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This is VAERS ID 595084

History of Changes from the VAERS Wayback Machine

First Appeared on 9/14/2015

VAERS ID: 595084
VAERS Form:
Age:12.0
Sex:Female
Location:Tennessee
Vaccinated:2015-08-31
Onset:2015-08-31
Submitted:2015-09-02
Entered:2015-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH 28923 / 1 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray abnormal, Headache, Myalgia, Pleural effusion, Pneumonia, Pyrexia, Laboratory test normal, Respiratory viral panel

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Respiratory Panel-neg x 2; CXR-left lower lobe infiltrate-sm effusion
CDC 'Split Type':

Write-up: Patient had onset of fever, myalgias & headache within several hours of vaccine. Temp has persisted up to 103 - subsequently diagnosed with left lower lobe pneumonia - failed outpatient antibiotics - admitted x 24 hrs for IV antibiotics.

Changed on 9/14/2017

VAERS ID: 595084 Before After
VAERS Form:(blank) 1
Age:12.0
Sex:Female
Location:Tennessee
Vaccinated:2015-08-31
Onset:2015-08-31
Submitted:2015-09-02
Entered:2015-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH 28923 / 1 2 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray abnormal, Headache, Myalgia, Pleural effusion, Pneumonia, Pyrexia, Laboratory test normal, Respiratory viral panel

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Respiratory Panel-neg x 2; CXR-left lower lobe infiltrate-sm effusion
CDC 'Split Type':

Write-up: Patient had onset of fever, myalgias & headache within several hours of vaccine. Temp has persisted up to 103 - subsequently diagnosed with left lower lobe pneumonia - failed outpatient antibiotics - admitted x 24 hrs for IV antibiotics.

Changed on 2/14/2018

VAERS ID: 595084 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Tennessee
Vaccinated:2015-08-31
Onset:2015-08-31
Submitted:2015-09-02
Entered:2015-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH 28923 / 2 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray abnormal, Headache, Myalgia, Pleural effusion, Pneumonia, Pyrexia, Laboratory test normal, Respiratory viral panel

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Respiratory Panel-neg x 2; CXR-left lower lobe infiltrate-sm effusion
CDC 'Split Type':

Write-up: Patient had onset of fever, myalgias & headache within several hours of vaccine. Temp has persisted up to 103 - subsequently diagnosed with left lower lobe pneumonia - failed outpatient antibiotics - admitted x 24 hrs for IV antibiotics.

Changed on 6/14/2018

VAERS ID: 595084 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Tennessee
Vaccinated:2015-08-31
Onset:2015-08-31
Submitted:2015-09-02
Entered:2015-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH 28923 / 2 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray abnormal, Headache, Myalgia, Pleural effusion, Pneumonia, Pyrexia, Laboratory test normal, Respiratory viral panel

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Respiratory Panel-neg x 2; CXR-left lower lobe infiltrate-sm effusion
CDC 'Split Type':

Write-up: Patient had onset of fever, myalgias & headache within several hours of vaccine. Temp has persisted up to 103 - subsequently diagnosed with left lower lobe pneumonia - failed outpatient antibiotics - admitted x 24 hrs for IV antibiotics.

Changed on 8/14/2018

VAERS ID: 595084 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Tennessee
Vaccinated:2015-08-31
Onset:2015-08-31
Submitted:2015-09-02
Entered:2015-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH 28923 / 2 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray abnormal, Headache, Myalgia, Pleural effusion, Pneumonia, Pyrexia, Laboratory test normal, Respiratory viral panel

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Respiratory Panel-neg x 2; CXR-left lower lobe infiltrate-sm effusion
CDC 'Split Type':

Write-up: Patient had onset of fever, myalgias & headache within several hours of vaccine. Temp has persisted up to 103 - subsequently diagnosed with left lower lobe pneumonia - failed outpatient antibiotics - admitted x 24 hrs for IV antibiotics.

Changed on 9/14/2018

VAERS ID: 595084 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Tennessee
Vaccinated:2015-08-31
Onset:2015-08-31
Submitted:2015-09-02
Entered:2015-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH 28923 / 2 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray abnormal, Headache, Myalgia, Pleural effusion, Pneumonia, Pyrexia, Laboratory test normal, Respiratory viral panel

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Respiratory Panel-neg x 2; CXR-left lower lobe infiltrate-sm effusion
CDC 'Split Type':

Write-up: Patient had onset of fever, myalgias & headache within several hours of vaccine. Temp has persisted up to 103 - subsequently diagnosed with left lower lobe pneumonia - failed outpatient antibiotics - admitted x 24 hrs for IV antibiotics.

Changed on 10/14/2018

VAERS ID: 595084 Before After
VAERS Form:1
Age:12.0
Sex:Female
Location:Tennessee
Vaccinated:2015-08-31
Onset:2015-08-31
Submitted:2015-09-02
Entered:2015-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH 28923 / 2 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray abnormal, Headache, Myalgia, Pleural effusion, Pneumonia, Pyrexia, Laboratory test normal, Respiratory viral panel

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Respiratory Panel-neg x 2; CXR-left lower lobe infiltrate-sm effusion
CDC 'Split Type':

Write-up: Patient had onset of fever, myalgias & headache within several hours of vaccine. Temp has persisted up to 103 - subsequently diagnosed with left lower lobe pneumonia - failed outpatient antibiotics - admitted x 24 hrs for IV antibiotics.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=595084&WAYBACKHISTORY=ON


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