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This is VAERS ID 96955

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 96955
VAERS Form:
Age:64.7
Sex:Female
Location:Kansas
Vaccinated:1996-10-25
Onset:1996-10-25
Submitted:1997-01-22
Entered:1997-04-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB / MSD 1595B / 2 RA / IM
HEPA: HAVRIX / SMITHKLINE VHA513B4 / 1 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: ARTHRALGIA, ERYTHEMA MULT, INSOMNIA, DIARRHEA, HYPERGLYCEM

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: 1     Extended hospital stay? No
Previous Vaccinations: NA
Other Medications: Synthroid;Timoptic;Estrase;Vaginal estrogen;
Current Illness: possible inc T4;
Preexisting Conditions: glaucoma, hypothyroidism, hypohyperglycemia, poss bipolar illness
Allergies:
Diagnostic Lab Data: T4 elevated, TSH elevated, glucose tolerance test inc, FBS elevated, 30min-4hr blood glucose, urinary glucose;
CDC 'Split Type': glaucoma, hypothyroidism, hypohyperglycemia, poss bipolar illness

Write-up: 25OCT96PM sore arm, insomnia;26OCT & 27OCT96 gen joint aches, frequent stools, frequent urination, tinnitus, visual disturbances;28OCT96 emotional high, sweating;29OCT96 hypoglycemia sx, tachycardia, erythema multiforme;cloudy vision;


Changed on 12/8/2009

VAERS ID: 96955 Before After
VAERS Form:
Age:64.7 64.0
Sex:Female
Location:Kansas
Vaccinated:1996-10-25
Onset:1996-10-25
Submitted:1997-01-22
Entered:1997-04-21 1997-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: RECOMBIVAX HB HEP B (RECOMBIVAX HB) / MSD MERCK & CO. INC. 1595B / 2 RA / IM
HEPA: HAVRIX HEP A (HAVRIX) / SMITHKLINE SMITHKLINE BEECHAM VHA513B4 513B4 / 1 LA / IM

Administered by: Public Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Diarrhoea, Erythema multiforme, Hyperglycaemia, Insomnia, Pollakiuria, Tachycardia, Visual disturbance, ARTHRALGIA, ERYTHEMA MULT, INSOMNIA, DIARRHEA, HYPERGLYCEM

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: 1     Extended hospital stay? No
Previous Vaccinations: NA
Other Medications: Synthroid;Timoptic;Estrase;Vaginal estrogen;
Current Illness: possible inc T4;
Preexisting Conditions: glaucoma, hypothyroidism, hypohyperglycemia, poss bipolar illness
Allergies:
Diagnostic Lab Data: T4 elevated, TSH elevated, glucose tolerance test inc, FBS elevated, 30min-4hr blood glucose, urinary glucose;
CDC 'Split Type': glaucoma, hypothyroidism, hypohyperglycemia, poss bipolar illness KS97006

Write-up: 25OCT96PM sore arm, insomnia;26OCT & 27OCT96 gen joint aches, frequent stools, frequent urination, tinnitus, visual disturbances;28OCT96 emotional high, sweating;29OCT96 hypoglycemia sx, tachycardia, erythema multiforme;cloudy vision;


Changed on 5/14/2017

VAERS ID: 96955 Before After
VAERS Form:
Age:64.0
Sex:Female
Location:Kansas
Vaccinated:1996-10-25
Onset:1996-10-25
Submitted:1997-01-22
Entered:1997-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1595B / 2 RA / IM
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 513B4 / 1 LA / IM

Administered by: Unknown Public      Purchased by: Unknown Private
Symptoms: Arthralgia, Diarrhoea, Erythema multiforme, Hyperglycaemia, Insomnia, Pollakiuria, Tachycardia, Visual disturbance

