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This is VAERS ID 25133

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25133
VAERS Form:
Age:50.0
Sex:Female
Location:Texas
Vaccinated:1990-03-02
Onset:1990-04-04
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B / SMITHKLINE 1648R / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: HEMATURIA, PAIN BACK

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:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NO PREVIOUS KIDNEY PROBLEMS
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SEVERE BACK PAIN & SEVERE HEMATURIA RESULTED WITHIN 2 DAYS /P 1ST DOSE OF HBV-VACCINE GIVEN OF 2MAR90. 2ND INJECT GIVEN ON 8MAY90. WITHIN 2 DAYS PT C/O BACK PAIN AND HEMATURIA. PHYSICIAN FELT SYMPTOMS FROM VACCINE.


Changed on 12/8/2009

VAERS ID: 25133 Before After
VAERS Form:
Age:50.0
Sex:Female
Location:Texas
Vaccinated:1990-03-02
Onset:1990-04-04
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B HEP B (ENGERIX-B) / SMITHKLINE SMITHKLINE BEECHAM 1648R / - - / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Back pain, Haematuria, HEMATURIA, PAIN BACK

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:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NO PREVIOUS KIDNEY PROBLEMS
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SEVERE BACK PAIN & SEVERE HEMATURIA RESULTED WITHIN 2 DAYS /P 1ST DOSE OF HBV-VACCINE GIVEN OF 2MAR90. 2ND INJECT GIVEN ON 8MAY90. WITHIN 2 DAYS PT C/O BACK PAIN AND HEMATURIA. PHYSICIAN FELT SYMPTOMS FROM VACCINE.


Changed on 5/14/2017

VAERS ID: 25133 Before After
VAERS Form:
Age:50.0
Sex:Female
Location:Texas
Vaccinated:1990-03-02
Onset:1990-04-04
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1648R / - - / IM

Administered by: Private      Purchased by: Private
Symptoms: Back pain, Haematuria

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:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NO PREVIOUS KIDNEY PROBLEMS
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SEVERE BACK PAIN & SEVERE HEMATURIA RESULTED WITHIN 2 DAYS /P 1ST DOSE OF HBV-VACCINE GIVEN OF 2MAR90. 2ND INJECT GIVEN ON 8MAY90. WITHIN 2 DAYS PT C/O BACK PAIN AND HEMATURIA. PHYSICIAN FELT SYMPTOMS FROM VACCINE.


Changed on 9/14/2017

VAERS ID: 25133 Before After
VAERS Form:(blank) 1
Age:50.0
Sex:Female
Location:Texas
Vaccinated:1990-03-02
Onset:1990-04-04
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1648R / - UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Back pain, Haematuria

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:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NO PREVIOUS KIDNEY PROBLEMS
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SEVERE BACK PAIN & SEVERE HEMATURIA RESULTED WITHIN 2 DAYS /P 1ST DOSE OF HBV-VACCINE GIVEN OF 2MAR90. 2ND INJECT GIVEN ON 8MAY90. WITHIN 2 DAYS PT C/O BACK PAIN AND HEMATURIA. PHYSICIAN FELT SYMPTOMS FROM VACCINE.


Changed on 2/14/2018

VAERS ID: 25133 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Texas
Vaccinated:1990-03-02
Onset:1990-04-04
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1648R / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Back pain, Haematuria

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:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NO PREVIOUS KIDNEY PROBLEMS
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SEVERE BACK PAIN & SEVERE HEMATURIA RESULTED WITHIN 2 DAYS /P 1ST DOSE OF HBV-VACCINE GIVEN OF 2MAR90. 2ND INJECT GIVEN ON 8MAY90. WITHIN 2 DAYS PT C/O BACK PAIN AND HEMATURIA. PHYSICIAN FELT SYMPTOMS FROM VACCINE.


Changed on 6/14/2018

VAERS ID: 25133 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Texas
Vaccinated:1990-03-02
Onset:1990-04-04
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1648R / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Back pain, Haematuria

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:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NO PREVIOUS KIDNEY PROBLEMS
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SEVERE BACK PAIN & SEVERE HEMATURIA RESULTED WITHIN 2 DAYS /P 1ST DOSE OF HBV-VACCINE GIVEN OF 2MAR90. 2ND INJECT GIVEN ON 8MAY90. WITHIN 2 DAYS PT C/O BACK PAIN AND HEMATURIA. PHYSICIAN FELT SYMPTOMS FROM VACCINE.


Changed on 8/14/2018

VAERS ID: 25133 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Texas
Vaccinated:1990-03-02
Onset:1990-04-04
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1648R / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Back pain, Haematuria

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:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NO PREVIOUS KIDNEY PROBLEMS
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SEVERE BACK PAIN & SEVERE HEMATURIA RESULTED WITHIN 2 DAYS /P 1ST DOSE OF HBV-VACCINE GIVEN OF 2MAR90. 2ND INJECT GIVEN ON 8MAY90. WITHIN 2 DAYS PT C/O BACK PAIN AND HEMATURIA. PHYSICIAN FELT SYMPTOMS FROM VACCINE.


Changed on 9/14/2018

VAERS ID: 25133 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Texas
Vaccinated:1990-03-02
Onset:1990-04-04
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1648R / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Back pain, Haematuria

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:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NO PREVIOUS KIDNEY PROBLEMS
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SEVERE BACK PAIN & SEVERE HEMATURIA RESULTED WITHIN 2 DAYS /P 1ST DOSE OF HBV-VACCINE GIVEN OF 2MAR90. 2ND INJECT GIVEN ON 8MAY90. WITHIN 2 DAYS PT C/O BACK PAIN AND HEMATURIA. PHYSICIAN FELT SYMPTOMS FROM VACCINE.


Changed on 10/14/2018

VAERS ID: 25133 Before After
VAERS Form:1
Age:50.0
Sex:Female
Location:Texas
Vaccinated:1990-03-02
Onset:1990-04-04
Submitted:0000-00-00
Entered:1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1648R / UNK - / IM

Administered by: Private      Purchased by: Private
Symptoms: Back pain, Haematuria

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:     Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NO PREVIOUS KIDNEY PROBLEMS
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: SEVERE BACK PAIN & SEVERE HEMATURIA RESULTED WITHIN 2 DAYS /P 1ST DOSE OF HBV-VACCINE GIVEN OF 2MAR90. 2ND INJECT GIVEN ON 8MAY90. WITHIN 2 DAYS PT C/O BACK PAIN AND HEMATURIA. PHYSICIAN FELT SYMPTOMS FROM VACCINE.

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