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This is VAERS ID 568707

Case Details

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.


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