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This is VAERS ID 581776

Case Details

VAERS ID: 581776 (history)  
Form: Version 1.0  
Age: 30.0  
Sex: Female  
Location: New York  
Vaccinated:2015-06-03
Onset:2015-06-03
   Days after vaccination:0
Submitted: 2015-06-12
   Days after onset:9
Entered: 2015-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J29203 / 1 RA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Dizziness, Dyspnoea, Injection site pain, Nausea, Pharyngeal oedema, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Fever, pain at injection site, nausea, dizziness, throat swelling and shortness of breath. Onset 4 hours after vaccination. Fully subsided within 48 hours.


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