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid;Timoptic;Estrase;Vaginal estrogen;
Current Illness: possible inc T4;
Preexisting Conditions: glaucoma, hypothyroidism, hypohyperglycemia, poss bipolar illness
Allergies:
Diagnostic Lab Data: T4 elevated, TSH elevated, glucose tolerance test inc, FBS elevated, 30min-4hr blood glucose, urinary glucose;
CDC 'Split Type': KS97006

Write-up: 25OCT96PM sore arm, insomnia;26OCT & 27OCT96 gen joint aches, frequent stools, frequent urination, tinnitus, visual disturbances;28OCT96 emotional high, sweating;29OCT96 hypoglycemia sx, tachycardia, erythema multiforme;cloudy vision;


Changed on 9/14/2017

VAERS ID: 96955 Before After
VAERS Form:(blank) 1
Age:64.0
Sex:Female
Location:Kansas
Vaccinated:1996-10-25
Onset:1996-10-25
Submitted:1997-01-22
Entered:1997-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1595B / 2 3 RA / IM
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 513B4 / 1 2 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Erythema multiforme, Hyperglycaemia, Insomnia, Pollakiuria, Tachycardia, Visual disturbance

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid;Timoptic;Estrase;Vaginal estrogen;
Current Illness: possible inc T4;
Preexisting Conditions: glaucoma, hypothyroidism, hypohyperglycemia, poss bipolar illness
Allergies:
Diagnostic Lab Data: T4 elevated, TSH elevated, glucose tolerance test inc, FBS elevated, 30min-4hr blood glucose, urinary glucose;
CDC 'Split Type': KS97006

Write-up: 25OCT96PM sore arm, insomnia;26OCT & 27OCT96 gen joint aches, frequent stools, frequent urination, tinnitus, visual disturbances;28OCT96 emotional high, sweating;29OCT96 hypoglycemia sx, tachycardia, erythema multiforme;cloudy vision;


Changed on 2/14/2018

VAERS ID: 96955 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Kansas
Vaccinated:1996-10-25
Onset:1996-10-25
Submitted:1997-01-22
Entered:1997-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1595B / 3 RA / IM
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 513B4 / 2 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Erythema multiforme, Hyperglycaemia, Insomnia, Pollakiuria, Tachycardia, Visual disturbance

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid;Timoptic;Estrase;Vaginal estrogen;
Current Illness: possible inc T4;
Preexisting Conditions: glaucoma, hypothyroidism, hypohyperglycemia, poss bipolar illness
Allergies:
Diagnostic Lab Data: T4 elevated, TSH elevated, glucose tolerance test inc, FBS elevated, 30min-4hr blood glucose, urinary glucose;
CDC 'Split Type': KS97006

Write-up: 25OCT96PM sore arm, insomnia;26OCT & 27OCT96 gen joint aches, frequent stools, frequent urination, tinnitus, visual disturbances;28OCT96 emotional high, sweating;29OCT96 hypoglycemia sx, tachycardia, erythema multiforme;cloudy vision;


Changed on 6/14/2018

VAERS ID: 96955 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Kansas
Vaccinated:1996-10-25
Onset:1996-10-25
Submitted:1997-01-22
Entered:1997-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1595B / 3 RA / IM
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 513B4 / 2 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Erythema multiforme, Hyperglycaemia, Insomnia, Pollakiuria, Tachycardia, Visual disturbance

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid;Timoptic;Estrase;Vaginal estrogen;
Current Illness: possible inc T4;
Preexisting Conditions: glaucoma, hypothyroidism, hypohyperglycemia, poss bipolar illness
Allergies:
Diagnostic Lab Data: T4 elevated, TSH elevated, glucose tolerance test inc, FBS elevated, 30min-4hr blood glucose, urinary glucose;
CDC 'Split Type': KS97006

Write-up: 25OCT96PM sore arm, insomnia;26OCT & 27OCT96 gen joint aches, frequent stools, frequent urination, tinnitus, visual disturbances;28OCT96 emotional high, sweating;29OCT96 hypoglycemia sx, tachycardia, erythema multiforme;cloudy vision;


