|
| VAERS ID: |
568192 (history) |
| Form: |
Version 1.0 |
| Age: |
18.0 |
| Sex: |
Female |
| Location: |
Oregon |
| Vaccinated: | 2015-03-04 |
| Onset: | 2015-03-04 |
| Days after vaccination: | 0 |
| Submitted: |
2015-03-05 |
| Days after onset: | 1 |
| Entered: |
2015-03-05 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH |
- / 1 |
RA / - |
Administered by: Public Purchased by: Other
Symptoms: Abdominal pain upper,
Back pain,
Crying,
Headache,
Pain in extremity
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline daily 50mg
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Intense aches and pains: headache, stomachache, legs and arms hurt, back hurt. Maybe fever but no thermometer was available. Pain so bad that I cried for approx. 1/2 hr. Took two ibuprofen and managed to stop crying after that. |
|
| VAERS ID: |
568287 (history) |
| Form: |
Version 1.0 |
| Age: |
25.0 |
| Sex: |
Female |
| Location: |
Oregon |
| Vaccinated: | 2015-03-04 |
| Onset: | 2015-03-04 |
| Days after vaccination: | 0 |
| Submitted: |
2015-03-05 |
| Days after onset: | 1 |
| Entered: |
2015-03-05 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH |
- / 1 |
LA / SYR |
Administered by: Other Purchased by: Other
Symptoms: Chills,
Daydreaming,
Feeling abnormal,
Headache,
Nausea
SMQs:, Acute pancreatitis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergy to PPD shot
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: General fuzzy/absent-minded feeling, nausea, headache, chills. |
|
| VAERS ID: |
568294 (history) |
| Form: |
Version 1.0 |
| Age: |
20.0 |
| Sex: |
Male |
| Location: |
California |
| Vaccinated: | 2015-03-03 |
| Onset: | 0000-00-00 |
| Submitted: |
2015-03-05 |
| Entered: |
2015-03-05 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH |
- / 1 |
LA / IM |
Administered by: Public Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Severe redness around injection site. |
|
| VAERS ID: |
568317 (history) |
| Form: |
Version 1.0 |
| Age: |
44.0 |
| Sex: |
Female |
| Location: |
Oregon |
| Vaccinated: | 2015-02-27 |
| Onset: | 2015-02-28 |
| Days after vaccination: | 1 |
| Submitted: |
2015-03-05 |
| Days after onset: | 5 |
| Entered: |
2015-03-05 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS |
146101 / 1 |
RA / IM |
| MNQ: MENINGOCOCCAL CONJUGATE (MENVEO) / NOVARTIS VACCINES AND DIAGNOSTICS |
M14072 / 1 |
LA / IM |
Administered by: Public Purchased by: Public
Symptoms: Activities of daily living impaired,
Chills,
Cold sweat,
Feeling cold,
Hyperhidrosis,
Pain
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: "I felt fine."
Preexisting Conditions: I am allergic to PCN and Monestat.
