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This is VAERS ID 585704

History of Changes from the VAERS Wayback Machine

First Appeared on 7/14/2015

VAERS ID: 585704
VAERS Form:
Age:13.0
Sex:Male
Location:New Jersey
Vaccinated:2015-07-07
Onset:2015-07-08
Submitted:0000-00-00
Entered:2015-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS U4799BA / 1 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 146801 / 0 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Headache, Injection site pain, Pain, Pyrexia, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Pt had headache, bilateral injection site pain in arms and body aches 7/8/15. Pt had syncope episodes 7/9/15 and fever 7/9/15.


Changed on 9/14/2017

VAERS ID: 585704 Before After
VAERS Form:(blank) 1
Age:13.0
Sex:Male
Location:New Jersey
Vaccinated:2015-07-07
Onset:2015-07-08
Submitted:0000-00-00
Entered:2015-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS U4799BA / 1 2 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 146801 / 0 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Headache, Injection site pain, Pain, Pyrexia, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Pt had headache, bilateral injection site pain in arms and body aches 7/8/15. Pt had syncope episodes 7/9/15 and fever 7/9/15.


Changed on 2/14/2018

VAERS ID: 585704 Before After
VAERS Form:1
Age:13.0
Sex:Male
Location:New Jersey
Vaccinated:2015-07-07
Onset:2015-07-08
Submitted:0000-00-00
Entered:2015-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS U4799BA / 2 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 146801 / 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Headache, Injection site pain, Pain, Pyrexia, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Pt had headache, bilateral injection site pain in arms and body aches 7/8/15. Pt had syncope episodes 7/9/15 and fever 7/9/15.


Changed on 6/14/2018

VAERS ID: 585704 Before After
VAERS Form:1
Age:13.0
Sex:Male
Location:New Jersey
Vaccinated:2015-07-07
Onset:2015-07-08
Submitted:0000-00-00
Entered:2015-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS U4799BA / 2 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 146801 / 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Headache, Injection site pain, Pain, Pyrexia, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Pt had headache, bilateral injection site pain in arms and body aches 7/8/15. Pt had syncope episodes 7/9/15 and fever 7/9/15.


Changed on 8/14/2018

VAERS ID: 585704 Before After
VAERS Form:1
Age:13.0
Sex:Male
Location:New Jersey
Vaccinated:2015-07-07
Onset:2015-07-08
Submitted:0000-00-00
Entered:2015-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS U4799BA / 2 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 146801 / 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Headache, Injection site pain, Pain, Pyrexia, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Pt had headache, bilateral injection site pain in arms and body aches 7/8/15. Pt had syncope episodes 7/9/15 and fever 7/9/15.


Changed on 9/14/2018

VAERS ID: 585704 Before After
VAERS Form:1
Age:13.0
Sex:Male
Location:New Jersey
Vaccinated:2015-07-07
Onset:2015-07-08
Submitted:0000-00-00
Entered:2015-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS U4799BA / 2 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 146801 / 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Headache, Injection site pain, Pain, Pyrexia, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Pt had headache, bilateral injection site pain in arms and body aches 7/8/15. Pt had syncope episodes 7/9/15 and fever 7/9/15.


Changed on 10/14/2018

VAERS ID: 585704 Before After
VAERS Form:1
Age:13.0
Sex:Male
Location:New Jersey
Vaccinated:2015-07-07
Onset:2015-07-08
Submitted:0000-00-00
Entered:2015-07-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS U4799BA / 2 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 146801 / 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Headache, Injection site pain, Pain, Pyrexia, Syncope

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Pt had headache, bilateral injection site pain in arms and body aches 7/8/15. Pt had syncope episodes 7/9/15 and fever 7/9/15.

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