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This is VAERS ID 151824

(NOTE: This result is from the 2/14/2018 version of the VAERS database)

Case Details

VAERS ID: 151824 (history)  
Form: Version 1.0  
Age: 56.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2000-01-13
Onset:2000-01-13
   Days after vaccination:0
Submitted: 2000-04-21
   Days after onset:98
Entered: 2000-05-10
   Days after submission:19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM LY126A2 / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Contac, acetylasalicysic acid, Advil
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 20000011991

Write-up: On 1/13/00, the pt received his first right arm dose of Lymerix. Following the first dose on 1/13/00, the pt experienced severe arm pain which kept his awake all night. No treatment was given. The most recent information received on 1/14/00, reported the condition of the pt as unknown.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180214&IDNUMBER=151824


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