Changed on 8/14/2018

VAERS ID: 96955 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Kansas
Vaccinated:1996-10-25
Onset:1996-10-25
Submitted:1997-01-22
Entered:1997-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1595B / 3 RA / IM
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 513B4 / 2 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Erythema multiforme, Hyperglycaemia, Insomnia, Pollakiuria, Tachycardia, Visual disturbance

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid;Timoptic;Estrase;Vaginal estrogen;
Current Illness: possible inc T4;
Preexisting Conditions: glaucoma, hypothyroidism, hypohyperglycemia, poss bipolar illness
Allergies:
Diagnostic Lab Data: T4 elevated, TSH elevated, glucose tolerance test inc, FBS elevated, 30min-4hr blood glucose, urinary glucose;
CDC 'Split Type': KS97006

Write-up: 25OCT96PM sore arm, insomnia;26OCT & 27OCT96 gen joint aches, frequent stools, frequent urination, tinnitus, visual disturbances;28OCT96 emotional high, sweating;29OCT96 hypoglycemia sx, tachycardia, erythema multiforme;cloudy vision;


Changed on 9/14/2018

VAERS ID: 96955 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Kansas
Vaccinated:1996-10-25
Onset:1996-10-25
Submitted:1997-01-22
Entered:1997-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1595B / 3 RA / IM
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 513B4 / 2 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Erythema multiforme, Hyperglycaemia, Insomnia, Pollakiuria, Tachycardia, Visual disturbance

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid;Timoptic;Estrase;Vaginal estrogen;
Current Illness: possible inc T4;
Preexisting Conditions: glaucoma, hypothyroidism, hypohyperglycemia, poss bipolar illness
Allergies:
Diagnostic Lab Data: T4 elevated, TSH elevated, glucose tolerance test inc, FBS elevated, 30min-4hr blood glucose, urinary glucose;
CDC 'Split Type': KS97006

Write-up: 25OCT96PM sore arm, insomnia;26OCT & 27OCT96 gen joint aches, frequent stools, frequent urination, tinnitus, visual disturbances;28OCT96 emotional high, sweating;29OCT96 hypoglycemia sx, tachycardia, erythema multiforme;cloudy vision;


Changed on 10/14/2018

VAERS ID: 96955 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Kansas
Vaccinated:1996-10-25
Onset:1996-10-25
Submitted:1997-01-22
Entered:1997-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1595B / 3 RA / IM
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 513B4 / 2 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Erythema multiforme, Hyperglycaemia, Insomnia, Pollakiuria, Tachycardia, Visual disturbance

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid;Timoptic;Estrase;Vaginal estrogen;
Current Illness: possible inc T4;
Preexisting Conditions: glaucoma, hypothyroidism, hypohyperglycemia, poss bipolar illness
Allergies:
Diagnostic Lab Data: T4 elevated, TSH elevated, glucose tolerance test inc, FBS elevated, 30min-4hr blood glucose, urinary glucose;
CDC 'Split Type': KS97006

Write-up: 25OCT96PM sore arm, insomnia;26OCT & 27OCT96 gen joint aches, frequent stools, frequent urination, tinnitus, visual disturbances;28OCT96 emotional high, sweating;29OCT96 hypoglycemia sx, tachycardia, erythema multiforme;cloudy vision;


Changed on 12/24/2020

VAERS ID: 96955 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Kansas
Vaccinated:1996-10-25
Onset:1996-10-25
Submitted:1997-01-22
Entered:1997-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1595B / 3 RA / IM
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 513B4 / 2 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Erythema multiforme, Hyperglycaemia, Insomnia, Pollakiuria, Tachycardia, Visual disturbance

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid;Timoptic;Estrase;Vaginal estrogen;
Current Illness: possible inc T4;
Preexisting Conditions: glaucoma, hypothyroidism, hypohyperglycemia, poss bipolar illness
Allergies:
Diagnostic Lab Data: T4 elevated, TSH elevated, glucose tolerance test inc, FBS elevated, 30min-4hr blood glucose, urinary glucose;
CDC 'Split Type': KS97006

