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This is VAERS ID 95859

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 95859
VAERS Form:
Age:67.2
Sex:Male
Location:Colorado
Vaccinated:1996-07-24
Onset:1996-08-10
Submitted:1997-03-12
Entered:1997-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE VHA493A4 / 1 - / -

Administered by: Public      Purchased by: Unknown
Symptoms: HYPOKINESIA, HYPOTENS, BRADYCARDIA, ESR INC, CORONARY ART DIS

Life Threatening? No
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Sed rate taken 3JAN97 27;sed rate retaken 20FEB97 now at 5;ultra sound NIVA arteries # hosp 8JAN97;
CDC 'Split Type': NONE

Write-up: aches & pain in upper arm (muscle area) approx 10-15 days;aches & pain cont in arms (shoulder to hands) extend depends on exertion of arms;unable to get pulse or BP reading either arm;blockage determined in artery;vasculitis;


Changed on 12/8/2009

VAERS ID: 95859 Before After
VAERS Form:
Age:67.2
Sex:Male
Location:Colorado
Vaccinated:1996-07-24
Onset:1996-08-10
Submitted:1997-03-12
Entered:1997-03-19 1997-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM VHA493A4 / 1 - / -

Administered by: Public      Purchased by: Unknown Private
Symptoms: Bradycardia, Coronary artery disease, Coronary artery occlusion, Hypokinesia, Hypotension, Myalgia, Vasculitis, Red blood cell sedimentation rate increased, HYPOKINESIA, HYPOTENS, BRADYCARDIA, ESR INC, CORONARY ART DIS

Life Threatening? No
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Sed rate taken 3JAN97 27;sed rate retaken 20FEB97 now at 5;ultra sound NIVA arteries # hosp 8JAN97;
CDC 'Split Type': NONE (blank)

Write-up: aches & pain in upper arm (muscle area) approx 10-15 days;aches & pain cont in arms (shoulder to hands) extend depends on exertion of arms;unable to get pulse or BP reading either arm;blockage determined in artery;vasculitis;


Changed on 2/14/2017

VAERS ID: 95859 Before After
VAERS Form:
Age:67.2 67.0
Sex:Male
Location:Colorado
Vaccinated:1996-07-24
Onset:1996-08-10
Submitted:1997-03-12
Entered:1997-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA493A4 / 1 - / -

Administered by: Public      Purchased by: Private
Symptoms: Bradycardia, Coronary artery disease, Coronary artery occlusion, Hypokinesia, Hypotension, Myalgia, Vasculitis, Red blood cell sedimentation rate increased

Life Threatening? No
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Sed rate taken 3JAN97 27;sed rate retaken 20FEB97 now at 5;ultra sound NIVA arteries # hosp 8JAN97;
CDC 'Split Type':

Write-up: aches & pain in upper arm (muscle area) approx 10-15 days;aches & pain cont in arms (shoulder to hands) extend depends on exertion of arms;unable to get pulse or BP reading either arm;blockage determined in artery;vasculitis;


Changed on 5/14/2017

VAERS ID: 95859 Before After
VAERS Form:
Age:67.0
Sex:Male
Location:Colorado
Vaccinated:1996-07-24
Onset:1996-08-10
Submitted:1997-03-12
Entered:1997-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA493A4 / 1 - / -

Administered by: Public      Purchased by: Private
Symptoms: Bradycardia, Coronary artery disease, Coronary artery occlusion, Hypokinesia, Hypotension, Myalgia, Vasculitis, Red blood cell sedimentation rate increased

Life Threatening? No
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: NA NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Sed rate taken 3JAN97 27;sed rate retaken 20FEB97 now at 5;ultra sound NIVA arteries # hosp 8JAN97;
CDC 'Split Type':

Write-up: aches & pain in upper arm (muscle area) approx 10-15 days;aches & pain cont in arms (shoulder to hands) extend depends on exertion of arms;unable to get pulse or BP reading either arm;blockage determined in artery;vasculitis;


Changed on 9/14/2017

VAERS ID: 95859 Before After
VAERS Form:(blank) 1
Age:67.0
Sex:Male
Location:Colorado
Vaccinated:1996-07-24
Onset:1996-08-10
Submitted:1997-03-12
Entered:1997-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA493A4 / 1 2 - / -

