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This is VAERS ID 51148

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 51148
VAERS Form:
Age:54.6
Sex:Male
Location:D.C.
Vaccinated:1993-02-20
Onset:1993-02-21
Submitted:1993-03-16
Entered:1993-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENOMUNE A/C/Y/W / CONNAUGHT LABS 2K41040 / - A / IM
TYP: TYPHOID / WYETH 4928055 / - A / SC
YF: YELLOW FEVER / CONNAUGHT LABS 2H31154 / - A / IM

Administered by: Military      Purchased by: Unknown
Symptoms: CHILLS, FEVER, DYSPNEA, ASTHENIA

Life Threatening? Yes
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pt recvd Immune Globulin by Armour Pharm co lot# F15907; Lopressor
Current Illness:
Preexisting Conditions: pt has hx of hypertrophic cardiomyopathy;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt devel fever, chills, SOB & weakness, 24 hrs p/vax;


Changed on 12/8/2009

VAERS ID: 51148 Before After
VAERS Form:
Age:54.6
Sex:Male
Location:D.C.
Vaccinated:1993-02-20
Onset:1993-02-21
Submitted:1993-03-16
Entered:1993-03-30 1993-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENOMUNE A/C/Y/W MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABS CONNAUGHT LABORATORIES 2K41040 / - A / IM
TYP: TYPHOID TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / WYETH WYETH PHARMACEUTICALS, INC 4928055 / - A / SC
YF: YELLOW FEVER YELLOW FEVER (YF-VAX) / CONNAUGHT LABS CONNAUGHT LABORATORIES 2H31154 / - A / IM

Administered by: Military      Purchased by: Unknown Military
Symptoms: Asthenia, Chills, Dyspnoea, Pyrexia, CHILLS, FEVER, DYSPNEA, ASTHENIA

Life Threatening? Yes
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: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pt recvd Immune Globulin by Armour Pharm co lot# F15907; Lopressor
Current Illness:
Preexisting Conditions: pt has hx of hypertrophic cardiomyopathy;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 893075002E

Write-up: Pt devel fever, chills, SOB & weakness, 24 hrs p/vax;


Changed on 1/5/2010

VAERS ID: 51148 Before After
VAERS Form:
Age:54.6 54.0
Sex:Male
Location:D.C.
Vaccinated:1993-02-20
Onset:1993-02-21
Submitted:1993-03-16
Entered:1993-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 2K41040 / - A - / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC 4928055 / - A - / SC
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 2H31154 / - A - / IM

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Chills, Dyspnoea, Pyrexia

Life Threatening? Yes
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~ ~~In patient
Other Medications: Pt recvd Immune Globulin by Armour Pharm co lot# F15907; Lopressor
Current Illness:
Preexisting Conditions: pt has hx of hypertrophic cardiomyopathy;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893075002E

Write-up: Pt devel fever, chills, SOB & weakness, 24 hrs p/vax;


Changed on 8/31/2010

VAERS ID: 51148 Before After
VAERS Form:
Age:54.0
Sex:Male
Location:D.C.
Vaccinated:1993-02-20
Onset:1993-02-21
Submitted:1993-03-16
Entered:1993-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 2K41040 / - - / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4928055 / - - / SC
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 2H31154 / - - / IM

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Chills, Dyspnoea, Pyrexia

Life Threatening? Yes
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~ ~~In patient
Other Medications: Pt recvd Immune Globulin by Armour Pharm co lot# F15907; Lopressor
Current Illness:
Preexisting Conditions: pt has hx of hypertrophic cardiomyopathy;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893075002E

Write-up: Pt devel fever, chills, SOB & weakness, 24 hrs p/vax;


Changed on 6/14/2014

VAERS ID: 51148 Before After
VAERS Form:
Age:54.0
Sex:Male
Location:D.C.
Vaccinated:1993-02-20
Onset:1993-02-21
Submitted:1993-03-16
Entered:1993-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 2K41040 / - - / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4928055 / - - / SC
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 2H31154 / - - / IM

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Chills, Dyspnoea, Pyrexia

Life Threatening? Yes
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~ ~~In patient
Other Medications: Pt recvd Immune Globulin by Armour Pharm co lot# F15907; Lopressor
Current Illness:
Preexisting Conditions: pt has hx of hypertrophic cardiomyopathy;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893075002E

Write-up: Pt devel fever, chills, SOB & weakness, 24 hrs p/vax;


Changed on 2/14/2017

VAERS ID: 51148 Before After
VAERS Form:
Age:54.0
Sex:Male
Location:D.C.
Vaccinated:1993-02-20
Onset:1993-02-21
Submitted:1993-03-16
Entered:1993-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 2K41040 / - - / IM IM A
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4928055 / - - / SC SC A
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 2H31154 / - - / IM IM A

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Chills, Dyspnoea, Pyrexia

Life Threatening? Yes
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~ ~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: pt has hx of hypertrophic cardiomyopathy;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893075002E

Write-up: Pt devel fever, chills, SOB & weakness, 24 hrs p/vax;


