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This is VAERS ID 568921

Case Details

VAERS ID: 568921 (history)  
Form: Version 1.0  
Age: 19.0  
Sex: Female  
Location: Oregon  
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.


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