Write-up: 25OCT96PM sore arm, insomnia;26OCT & 27OCT96 gen joint aches, frequent stools, frequent urination, tinnitus, visual disturbances;28OCT96 emotional high, sweating;29OCT96 hypoglycemia sx, tachycardia, erythema multiforme;cloudy vision;


Changed on 12/30/2020

VAERS ID: 96955 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Kansas
Vaccinated:1996-10-25
Onset:1996-10-25
Submitted:1997-01-22
Entered:1997-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1595B / 3 RA / IM
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 513B4 / 2 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Erythema multiforme, Hyperglycaemia, Insomnia, Pollakiuria, Tachycardia, Visual disturbance

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid;Timoptic;Estrase;Vaginal estrogen;
Current Illness: possible inc T4;
Preexisting Conditions: glaucoma, hypothyroidism, hypohyperglycemia, poss bipolar illness
Allergies:
Diagnostic Lab Data: T4 elevated, TSH elevated, glucose tolerance test inc, FBS elevated, 30min-4hr blood glucose, urinary glucose;
CDC 'Split Type': KS97006

Write-up: 25OCT96PM sore arm, insomnia;26OCT & 27OCT96 gen joint aches, frequent stools, frequent urination, tinnitus, visual disturbances;28OCT96 emotional high, sweating;29OCT96 hypoglycemia sx, tachycardia, erythema multiforme;cloudy vision;


Changed on 5/7/2021

VAERS ID: 96955 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Kansas
Vaccinated:1996-10-25
Onset:1996-10-25
Submitted:1997-01-22
Entered:1997-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1595B / 3 RA / IM
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 513B4 / 2 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Erythema multiforme, Hyperglycaemia, Insomnia, Pollakiuria, Tachycardia, Visual disturbance

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid;Timoptic;Estrase;Vaginal estrogen;
Current Illness: possible inc T4;
Preexisting Conditions: glaucoma, hypothyroidism, hypohyperglycemia, poss bipolar illness
Allergies:
Diagnostic Lab Data: T4 elevated, TSH elevated, glucose tolerance test inc, FBS elevated, 30min-4hr blood glucose, urinary glucose;
CDC 'Split Type': KS97006

Write-up: 25OCT96PM sore arm, insomnia;26OCT & 27OCT96 gen joint aches, frequent stools, frequent urination, tinnitus, visual disturbances;28OCT96 emotional high, sweating;29OCT96 hypoglycemia sx, tachycardia, erythema multiforme;cloudy vision;


Changed on 5/21/2021

VAERS ID: 96955 Before After
VAERS Form:1
Age:64.0
Sex:Female
Location:Kansas
Vaccinated:1996-10-25
Onset:1996-10-25
Submitted:1997-01-22
Entered:1997-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1595B / 3 RA / IM
HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM 513B4 / 2 LA / IM

Administered by: Public      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Erythema multiforme, Hyperglycaemia, Insomnia, Pollakiuria, Tachycardia, Visual disturbance

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid;Timoptic;Estrase;Vaginal estrogen;
Current Illness: possible inc T4;
Preexisting Conditions: glaucoma, hypothyroidism, hypohyperglycemia, poss bipolar illness
Allergies:
Diagnostic Lab Data: T4 elevated, TSH elevated, glucose tolerance test inc, FBS elevated, 30min-4hr blood glucose, urinary glucose;
CDC 'Split Type': KS97006

Write-up: 25OCT96PM sore arm, insomnia;26OCT & 27OCT96 gen joint aches, frequent stools, frequent urination, tinnitus, visual disturbances;28OCT96 emotional high, sweating;29OCT96 hypoglycemia sx, tachycardia, erythema multiforme;cloudy vision;

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