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This is VAERS ID 96427

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 96427
VAERS Form:
Age:63.2
Sex:Female
Location:Wisconsin
Vaccinated:1997-01-23
Onset:1997-02-10
Submitted:1997-03-07
Entered:1997-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE 504B6 / 0 - / IM
YF: UNK.YELLOW FEVER / UNCLASSIFIED - / 0 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND, GAIT ABNORM, LAB TEST ABNORM, MYASTHENIA, HYPERTENS

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax JAN97 & the weekend of 8FEB97 pt suffered a h/a & BP was sky high;pt was seen in ER 13FEB97 dx w/GBS & hosp;


Changed on 12/8/2009

VAERS ID: 96427 Before After
VAERS Form:
Age:63.2 63.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-01-23
Onset:1997-02-10
Submitted:1997-03-07
Entered:1997-03-27 1997-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM 504B6 / 0 - / IM
YF: UNK.YELLOW FEVER YELLOW FEVER (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / 0 - / -

Administered by: Private Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Hypertension, Laboratory test abnormal, Myasthenic syndrome, Paraesthesia, Thrombocythaemia, GUILLAIN BARRE SYND, GAIT ABNORM, LAB TEST ABNORM, MYASTHENIA, HYPERTENS

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 970031771

Write-up: pt recv vax JAN97 & the weekend of 8FEB97 pt suffered a h/a & BP was sky high;pt was seen in ER 13FEB97 dx w/GBS & hosp;


Changed on 9/14/2017

VAERS ID: 96427 Before After
VAERS Form:(blank) 1
Age:63.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-01-23
Onset:1997-02-10
Submitted:1997-03-07
Entered:1997-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 504B6 / 0 1 - / IM
YF: YELLOW FEVER (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Hypertension, Laboratory test abnormal, Myasthenic syndrome, Paraesthesia, Thrombocythaemia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 970031771

Write-up: pt recv vax JAN97 & the weekend of 8FEB97 pt suffered a h/a & BP was sky high;pt was seen in ER 13FEB97 dx w/GBS & hosp;


Changed on 2/14/2018

VAERS ID: 96427 Before After
VAERS Form:1
Age:63.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-01-23
Onset:1997-02-10
Submitted:1997-03-07
Entered:1997-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 504B6 / 1 - / IM
YF: YELLOW FEVER (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Hypertension, Laboratory test abnormal, Myasthenic syndrome, Paraesthesia, Thrombocythaemia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 970031771

Write-up: pt recv vax JAN97 & the weekend of 8FEB97 pt suffered a h/a & BP was sky high;pt was seen in ER 13FEB97 dx w/GBS & hosp;


Changed on 6/14/2018

VAERS ID: 96427 Before After
VAERS Form:1
Age:63.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-01-23
Onset:1997-02-10
Submitted:1997-03-07
Entered:1997-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 504B6 / 1 - / IM
YF: YELLOW FEVER (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Hypertension, Laboratory test abnormal, Myasthenic syndrome, Paraesthesia, Thrombocythaemia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 970031771

Write-up: pt recv vax JAN97 & the weekend of 8FEB97 pt suffered a h/a & BP was sky high;pt was seen in ER 13FEB97 dx w/GBS & hosp;


Changed on 8/14/2018

VAERS ID: 96427 Before After
VAERS Form:1
Age:63.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-01-23
Onset:1997-02-10
Submitted:1997-03-07
Entered:1997-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 504B6 / 1 - / IM
YF: YELLOW FEVER (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Hypertension, Laboratory test abnormal, Myasthenic syndrome, Paraesthesia, Thrombocythaemia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 970031771

Write-up: pt recv vax JAN97 & the weekend of 8FEB97 pt suffered a h/a & BP was sky high;pt was seen in ER 13FEB97 dx w/GBS & hosp;


Changed on 9/14/2018

VAERS ID: 96427 Before After
VAERS Form:1
Age:63.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-01-23
Onset:1997-02-10
Submitted:1997-03-07
Entered:1997-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 504B6 / 1 - / IM
YF: YELLOW FEVER (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Hypertension, Laboratory test abnormal, Myasthenic syndrome, Paraesthesia, Thrombocythaemia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 970031771

Write-up: pt recv vax JAN97 & the weekend of 8FEB97 pt suffered a h/a & BP was sky high;pt was seen in ER 13FEB97 dx w/GBS & hosp;


Changed on 10/14/2018

VAERS ID: 96427 Before After
VAERS Form:1
Age:63.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-01-23
Onset:1997-02-10
Submitted:1997-03-07
Entered:1997-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 504B6 / 1 - / IM
YF: YELLOW FEVER (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Hypertension, Laboratory test abnormal, Myasthenic syndrome, Paraesthesia, Thrombocythaemia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 970031771

Write-up: pt recv vax JAN97 & the weekend of 8FEB97 pt suffered a h/a & BP was sky high;pt was seen in ER 13FEB97 dx w/GBS & hosp;


Changed on 12/24/2020

VAERS ID: 96427 Before After
VAERS Form:1
Age:63.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-01-23
Onset:1997-02-10
Submitted:1997-03-07
Entered:1997-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 504B6 / 1 - / IM
YF: YELLOW FEVER (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Hypertension, Laboratory test abnormal, Myasthenic syndrome, Paraesthesia, Thrombocythaemia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 970031771

Write-up: pt recv vax JAN97 & the weekend of 8FEB97 pt suffered a h/a & BP was sky high;pt was seen in ER 13FEB97 dx w/GBS & hosp;


Changed on 12/30/2020

VAERS ID: 96427 Before After
VAERS Form:1
Age:63.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-01-23
Onset:1997-02-10
Submitted:1997-03-07
Entered:1997-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 504B6 / 1 - / IM
YF: YELLOW FEVER (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Hypertension, Laboratory test abnormal, Myasthenic syndrome, Paraesthesia, Thrombocythaemia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 970031771

Write-up: pt recv vax JAN97 & the weekend of 8FEB97 pt suffered a h/a & BP was sky high;pt was seen in ER 13FEB97 dx w/GBS & hosp;


Changed on 5/7/2021

VAERS ID: 96427 Before After
VAERS Form:1
Age:63.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-01-23
Onset:1997-02-10
Submitted:1997-03-07
Entered:1997-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 504B6 / 1 - / IM
YF: YELLOW FEVER (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Hypertension, Laboratory test abnormal, Myasthenic syndrome, Paraesthesia, Thrombocythaemia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 970031771

Write-up: pt recv vax JAN97 & the weekend of 8FEB97 pt suffered a h/a & BP was sky high;pt was seen in ER 13FEB97 dx w/GBS & hosp;


Changed on 5/21/2021

VAERS ID: 96427 Before After
VAERS Form:1
Age:63.0
Sex:Female
Location:Wisconsin
Vaccinated:1997-01-23
Onset:1997-02-10
Submitted:1997-03-07
Entered:1997-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 504B6 / 1 - / IM
YF: YELLOW FEVER (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Gait disturbance, Guillain-Barre syndrome, Hypertension, Laboratory test abnormal, Myasthenic syndrome, Paraesthesia, Thrombocythaemia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 970031771

Write-up: pt recv vax JAN97 & the weekend of 8FEB97 pt suffered a h/a & BP was sky high;pt was seen in ER 13FEB97 dx w/GBS & hosp;

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