Form:
Age:
Sex:Male
Location:D.C.
Vaccinated:1995-06-21
Onset:1995-07-12
Submitted:1996-05-30
Entered:1996-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 0 - / -

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Eye disorder, Laboratory test abnormal, Multiple sclerosis, Nausea, Neuropathy, Vomiting, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 23SEP96-Mfr f/u-lab results reported-CSF & MRI-consistent with Demyelinating Disease.
CDC 'Split Type': 960070861

Write-up: pt recv vax & 2.5 wk later pt exp neurological sx, weakness, & poss multiple sclerosis-like signs & sx;sx lasted a couple days & then resolved;


Changed on 9/14/2017

VAERS ID: 87758 Before After
VAERS Form:(blank) 1
Age:
Sex:Male
Location:D.C.
Vaccinated:1995-06-21
Onset:1995-07-12
Submitted:1996-05-30
Entered:1996-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 0 1 - / -

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Eye disorder, Laboratory test abnormal, Multiple sclerosis, Nausea, Neuropathy, Vomiting, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 23SEP96-Mfr f/u-lab results reported-CSF & MRI-consistent with Demyelinating Disease.
CDC 'Split Type': 960070861

Write-up: pt recv vax & 2.5 wk later pt exp neurological sx, weakness, & poss multiple sclerosis-like signs & sx;sx lasted a couple days & then resolved;


Changed on 2/14/2018

VAERS ID: 87758 Before After
VAERS Form:1
Age:
Sex:Male
Location:D.C.
Vaccinated:1995-06-21
Onset:1995-07-12
Submitted:1996-05-30
Entered:1996-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Eye disorder, Laboratory test abnormal, Multiple sclerosis, Nausea, Neuropathy, Vomiting, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 23SEP96-Mfr f/u-lab results reported-CSF & MRI-consistent with Demyelinating Disease.
CDC 'Split Type': 960070861

Write-up: pt recv vax & 2.5 wk later pt exp neurological sx, weakness, & poss multiple sclerosis-like signs & sx;sx lasted a couple days & then resolved;


Changed on 6/14/2018

VAERS ID: 87758 Before After
VAERS Form:1
Age:
Sex:Male
Location:D.C.
Vaccinated:1995-06-21
Onset:1995-07-12
Submitted:1996-05-30
Entered:1996-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Eye disorder, Laboratory test abnormal, Multiple sclerosis, Nausea, Neuropathy, Vomiting, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 23SEP96-Mfr f/u-lab results reported-CSF & MRI-consistent with Demyelinating Disease.
CDC 'Split Type': 960070861

Write-up: pt recv vax & 2.5 wk later pt exp neurological sx, weakness, & poss multiple sclerosis-like signs & sx;sx lasted a couple days & then resolved;


Changed on 8/14/2018

VAERS ID: 87758 Before After
VAERS Form:1
Age:
Sex:Male
Location:D.C.
Vaccinated:1995-06-21
Onset:1995-07-12
Submitted:1996-05-30
Entered:1996-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Eye disorder, Laboratory test abnormal, Multiple sclerosis, Nausea, Neuropathy, Vomiting, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 23SEP96-Mfr f/u-lab results reported-CSF & MRI-consistent with Demyelinating Disease.
CDC 'Split Type': 960070861

Write-up: pt recv vax & 2.5 wk later pt exp neurological sx, weakness, & poss multiple sclerosis-like signs & sx;sx lasted a couple days & then resolved;


Changed on 9/14/2018

VAERS ID: 87758 Before After
VAERS Form:1
Age:
Sex:Male
Location:D.C.
Vaccinated:1995-06-21
Onset:1995-07-12
Submitted:1996-05-30
Entered:1996-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Eye disorder, Laboratory test abnormal, Multiple sclerosis, Nausea, Neuropathy, Vomiting, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 23SEP96-Mfr f/u-lab results reported-CSF & MRI-consistent with Demyelinating Disease.
CDC 'Split Type': 960070861

Write-up: pt recv vax & 2.5 wk later pt exp neurological sx, weakness, & poss multiple sclerosis-like signs & sx;sx lasted a couple days & then resolved;


Changed on 10/14/2018

VAERS ID: 87758 Before After
VAERS Form:1
Age:
Sex:Male
Location:D.C.
Vaccinated:1995-06-21
Onset:1995-07-12
Submitted:1996-05-30
Entered:1996-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Eye disorder, Laboratory test abnormal, Multiple sclerosis, Nausea, Neuropathy, Vomiting, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 23SEP96-Mfr f/u-lab results reported-CSF & MRI-consistent with Demyelinating Disease.
CDC 'Split Type': 960070861

Write-up: pt recv vax & 2.5 wk later pt exp neurological sx, weakness, & poss multiple sclerosis-like signs & sx;sx lasted a couple days & then resolved;


Changed on 12/24/2020

VAERS ID: 87758 Before After
VAERS Form:1
Age:
Sex:Male
Location:D.C.
Vaccinated:1995-06-21
Onset:1995-07-12
Submitted:1996-05-30
Entered:1996-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Eye disorder, Laboratory test abnormal, Multiple sclerosis, Nausea, Neuropathy, Vomiting, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 23SEP96-Mfr f/u-lab results reported-CSF & MRI-consistent with Demyelinating Disease.
CDC 'Split Type': 960070861

Write-up: pt recv vax & 2.5 wk later pt exp neurological sx, weakness, & poss multiple sclerosis-like signs & sx;sx lasted a couple days & then resolved;


Changed on 12/30/2020

VAERS ID: 87758 Before After
VAERS Form:1
Age:
Sex:Male
Location:D.C.
Vaccinated:1995-06-21
Onset:1995-07-12
Submitted:1996-05-30
Entered:1996-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Eye disorder, Laboratory test abnormal, Multiple sclerosis, Nausea, Neuropathy, Vomiting, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 23SEP96-Mfr f/u-lab results reported-CSF & MRI-consistent with Demyelinating Disease.
CDC 'Split Type': 960070861

Write-up: pt recv vax & 2.5 wk later pt exp neurological sx, weakness, & poss multiple sclerosis-like signs & sx;sx lasted a couple days & then resolved;


Changed on 5/7/2021

VAERS ID: 87758 Before After
VAERS Form:1
Age:
Sex:Male
Location:D.C.
Vaccinated:1995-06-21
Onset:1995-07-12
Submitted:1996-05-30
Entered:1996-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Eye disorder, Laboratory test abnormal, Multiple sclerosis, Nausea, Neuropathy, Vomiting, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 23SEP96-Mfr f/u-lab results reported-CSF & MRI-consistent with Demyelinating Disease.
CDC 'Split Type': 960070861

Write-up: pt recv vax & 2.5 wk later pt exp neurological sx, weakness, & poss multiple sclerosis-like signs & sx;sx lasted a couple days & then resolved;


Changed on 5/21/2021

VAERS ID: 87758 Before After
VAERS Form:1
Age:
Sex:Male
Location:D.C.
Vaccinated:1995-06-21
Onset:1995-07-12
Submitted:1996-05-30
Entered:1996-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Eye disorder, Laboratory test abnormal, Multiple sclerosis, Nausea, Neuropathy, Vomiting, Gaze palsy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 23SEP96-Mfr f/u-lab results reported-CSF & MRI-consistent with Demyelinating Disease.
CDC 'Split Type': 960070861

Write-up: pt recv vax & 2.5 wk later pt exp neurological sx, weakness, & poss multiple sclerosis-like signs & sx;sx lasted a couple days & then resolved;

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=87758&WAYBACKHISTORY=ON


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166