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This is VAERS ID 113911

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 113911
VAERS Form:
Age:56.5
Sex:Male
Location:New Jersey
Vaccinated:1997-07-01
Onset:1997-08-01
Submitted:0000-00-00
Entered:1998-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: UNK. HEPATITIS A / UNCLASSIFIED - / 1 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: CARCINOMA GI

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-11
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? No
Previous Vaccinations:
Other Medications: Zocar
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax DEC96 & JUL97 blood work in MAR showed no sign of disease;cancer of colon w/advanced metastases to liver detected in AUG because of rapid onset, want this on record;

Changed on 12/8/2009

VAERS ID: 113911 Before After
VAERS Form:
Age:56.5
Sex:Male
Location:New Jersey
Vaccinated:1997-07-01
Onset:1997-08-01
Submitted:0000-00-00
Entered:1998-09-09 1998-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: UNK. HEPATITIS A HEP A (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Gastrointestinal carcinoma, CARCINOMA GI

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-11
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? No
Previous Vaccinations:
Other Medications: Zocar
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax DEC96 & JUL97 blood work in MAR showed no sign of disease;cancer of colon w/advanced metastases to liver detected in AUG because of rapid onset, want this on record;

Changed on 2/14/2017

VAERS ID: 113911 Before After
VAERS Form:
Age:56.5 56.0
Sex:Male
Location:New Jersey
Vaccinated:1997-07-01
Onset:1997-08-01
Submitted:0000-00-00
Entered:1998-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Gastrointestinal carcinoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-11
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? No
Previous Vaccinations:
Other Medications: Zocar
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax DEC96 & JUL97 blood work in MAR showed no sign of disease;cancer of colon w/advanced metastases to liver detected in AUG because of rapid onset, want this on record;

Changed on 5/14/2017

VAERS ID: 113911 Before After
VAERS Form:
Age:56.0
Sex:Male
Location:New Jersey
Vaccinated:1997-07-01
Onset:1997-08-01
Submitted:0000-00-00
Entered:1998-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Gastrointestinal carcinoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-11
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Zocar
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax DEC96 & JUL97 blood work in MAR showed no sign of disease;cancer of colon w/advanced metastases to liver detected in AUG because of rapid onset, want this on record;

Changed on 9/14/2017

VAERS ID: 113911 Before After
VAERS Form:(blank) 1
Age:56.0
Sex:Male
Location:New Jersey
Vaccinated:1997-07-01
Onset:1997-08-01
Submitted:0000-00-00
Entered:1998-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 2 - / -

Administered by: Private      Purchased by: Private
Symptoms: Gastrointestinal carcinoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-11
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Zocar
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax DEC96 & JUL97 blood work in MAR showed no sign of disease;cancer of colon w/advanced metastases to liver detected in AUG because of rapid onset, want this on record;

Changed on 2/14/2018

VAERS ID: 113911 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:New Jersey
Vaccinated:1997-07-01
Onset:1997-08-01
Submitted:0000-00-00
Entered:1998-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -

Administered by: Private      Purchased by: Private
Symptoms: Gastrointestinal carcinoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-11
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Zocar
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax DEC96 & JUL97 blood work in MAR showed no sign of disease;cancer of colon w/advanced metastases to liver detected in AUG because of rapid onset, want this on record;

Changed on 6/14/2018

VAERS ID: 113911 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:New Jersey
Vaccinated:1997-07-01
Onset:1997-08-01
Submitted:0000-00-00
Entered:1998-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -

Administered by: Private      Purchased by: Private
Symptoms: Gastrointestinal carcinoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-11
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Zocar
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax DEC96 & JUL97 blood work in MAR showed no sign of disease;cancer of colon w/advanced metastases to liver detected in AUG because of rapid onset, want this on record;

Changed on 8/14/2018

VAERS ID: 113911 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:New Jersey
Vaccinated:1997-07-01
Onset:1997-08-01
Submitted:0000-00-00
Entered:1998-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -

Administered by: Private      Purchased by: Private
Symptoms: Gastrointestinal carcinoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-11
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Zocar
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax DEC96 & JUL97 blood work in MAR showed no sign of disease;cancer of colon w/advanced metastases to liver detected in AUG because of rapid onset, want this on record;

Changed on 9/14/2018

VAERS ID: 113911 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:New Jersey
Vaccinated:1997-07-01
Onset:1997-08-01
Submitted:0000-00-00
Entered:1998-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -

Administered by: Private      Purchased by: Private
Symptoms: Gastrointestinal carcinoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-11
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Zocar
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax DEC96 & JUL97 blood work in MAR showed no sign of disease;cancer of colon w/advanced metastases to liver detected in AUG because of rapid onset, want this on record;

Changed on 10/14/2018

VAERS ID: 113911 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:New Jersey
Vaccinated:1997-07-01
Onset:1997-08-01
Submitted:0000-00-00
Entered:1998-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -

Administered by: Private      Purchased by: Private
Symptoms: Gastrointestinal carcinoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-11
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Zocar
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax DEC96 & JUL97 blood work in MAR showed no sign of disease;cancer of colon w/advanced metastases to liver detected in AUG because of rapid onset, want this on record;

Changed on 12/24/2020

VAERS ID: 113911 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:New Jersey
Vaccinated:1997-07-01
Onset:1997-08-01
Submitted:0000-00-00
Entered:1998-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -

Administered by: Private      Purchased by: Private
Symptoms: Gastrointestinal carcinoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-11
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Zocar
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax DEC96 & JUL97 blood work in MAR showed no sign of disease;cancer of colon w/advanced metastases to liver detected in AUG because of rapid onset, want this on record;

Changed on 12/30/2020

VAERS ID: 113911 Before After
VAERS Form:1
Age:56.0
Sex:Male
Location:New Jersey
Vaccinated:1997-07-01
Onset:1997-08-01
Submitted:0000-00-00
Entered:1998-09-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -

Administered by: Private      Purchased by: Private
Symptoms: Gastrointestinal carcinoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1997-10-11
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Zocar
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: pt recv vax DEC96 & JUL97 blood work in MAR showed no sign of disease;cancer of colon w/advanced metastases to liver detected in AUG because of rapid onset, want this on record;

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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=113911&WAYBACKHISTORY=ON


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