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This is VAERS ID 597703

Case Details

VAERS ID: 597703 (history)  
Form: Version 1.0  
Age: 11.0  
Sex: Male  
Location: Nevada  
Vaccinated:2014-12-23
Onset:2014-12-23
   Days after vaccination:0
Submitted: 2015-02-10
   Days after onset:49
Entered: 2015-09-21
   Days after submission:222
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK LA / UN

Administered by: Private       Purchased by: Other
Symptoms: Mobility decreased, Pain in extremity, Peripheral swelling, Vomiting
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)

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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 2014358813

Write-up: This is a spontaneous report from a consumer (a Pfizer Employee) who reported for his son. This 11-year-old male patient received on 23Dec2014 at 16:00 a single dose of TRUMENBA in left arm. The patient did not take any other concomitant medications or vaccine and did not have any relevant medical conditions. Approximately one half hour after receiving the vaccine, the patient noticed soreness in his arm and shortly after he had difficulty moving arm. On 24Dec2014 in the morning, the patient threw up a couple times and swelling arm was noticed. Two of his other children received the vaccine at the same time, and they have not experienced any adverse events. Outocme was not recovered.


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