Administered by: Public      Purchased by: Private
Symptoms: Bradycardia, Coronary artery disease, Coronary artery occlusion, Hypokinesia, Hypotension, Myalgia, Vasculitis, Red blood cell sedimentation rate increased

Life Threatening? No
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Sed rate taken 3JAN97 27;sed rate retaken 20FEB97 now at 5;ultra sound NIVA arteries # hosp 8JAN97;
CDC 'Split Type':

Write-up: aches & pain in upper arm (muscle area) approx 10-15 days;aches & pain cont in arms (shoulder to hands) extend depends on exertion of arms;unable to get pulse or BP reading either arm;blockage determined in artery;vasculitis;


Changed on 2/14/2018

VAERS ID: 95859 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Colorado
Vaccinated:1996-07-24
Onset:1996-08-10
Submitted:1997-03-12
Entered:1997-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA493A4 / 2 - / -

Administered by: Public      Purchased by: Private
Symptoms: Bradycardia, Coronary artery disease, Coronary artery occlusion, Hypokinesia, Hypotension, Myalgia, Vasculitis, Red blood cell sedimentation rate increased

Life Threatening? No
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Sed rate taken 3JAN97 27;sed rate retaken 20FEB97 now at 5;ultra sound NIVA arteries # hosp 8JAN97;
CDC 'Split Type':

Write-up: aches & pain in upper arm (muscle area) approx 10-15 days;aches & pain cont in arms (shoulder to hands) extend depends on exertion of arms;unable to get pulse or BP reading either arm;blockage determined in artery;vasculitis;


Changed on 6/14/2018

VAERS ID: 95859 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Colorado
Vaccinated:1996-07-24
Onset:1996-08-10
Submitted:1997-03-12
Entered:1997-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA493A4 / 2 - / -

Administered by: Public      Purchased by: Private
Symptoms: Bradycardia, Coronary artery disease, Coronary artery occlusion, Hypokinesia, Hypotension, Myalgia, Vasculitis, Red blood cell sedimentation rate increased

Life Threatening? No
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Sed rate taken 3JAN97 27;sed rate retaken 20FEB97 now at 5;ultra sound NIVA arteries # hosp 8JAN97;
CDC 'Split Type':

Write-up: aches & pain in upper arm (muscle area) approx 10-15 days;aches & pain cont in arms (shoulder to hands) extend depends on exertion of arms;unable to get pulse or BP reading either arm;blockage determined in artery;vasculitis;


Changed on 8/14/2018

VAERS ID: 95859 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Colorado
Vaccinated:1996-07-24
Onset:1996-08-10
Submitted:1997-03-12
Entered:1997-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA493A4 / 2 - / -

Administered by: Public      Purchased by: Private
Symptoms: Bradycardia, Coronary artery disease, Coronary artery occlusion, Hypokinesia, Hypotension, Myalgia, Vasculitis, Red blood cell sedimentation rate increased

Life Threatening? No
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Sed rate taken 3JAN97 27;sed rate retaken 20FEB97 now at 5;ultra sound NIVA arteries # hosp 8JAN97;
CDC 'Split Type':

Write-up: aches & pain in upper arm (muscle area) approx 10-15 days;aches & pain cont in arms (shoulder to hands) extend depends on exertion of arms;unable to get pulse or BP reading either arm;blockage determined in artery;vasculitis;


Changed on 9/14/2018

VAERS ID: 95859 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Colorado
Vaccinated:1996-07-24
Onset:1996-08-10
Submitted:1997-03-12
Entered:1997-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA493A4 / 2 - / -

Administered by: Public      Purchased by: Private
Symptoms: Bradycardia, Coronary artery disease, Coronary artery occlusion, Hypokinesia, Hypotension, Myalgia, Vasculitis, Red blood cell sedimentation rate increased

Life Threatening? No
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Sed rate taken 3JAN97 27;sed rate retaken 20FEB97 now at 5;ultra sound NIVA arteries # hosp 8JAN97;
CDC 'Split Type':

Write-up: aches & pain in upper arm (muscle area) approx 10-15 days;aches & pain cont in arms (shoulder to hands) extend depends on exertion of arms;unable to get pulse or BP reading either arm;blockage determined in artery;vasculitis;


Changed on 10/14/2018

VAERS ID: 95859 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Colorado
Vaccinated:1996-07-24
Onset:1996-08-10
Submitted:1997-03-12
Entered:1997-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA493A4 / 2 - / -

