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This is VAERS ID 597702

Case Details

VAERS ID: 597702 (history)  
Form: Version 1.0  
Age: 19.0  
Sex: Female  
Location: Unknown  
Vaccinated:2015-02-08
Onset:0000-00-00
Submitted: 2015-05-15
Entered: 2015-09-21
   Days after submission:129
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH 09203 / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Nasal discomfort
SMQs:

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: SYNTHROID
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 2015057102

Write-up: This is a spontaneous report from a Pfizer Colleague who reported on behalf of contactable consumer (friend) reporting for a patient (friend''s daughter). A 19-year-old female patient received TRUMENBA (lot# 09203, exp date Jun2016), via an unspecified route of administration on 08Feb2015, at single dose, as she had case of meningitis at her college. Relevant medical history was not reported. Concomitant medication included SYNTHROID from 2013 and ongoing. On an unspecified date the patient experienced nostril flared with outcome of unknown. Follow-up (17Mar2015): new information received from a contactable consumer includes: TRUMENBA details, concomitant medication. Follow-up attempts completed. No further information expected. Follow-up (15MAY-2015): Follow-up attempts completed. No further information expected.


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