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This is VAERS ID 90084

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 90084
VAERS Form:
Age:34.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1996-09-16
Entered:1996-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE - / 0 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: LYMPHADENO, MALAISE, IMMUNE SYSTEM 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: pt is native of Ghana
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax & 2 days post vax pt became ill w/serious multi-systems illness requiring a 2wk hosp;pt was found to have angioimmunoblastic lymphadenopathy;pt recovered;


Changed on 12/8/2009

VAERS ID: 90084 Before After
VAERS Form:
Age:34.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1996-09-16
Entered:1996-09-24 1996-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM - / 0 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Immune system disorder, Lymphadenopathy, Malaise, LYMPHADENO, MALAISE, IMMUNE SYSTEM 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: pt is native of Ghana
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 960135631

Write-up: pt recv vax & 2 days post vax pt became ill w/serious multi-systems illness requiring a 2wk hosp;pt was found to have angioimmunoblastic lymphadenopathy;pt recovered;


Changed on 5/14/2017

VAERS ID: 90084 Before After
VAERS Form:
Age:34.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1996-09-16
Entered:1996-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 0 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Immune system disorder, Lymphadenopathy, Malaise

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: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: pt is native of Ghana
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 960135631

Write-up: pt recv vax & 2 days post vax pt became ill w/serious multi-systems illness requiring a 2wk hosp;pt was found to have angioimmunoblastic lymphadenopathy;pt recovered;


Changed on 9/14/2017

VAERS ID: 90084 Before After
VAERS Form:(blank) 1
Age:34.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1996-09-16
Entered:1996-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 0 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Immune system disorder, Lymphadenopathy, Malaise

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: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: pt is native of Ghana
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 960135631

Write-up: pt recv vax & 2 days post vax pt became ill w/serious multi-systems illness requiring a 2wk hosp;pt was found to have angioimmunoblastic lymphadenopathy;pt recovered;


Changed on 2/14/2018

VAERS ID: 90084 Before After
VAERS Form:1
Age:34.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1996-09-16
Entered:1996-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Immune system disorder, Lymphadenopathy, Malaise

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: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: pt is native of Ghana
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 960135631

Write-up: pt recv vax & 2 days post vax pt became ill w/serious multi-systems illness requiring a 2wk hosp;pt was found to have angioimmunoblastic lymphadenopathy;pt recovered;


Changed on 6/14/2018

VAERS ID: 90084 Before After
VAERS Form:1
Age:34.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1996-09-16
Entered:1996-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Immune system disorder, Lymphadenopathy, Malaise

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: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: pt is native of Ghana
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 960135631

Write-up: pt recv vax & 2 days post vax pt became ill w/serious multi-systems illness requiring a 2wk hosp;pt was found to have angioimmunoblastic lymphadenopathy;pt recovered;


Changed on 8/14/2018

VAERS ID: 90084 Before After
VAERS Form:1
Age:34.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1996-09-16
Entered:1996-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Immune system disorder, Lymphadenopathy, Malaise

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: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: pt is native of Ghana
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 960135631

Write-up: pt recv vax & 2 days post vax pt became ill w/serious multi-systems illness requiring a 2wk hosp;pt was found to have angioimmunoblastic lymphadenopathy;pt recovered;


Changed on 9/14/2018

VAERS ID: 90084 Before After
VAERS Form:1
Age:34.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1996-09-16
Entered:1996-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Immune system disorder, Lymphadenopathy, Malaise

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: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: pt is native of Ghana
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 960135631

Write-up: pt recv vax & 2 days post vax pt became ill w/serious multi-systems illness requiring a 2wk hosp;pt was found to have angioimmunoblastic lymphadenopathy;pt recovered;


Changed on 10/14/2018

VAERS ID: 90084 Before After
VAERS Form:1
Age:34.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1996-09-16
Entered:1996-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Immune system disorder, Lymphadenopathy, Malaise

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: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: pt is native of Ghana
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 960135631

Write-up: pt recv vax & 2 days post vax pt became ill w/serious multi-systems illness requiring a 2wk hosp;pt was found to have angioimmunoblastic lymphadenopathy;pt recovered;


Changed on 12/24/2020

VAERS ID: 90084 Before After
VAERS Form:1
Age:34.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1996-09-16
Entered:1996-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Immune system disorder, Lymphadenopathy, Malaise

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: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: pt is native of Ghana
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 960135631

Write-up: pt recv vax & 2 days post vax pt became ill w/serious multi-systems illness requiring a 2wk hosp;pt was found to have angioimmunoblastic lymphadenopathy;pt recovered;


Changed on 12/30/2020

VAERS ID: 90084 Before After
VAERS Form:1
Age:34.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1996-09-16
Entered:1996-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Immune system disorder, Lymphadenopathy, Malaise

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: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: pt is native of Ghana
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 960135631

Write-up: pt recv vax & 2 days post vax pt became ill w/serious multi-systems illness requiring a 2wk hosp;pt was found to have angioimmunoblastic lymphadenopathy;pt recovered;


Changed on 5/7/2021

VAERS ID: 90084 Before After
VAERS Form:1
Age:34.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1996-09-16
Entered:1996-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Immune system disorder, Lymphadenopathy, Malaise

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: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: pt is native of Ghana
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 960135631

Write-up: pt recv vax & 2 days post vax pt became ill w/serious multi-systems illness requiring a 2wk hosp;pt was found to have angioimmunoblastic lymphadenopathy;pt recovered;


Changed on 5/21/2021

VAERS ID: 90084 Before After
VAERS Form:1
Age:34.0
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:1996-09-16
Entered:1996-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Immune system disorder, Lymphadenopathy, Malaise

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: 14     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: pt is native of Ghana
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 960135631

Write-up: pt recv vax & 2 days post vax pt became ill w/serious multi-systems illness requiring a 2wk hosp;pt was found to have angioimmunoblastic lymphadenopathy;pt recovered;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=90084&WAYBACKHISTORY=ON


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