Allergies:
Diagnostic Lab Data: None
CDC Split Type:
Write-up: "I woke up shivering, cold at 0200. I had no pain; just cold and sweating. My breathing was normal. I waited for a little bit and called my doctor. He told me to go to urgent care but they were closed so he said to go to the emergency room. They monitored me for an hour and put in an IV of normal saline. I felt better. They did not give me any medications. They recommended I take ibuprofen when I got home. They took my temperature but I don''t know what it was. In the morning I feel body ache, so I took ibuprofen. After that I felt fine, but then I started shivering again, cold, clammy. I never had any pain. I did repeat ibuprofen after I took my temperature in my arm pit and it read 98. I fell asleep. Then on Sunday I was better than Saturday but not quite all right. I stayed home from work on Monday. I didn''t take any ibuprofen after Saturday. I went to my primary on Monday for something else and discussed reaction with her. She said I was fine. I want to get the next dose in the series in a month. I''ll be fine. |
|
| VAERS ID: |
570833 (history) |
| Form: |
Version 1.0 |
| Age: |
18.0 |
| Sex: |
Male |
| Location: |
Oregon |
| Vaccinated: | 2015-03-04 |
| Onset: | 2015-03-05 |
| Days after vaccination: | 1 |
| Submitted: |
2015-03-05 |
| Days after onset: | 0 |
| Entered: |
2015-03-05 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH |
J28923 / 1 |
LA / IM |
Administered by: Unknown Purchased by: Unknown
Symptoms: Back pain,
Headache,
Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Patient''s mother called said he had a 100.5 fever and giving TYLENOL. Also he has back pain and a headache. |
|
| VAERS ID: |
568546 (history) |
| Form: |
Version 1.0 |
| Age: |
20.0 |
| Sex: |
Female |
| Location: |
Oregon |
| Vaccinated: | 2015-03-05 |
| Onset: | 2015-03-05 |
| Days after vaccination: | 0 |
| Submitted: |
2015-03-07 |
| Days after onset: | 2 |
| Entered: |
2015-03-07 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH |
- / 2 |
LA / SYR |
Administered by: Public Purchased by: Public
Symptoms: Headache,
Nausea,
Pain,
Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Fever, headache, body aches, nausea. |
|
| VAERS ID: |
568700 (history) |
| Form: |
Version 1.0 |
| Age: |
21.0 |
| Sex: |
Female |
| Location: |
Oregon |
| Vaccinated: | 2015-03-05 |
| Onset: | 2015-03-06 |
| Days after vaccination: | 1 |
| Submitted: |
2015-03-06 |
| Days after onset: | 0 |
| Entered: |
2015-03-09 |
| Days after submission: | 2 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH |
- / 1 |
LA / SYR |
Administered by: Other Purchased by: Other
Symptoms: Injection site erythema,
Injection site pain,
Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Pain at site of injection. Redness just below site of injection. Feeling achy all over. |
|
| VAERS ID: |
568707 (history) |
| Form: |
Version 1.0 |
| Age: |
19.0 |
| Sex: |
Male |
| Location: |
Oregon |
| Vaccinated: | 2015-03-04 |
| Onset: | 2015-03-05 |
| Days after vaccination: | 1 |
| Submitted: |
2015-03-09 |
| Days after onset: | 3 |
| Entered: |
2015-03-09 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH |
J28923 / 1 |
LA / IM |
Administered by: Other Purchased by: Private
Symptoms: Flushing,
Headache,
Injection site erythema,
Myalgia,
Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: None known
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Received Trumenba at Pfizer sponsored at mass vaccination clinic. At midnight he began to feel feverish, headache, myalgia. Better in AM with ASA x 2. At 1700 on 03/05/2015 presents at Health Center with erythema covering complete left deltoid, 3 X 5.5 inches along with intermittent full body flushing. |
|
| VAERS ID: |
568747 (history) |
| Form: |
Version 1.0 |
| Age: |
28.0 |
| Sex: |
Female |
| Location: |
Oregon |
| Vaccinated: | 0000-00-00 |
| Onset: | 0000-00-00 |
| Submitted: |
2015-03-07 |
| Entered: |
2015-03-09 |
| Days after submission: | 1 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH |
- / 1 |
UN / IM |
Administered by: Other Purchased by: Private
Symptoms: Chest X-ray,
Full blood count,
Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
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: No
Current Illness: No
Preexisting Conditions: Clindamycin allergy
Allergies:
Diagnostic Lab Data: CBC/CXR
CDC Split Type:
Write-up: Wheezing on exam. |
|
| VAERS ID: |
568921 (history) |
| Form: |
Version 1.0 |
| Age: |
19.0 |
| Sex: |
Female |
| Location: |
California |
| Vaccinated: | 2015-03-05 |
| Onset: | 2015-03-06 |
| Days after vaccination: | 1 |
| Submitted: |
2015-03-10 |
| Days after onset: | 3 |
| Entered: |
2015-03-10 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH |
J28923 / 1 |
LA / IM |
Administered by: Other Purchased by: Other
Symptoms: Rash erythematous,
Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
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: BCP, Prozac
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:
Write-up: Diffuse itchy red, rash that started on arms and legs, spread to trunk and neck over several days. |
|