Changed on 5/14/2017

VAERS ID: 51148 Before After
VAERS Form:
Age:54.0
Sex:Male
Location:D.C.
Vaccinated:1993-02-20
Onset:1993-02-21
Submitted:1993-03-16
Entered:1993-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 2K41040 / - - / IM A
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4928055 / - - / SC A
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 2H31154 / - - / IM A

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Chills, Dyspnoea, Pyrexia

Life Threatening? Yes
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~ ~~In ()~~~In patient
Other Medications: Pt recvd Immune Globulin by Armour Pharm co lot# F15907; Lopressor
Current Illness:
Preexisting Conditions: pt has hx of hypertrophic cardiomyopathy;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893075002E

Write-up: Pt devel fever, chills, SOB & weakness, 24 hrs p/vax;


Changed on 9/14/2017

VAERS ID: 51148 Before After
VAERS Form:(blank) 1
Age:54.0
Sex:Male
Location:D.C.
Vaccinated:1993-02-20
Onset:1993-02-21
Submitted:1993-03-16
Entered:1993-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 2K41040 / - UNK - / IM A
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4928055 / - UNK - / SC A
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 2H31154 / - UNK - / IM A

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Chills, Dyspnoea, Pyrexia

Life Threatening? Yes
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Pt recvd Immune Globulin by Armour Pharm co lot# F15907; Lopressor
Current Illness:
Preexisting Conditions: pt has hx of hypertrophic cardiomyopathy;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893075002E

Write-up: Pt devel fever, chills, SOB & weakness, 24 hrs p/vax;


Changed on 2/14/2018

VAERS ID: 51148 Before After
VAERS Form:1
Age:54.0
Sex:Male
Location:D.C.
Vaccinated:1993-02-20
Onset:1993-02-21
Submitted:1993-03-16
Entered:1993-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 2K41040 / UNK - / IM A
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4928055 / UNK - / SC A
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 2H31154 / UNK - / IM A

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Chills, Dyspnoea, Pyrexia

Life Threatening? Yes
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Pt recvd Immune Globulin by Armour Pharm co lot# F15907; Lopressor
Current Illness:
Preexisting Conditions: pt has hx of hypertrophic cardiomyopathy;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893075002E

Write-up: Pt devel fever, chills, SOB & weakness, 24 hrs p/vax;


Changed on 6/14/2018

VAERS ID: 51148 Before After
VAERS Form:1
Age:54.0
Sex:Male
Location:D.C.
Vaccinated:1993-02-20
Onset:1993-02-21
Submitted:1993-03-16
Entered:1993-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 2K41040 / UNK - / IM A
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4928055 / UNK - / SC A
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 2H31154 / UNK - / IM A

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Chills, Dyspnoea, Pyrexia

Life Threatening? Yes
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Pt recvd Immune Globulin by Armour Pharm co lot# F15907; Lopressor
Current Illness:
Preexisting Conditions: pt has hx of hypertrophic cardiomyopathy;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893075002E

Write-up: Pt devel fever, chills, SOB & weakness, 24 hrs p/vax;


Changed on 8/14/2018

VAERS ID: 51148 Before After
VAERS Form:1
Age:54.0
Sex:Male
Location:D.C.
Vaccinated:1993-02-20
Onset:1993-02-21
Submitted:1993-03-16
Entered:1993-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 2K41040 / UNK - / IM A
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4928055 / UNK - / SC A
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 2H31154 / UNK - / IM A

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Chills, Dyspnoea, Pyrexia

Life Threatening? Yes
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Pt recvd Immune Globulin by Armour Pharm co lot# F15907; Lopressor
Current Illness:
Preexisting Conditions: pt has hx of hypertrophic cardiomyopathy;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893075002E

Write-up: Pt devel fever, chills, SOB & weakness, 24 hrs p/vax;


Changed on 9/14/2018

VAERS ID: 51148 Before After
VAERS Form:1
Age:54.0
Sex:Male
Location:D.C.
Vaccinated:1993-02-20
Onset:1993-02-21
Submitted:1993-03-16
Entered:1993-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 2K41040 / UNK - / IM A
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4928055 / UNK - / SC A
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 2H31154 / UNK - / IM A

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Chills, Dyspnoea, Pyrexia

Life Threatening? Yes
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Pt recvd Immune Globulin by Armour Pharm co lot# F15907; Lopressor
Current Illness:
Preexisting Conditions: pt has hx of hypertrophic cardiomyopathy;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893075002E

Write-up: Pt devel fever, chills, SOB & weakness, 24 hrs p/vax;


Changed on 10/14/2018

VAERS ID: 51148 Before After
VAERS Form:1
Age:54.0
Sex:Male
Location:D.C.
Vaccinated:1993-02-20
Onset:1993-02-21
Submitted:1993-03-16
Entered:1993-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES 2K41040 / UNK - / IM A
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4928055 / UNK - / SC A
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 2H31154 / UNK - / IM A

Administered by: Military      Purchased by: Military
Symptoms: Asthenia, Chills, Dyspnoea, Pyrexia

Life Threatening? Yes
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: 4     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Pt recvd Immune Globulin by Armour Pharm co lot# F15907; Lopressor
Current Illness:
Preexisting Conditions: pt has hx of hypertrophic cardiomyopathy;
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 893075002E

Write-up: Pt devel fever, chills, SOB & weakness, 24 hrs p/vax;

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