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This is VAERS ID 25521

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 25521
VAERS Form:
Age:47.0
Sex:Female
Location:Kentucky
Vaccinated:1990-04-05
Onset:1990-04-09
Submitted:0000-00-00
Entered:1990-07-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B / SMITHKLINE 591A4 / 3 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: DIZZINESS, NAUSEA, DYSPNEA, LIVER FUNC ABNORM, HYPOKALEM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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? No
Previous Vaccinations:
Other Medications: Ogen, Prinzide, Synthroid, Vivactil
Current Illness: Gallbladder removed 30 yrs ago;
Preexisting Conditions: Hypothyroid, Hypertension; Allergic to Codeine, sulfa;
Allergies:
Diagnostic Lab Data: LDH inc, GGTP inc, SGOT inc, Liver func Abnorm, CAT SCAN of ADBOMEN was negative
CDC 'Split Type':

Write-up: Pt given Engerix-B experienced dizziness, non responder, feeling of faintness, flank pain rt side, nausea became very pale, decreased potassium, and back pain rt side. Was admitted to hospital given Phenergan 25 mg & Demerol to relieve pain


Changed on 12/8/2009

VAERS ID: 25521 Before After
VAERS Form:
Age:47.0
Sex:Female
Location:Kentucky
Vaccinated:1990-04-05
Onset:1990-04-09
Submitted:0000-00-00
Entered:1990-07-18 1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B HEP B (ENGERIX-B) / SMITHKLINE SMITHKLINE BEECHAM 591A4 / 3 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Back pain, Dizziness, Drug ineffective, Dyspnoea, Hepatic function abnormal, Hypokalaemia, Nausea, Pallor, Vomiting, DIZZINESS, NAUSEA, DYSPNEA, LIVER FUNC ABNORM, HYPOKALEM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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? No
Previous Vaccinations:
Other Medications: Ogen, Prinzide, Synthroid, Vivactil
Current Illness: Gallbladder removed 30 yrs ago;
Preexisting Conditions: Hypothyroid, Hypertension; Allergic to Codeine, sulfa;
Allergies:
Diagnostic Lab Data: LDH inc, GGTP inc, SGOT inc, Liver func Abnorm, CAT SCAN of ADBOMEN was negative
CDC 'Split Type': (blank) EBU900128

Write-up: Pt given Engerix-B experienced dizziness, non responder, feeling of faintness, flank pain rt side, nausea became very pale, decreased potassium, and back pain rt side. Was admitted to hospital given Phenergan 25 mg & Demerol to relieve pain


Changed on 5/14/2017

VAERS ID: 25521 Before After
VAERS Form:
Age:47.0
Sex:Female
Location:Kentucky
Vaccinated:1990-04-05
Onset:1990-04-09
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / 3 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Back pain, Dizziness, Drug ineffective, Dyspnoea, Hepatic function abnormal, Hypokalaemia, Nausea, Pallor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ogen, Prinzide, Synthroid, Vivactil
Current Illness: Gallbladder removed 30 yrs ago;
Preexisting Conditions: Hypothyroid, Hypertension; Allergic to Codeine, sulfa;
Allergies:
Diagnostic Lab Data: LDH inc, GGTP inc, SGOT inc, Liver func Abnorm, CAT SCAN of ADBOMEN was negative
CDC 'Split Type': EBU900128

Write-up: Pt given Engerix-B experienced dizziness, non responder, feeling of faintness, flank pain rt side, nausea became very pale, decreased potassium, and back pain rt side. Was admitted to hospital given Phenergan 25 mg & Demerol to relieve pain


Changed on 9/14/2017

VAERS ID: 25521 Before After
VAERS Form:(blank) 1
Age:47.0
Sex:Female
Location:Kentucky
Vaccinated:1990-04-05
Onset:1990-04-09
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / 3 4 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Back pain, Dizziness, Drug ineffective, Dyspnoea, Hepatic function abnormal, Hypokalaemia, Nausea, Pallor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ogen, Prinzide, Synthroid, Vivactil
Current Illness: Gallbladder removed 30 yrs ago;
Preexisting Conditions: Hypothyroid, Hypertension; Allergic to Codeine, sulfa;
Allergies:
Diagnostic Lab Data: LDH inc, GGTP inc, SGOT inc, Liver func Abnorm, CAT SCAN of ADBOMEN was negative
CDC 'Split Type': EBU900128

Write-up: Pt given Engerix-B experienced dizziness, non responder, feeling of faintness, flank pain rt side, nausea became very pale, decreased potassium, and back pain rt side. Was admitted to hospital given Phenergan 25 mg & Demerol to relieve pain


