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From the 12/31/2003 release of VAERS data (an older release, current is 1/14/2022):

This is VAERS ID 81034

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Case Details

VAERS ID: 81034 (history)  
Form: Version .0  
Age: 22.0  
Sex: Female  
Location: California  
Vaccinated:1995-08-22
Onset:1995-08-23
   Days after vaccination:1
Submitted: 1995-09-07
   Days after onset:15
Entered: 1996-01-24
   Days after submission:139
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HAVRIX / SMITHKLINE - / 0 - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: ARTHRALGIA, MYALGIA
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: oral contraceptives
Current Illness:
Preexisting Conditions: chronic bronchitis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt recvd vax; exp arthralgia, myalgia in legs;


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