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This is VAERS ID 568921

History of Changes from the VAERS Wayback Machine

First Appeared on 4/14/2015

VAERS ID: 568921
VAERS Form:
Age:19.0
Sex:Female
Location:Oregon
Vaccinated:2015-03-05
Onset:2015-03-06
Submitted:2015-03-10
Entered:2015-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J28923 / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Rash erythematous, Rash pruritic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 9/14/2017

VAERS ID: 568921 Before After
VAERS Form:(blank) 1
Age:19.0
Sex:Female
Location:Oregon
Vaccinated:2015-03-05
Onset:2015-03-06
Submitted:2015-03-10
Entered:2015-03-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J28923 / 0 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Rash erythematous, Rash pruritic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 2/14/2018

VAERS ID: 568921 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Oregon
Vaccinated:2015-03-05
Onset:2015-03-06
Submitted:2015-03-10
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 6/14/2018

VAERS ID: 568921 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Oregon
Vaccinated:2015-03-05
Onset:2015-03-06
Submitted:2015-03-10
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 8/14/2018

VAERS ID: 568921 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Oregon
Vaccinated:2015-03-05
Onset:2015-03-06
Submitted:2015-03-10
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 9/14/2018

VAERS ID: 568921 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Oregon
Vaccinated:2015-03-05
Onset:2015-03-06
Submitted:2015-03-10
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 10/14/2018

VAERS ID: 568921 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Oregon
Vaccinated:2015-03-05
Onset:2015-03-06
Submitted:2015-03-10
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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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