Changed on 2/14/2018

VAERS ID: 25521 Before After
VAERS Form:1
Age:47.0
Sex:Female
Location:Kentucky
Vaccinated:1990-04-05
Onset:1990-04-09
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / 4 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Back pain, Dizziness, Drug ineffective, Dyspnoea, Hepatic function abnormal, Hypokalaemia, Nausea, Pallor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ogen, Prinzide, Synthroid, Vivactil
Current Illness: Gallbladder removed 30 yrs ago;
Preexisting Conditions: Hypothyroid, Hypertension; Allergic to Codeine, sulfa;
Allergies:
Diagnostic Lab Data: LDH inc, GGTP inc, SGOT inc, Liver func Abnorm, CAT SCAN of ADBOMEN was negative
CDC 'Split Type': EBU900128

Write-up: Pt given Engerix-B experienced dizziness, non responder, feeling of faintness, flank pain rt side, nausea became very pale, decreased potassium, and back pain rt side. Was admitted to hospital given Phenergan 25 mg & Demerol to relieve pain


Changed on 6/14/2018

VAERS ID: 25521 Before After
VAERS Form:1
Age:47.0
Sex:Female
Location:Kentucky
Vaccinated:1990-04-05
Onset:1990-04-09
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / 4 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Back pain, Dizziness, Drug ineffective, Dyspnoea, Hepatic function abnormal, Hypokalaemia, Nausea, Pallor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ogen, Prinzide, Synthroid, Vivactil
Current Illness: Gallbladder removed 30 yrs ago;
Preexisting Conditions: Hypothyroid, Hypertension; Allergic to Codeine, sulfa;
Allergies:
Diagnostic Lab Data: LDH inc, GGTP inc, SGOT inc, Liver func Abnorm, CAT SCAN of ADBOMEN was negative
CDC 'Split Type': EBU900128

Write-up: Pt given Engerix-B experienced dizziness, non responder, feeling of faintness, flank pain rt side, nausea became very pale, decreased potassium, and back pain rt side. Was admitted to hospital given Phenergan 25 mg & Demerol to relieve pain


Changed on 8/14/2018

VAERS ID: 25521 Before After
VAERS Form:1
Age:47.0
Sex:Female
Location:Kentucky
Vaccinated:1990-04-05
Onset:1990-04-09
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / 4 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Back pain, Dizziness, Drug ineffective, Dyspnoea, Hepatic function abnormal, Hypokalaemia, Nausea, Pallor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ogen, Prinzide, Synthroid, Vivactil
Current Illness: Gallbladder removed 30 yrs ago;
Preexisting Conditions: Hypothyroid, Hypertension; Allergic to Codeine, sulfa;
Allergies:
Diagnostic Lab Data: LDH inc, GGTP inc, SGOT inc, Liver func Abnorm, CAT SCAN of ADBOMEN was negative
CDC 'Split Type': EBU900128

Write-up: Pt given Engerix-B experienced dizziness, non responder, feeling of faintness, flank pain rt side, nausea became very pale, decreased potassium, and back pain rt side. Was admitted to hospital given Phenergan 25 mg & Demerol to relieve pain


Changed on 9/14/2018

VAERS ID: 25521 Before After
VAERS Form:1
Age:47.0
Sex:Female
Location:Kentucky
Vaccinated:1990-04-05
Onset:1990-04-09
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / 4 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Back pain, Dizziness, Drug ineffective, Dyspnoea, Hepatic function abnormal, Hypokalaemia, Nausea, Pallor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ogen, Prinzide, Synthroid, Vivactil
Current Illness: Gallbladder removed 30 yrs ago;
Preexisting Conditions: Hypothyroid, Hypertension; Allergic to Codeine, sulfa;
Allergies:
Diagnostic Lab Data: LDH inc, GGTP inc, SGOT inc, Liver func Abnorm, CAT SCAN of ADBOMEN was negative
CDC 'Split Type': EBU900128

Write-up: Pt given Engerix-B experienced dizziness, non responder, feeling of faintness, flank pain rt side, nausea became very pale, decreased potassium, and back pain rt side. Was admitted to hospital given Phenergan 25 mg & Demerol to relieve pain


Changed on 10/14/2018

VAERS ID: 25521 Before After
VAERS Form:1
Age:47.0
Sex:Female
Location:Kentucky
Vaccinated:1990-04-05
Onset:1990-04-09
Submitted:0000-00-00
Entered:1990-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / 4 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Back pain, Dizziness, Drug ineffective, Dyspnoea, Hepatic function abnormal, Hypokalaemia, Nausea, Pallor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ogen, Prinzide, Synthroid, Vivactil
Current Illness: Gallbladder removed 30 yrs ago;
Preexisting Conditions: Hypothyroid, Hypertension; Allergic to Codeine, sulfa;
Allergies:
Diagnostic Lab Data: LDH inc, GGTP inc, SGOT inc, Liver func Abnorm, CAT SCAN of ADBOMEN was negative
CDC 'Split Type': EBU900128

Write-up: Pt given Engerix-B experienced dizziness, non responder, feeling of faintness, flank pain rt side, nausea became very pale, decreased potassium, and back pain rt side. Was admitted to hospital given Phenergan 25 mg & Demerol to relieve pain

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