Administered by: Public      Purchased by: Private
Symptoms: Bradycardia, Coronary artery disease, Coronary artery occlusion, Hypokinesia, Hypotension, Myalgia, Vasculitis, Red blood cell sedimentation rate increased

Life Threatening? No
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Sed rate taken 3JAN97 27;sed rate retaken 20FEB97 now at 5;ultra sound NIVA arteries # hosp 8JAN97;
CDC 'Split Type':

Write-up: aches & pain in upper arm (muscle area) approx 10-15 days;aches & pain cont in arms (shoulder to hands) extend depends on exertion of arms;unable to get pulse or BP reading either arm;blockage determined in artery;vasculitis;


Changed on 12/24/2020

VAERS ID: 95859 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Colorado
Vaccinated:1996-07-24
Onset:1996-08-10
Submitted:1997-03-12
Entered:1997-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA493A4 / 2 - / -

Administered by: Public      Purchased by: Private
Symptoms: Bradycardia, Coronary artery disease, Coronary artery occlusion, Hypokinesia, Hypotension, Myalgia, Vasculitis, Red blood cell sedimentation rate increased

Life Threatening? No
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Sed rate taken 3JAN97 27;sed rate retaken 20FEB97 now at 5;ultra sound NIVA arteries # hosp 8JAN97;
CDC 'Split Type':

Write-up: aches & pain in upper arm (muscle area) approx 10-15 days;aches & pain cont in arms (shoulder to hands) extend depends on exertion of arms;unable to get pulse or BP reading either arm;blockage determined in artery;vasculitis;


Changed on 12/30/2020

VAERS ID: 95859 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Colorado
Vaccinated:1996-07-24
Onset:1996-08-10
Submitted:1997-03-12
Entered:1997-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA493A4 / 2 - / -

Administered by: Public      Purchased by: Private
Symptoms: Bradycardia, Coronary artery disease, Coronary artery occlusion, Hypokinesia, Hypotension, Myalgia, Vasculitis, Red blood cell sedimentation rate increased

Life Threatening? No
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Sed rate taken 3JAN97 27;sed rate retaken 20FEB97 now at 5;ultra sound NIVA arteries # hosp 8JAN97;
CDC 'Split Type':

Write-up: aches & pain in upper arm (muscle area) approx 10-15 days;aches & pain cont in arms (shoulder to hands) extend depends on exertion of arms;unable to get pulse or BP reading either arm;blockage determined in artery;vasculitis;


Changed on 5/7/2021

VAERS ID: 95859 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Colorado
Vaccinated:1996-07-24
Onset:1996-08-10
Submitted:1997-03-12
Entered:1997-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA493A4 / 2 - / -

Administered by: Public      Purchased by: Private
Symptoms: Bradycardia, Coronary artery disease, Coronary artery occlusion, Hypokinesia, Hypotension, Myalgia, Vasculitis, Red blood cell sedimentation rate increased

Life Threatening? No
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Sed rate taken 3JAN97 27;sed rate retaken 20FEB97 now at 5;ultra sound NIVA arteries # hosp 8JAN97;
CDC 'Split Type':

Write-up: aches & pain in upper arm (muscle area) approx 10-15 days;aches & pain cont in arms (shoulder to hands) extend depends on exertion of arms;unable to get pulse or BP reading either arm;blockage determined in artery;vasculitis;


Changed on 5/21/2021

VAERS ID: 95859 Before After
VAERS Form:1
Age:67.0
Sex:Male
Location:Colorado
Vaccinated:1996-07-24
Onset:1996-08-10
Submitted:1997-03-12
Entered:1997-03-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM VHA493A4 / 2 - / -

Administered by: Public      Purchased by: Private
Symptoms: Bradycardia, Coronary artery disease, Coronary artery occlusion, Hypokinesia, Hypotension, Myalgia, Vasculitis, Red blood cell sedimentation rate increased

Life Threatening? No
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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Sed rate taken 3JAN97 27;sed rate retaken 20FEB97 now at 5;ultra sound NIVA arteries # hosp 8JAN97;
CDC 'Split Type':

Write-up: aches & pain in upper arm (muscle area) approx 10-15 days;aches & pain cont in arms (shoulder to hands) extend depends on exertion of arms;unable to get pulse or BP reading either arm;blockage determined in artery;vasculitis;

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