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This is VAERS ID 597810

History of Changes from the VAERS Wayback Machine

First Appeared on 1/14/2016

VAERS ID: 597810
VAERS Form:
Age:14.0
Sex:Female
Location:California
Vaccinated:2015-03-11
Onset:0000-00-00
Submitted:2015-08-13
Entered:2015-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J28923 / - LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Mobility decreased, Vaccination site pain, Vaccination site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015163601

Write-up: This is a spontaneous report from a contactable physician through via a Pfizer Vaccine Sales Representative. A 14 years old female patient received a single dose of TRUMEMBA (lot J28923, expiry date Jun2016) on 11Mar2015 and on 15May2015, at single dose. Medical history and concomitant medications were not provided. The patient experienced on unspecified dates in 2015, after both vaccinations, limited arm movements, severe pain, swelling after the administration of the vaccine. The events occurred at vaccine site. Events outcome was not provided. The events did not require an emergency room or physician visit. The patient was not admitted to hospital. No specified tests and/or treatment were required. The physician considered there was a reasonable possibility that the event was related to suspect product. Follow-up (09Jul2015): Follow-up attempts completed. No further information expected. Follow-up (15Jul2015): New information from the same contactable physician includes: patient date in Birth, age and gender, vaccinations dates, lot number, expiry date, route of administration, anatomical location, reporter causality assessment.


Changed on 9/14/2017

VAERS ID: 597810 Before After
VAERS Form:(blank) 1
Age:14.0
Sex:Female
Location:California
Vaccinated:2015-03-11
Onset:0000-00-00
Submitted:2015-08-13
Entered:2015-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J28923 / - UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Mobility decreased, Vaccination site pain, Vaccination site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015163601

Write-up: This is a spontaneous report from a contactable physician through via a Pfizer Vaccine Sales Representative. A 14 years old female patient received a single dose of TRUMEMBA (lot J28923, expiry date Jun2016) on 11Mar2015 and on 15May2015, at single dose. Medical history and concomitant medications were not provided. The patient experienced on unspecified dates in 2015, after both vaccinations, limited arm movements, severe pain, swelling after the administration of the vaccine. The events occurred at vaccine site. Events outcome was not provided. The events did not require an emergency room or physician visit. The patient was not admitted to hospital. No specified tests and/or treatment were required. The physician considered there was a reasonable possibility that the event was related to suspect product. Follow-up (09Jul2015): Follow-up attempts completed. No further information expected. Follow-up (15Jul2015): New information from the same contactable physician includes: patient date in Birth, age and gender, vaccinations dates, lot number, expiry date, route of administration, anatomical location, reporter causality assessment.


Changed on 2/14/2018

VAERS ID: 597810 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:California
Vaccinated:2015-03-11
Onset:0000-00-00
Submitted:2015-08-13
Entered:2015-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J28923 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Mobility decreased, Vaccination site pain, Vaccination site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015163601

Write-up: This is a spontaneous report from a contactable physician through via a Pfizer Vaccine Sales Representative. A 14 years old female patient received a single dose of TRUMEMBA (lot J28923, expiry date Jun2016) on 11Mar2015 and on 15May2015, at single dose. Medical history and concomitant medications were not provided. The patient experienced on unspecified dates in 2015, after both vaccinations, limited arm movements, severe pain, swelling after the administration of the vaccine. The events occurred at vaccine site. Events outcome was not provided. The events did not require an emergency room or physician visit. The patient was not admitted to hospital. No specified tests and/or treatment were required. The physician considered there was a reasonable possibility that the event was related to suspect product. Follow-up (09Jul2015): Follow-up attempts completed. No further information expected. Follow-up (15Jul2015): New information from the same contactable physician includes: patient date in Birth, age and gender, vaccinations dates, lot number, expiry date, route of administration, anatomical location, reporter causality assessment.


Changed on 6/14/2018

VAERS ID: 597810 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:California
Vaccinated:2015-03-11
Onset:0000-00-00
Submitted:2015-08-13
Entered:2015-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J28923 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Mobility decreased, Vaccination site pain, Vaccination site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015163601

Write-up: This is a spontaneous report from a contactable physician through via a Pfizer Vaccine Sales Representative. A 14 years old female patient received a single dose of TRUMEMBA (lot J28923, expiry date Jun2016) on 11Mar2015 and on 15May2015, at single dose. Medical history and concomitant medications were not provided. The patient experienced on unspecified dates in 2015, after both vaccinations, limited arm movements, severe pain, swelling after the administration of the vaccine. The events occurred at vaccine site. Events outcome was not provided. The events did not require an emergency room or physician visit. The patient was not admitted to hospital. No specified tests and/or treatment were required. The physician considered there was a reasonable possibility that the event was related to suspect product. Follow-up (09Jul2015): Follow-up attempts completed. No further information expected. Follow-up (15Jul2015): New information from the same contactable physician includes: patient date in Birth, age and gender, vaccinations dates, lot number, expiry date, route of administration, anatomical location, reporter causality assessment.


Changed on 8/14/2018

VAERS ID: 597810 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:California
Vaccinated:2015-03-11
Onset:0000-00-00
Submitted:2015-08-13
Entered:2015-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J28923 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Mobility decreased, Vaccination site pain, Vaccination site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015163601

Write-up: This is a spontaneous report from a contactable physician through via a Pfizer Vaccine Sales Representative. A 14 years old female patient received a single dose of TRUMEMBA (lot J28923, expiry date Jun2016) on 11Mar2015 and on 15May2015, at single dose. Medical history and concomitant medications were not provided. The patient experienced on unspecified dates in 2015, after both vaccinations, limited arm movements, severe pain, swelling after the administration of the vaccine. The events occurred at vaccine site. Events outcome was not provided. The events did not require an emergency room or physician visit. The patient was not admitted to hospital. No specified tests and/or treatment were required. The physician considered there was a reasonable possibility that the event was related to suspect product. Follow-up (09Jul2015): Follow-up attempts completed. No further information expected. Follow-up (15Jul2015): New information from the same contactable physician includes: patient date in Birth, age and gender, vaccinations dates, lot number, expiry date, route of administration, anatomical location, reporter causality assessment.


Changed on 9/14/2018

VAERS ID: 597810 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:California
Vaccinated:2015-03-11
Onset:0000-00-00
Submitted:2015-08-13
Entered:2015-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J28923 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Mobility decreased, Vaccination site pain, Vaccination site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015163601

Write-up: This is a spontaneous report from a contactable physician through via a Pfizer Vaccine Sales Representative. A 14 years old female patient received a single dose of TRUMEMBA (lot J28923, expiry date Jun2016) on 11Mar2015 and on 15May2015, at single dose. Medical history and concomitant medications were not provided. The patient experienced on unspecified dates in 2015, after both vaccinations, limited arm movements, severe pain, swelling after the administration of the vaccine. The events occurred at vaccine site. Events outcome was not provided. The events did not require an emergency room or physician visit. The patient was not admitted to hospital. No specified tests and/or treatment were required. The physician considered there was a reasonable possibility that the event was related to suspect product. Follow-up (09Jul2015): Follow-up attempts completed. No further information expected. Follow-up (15Jul2015): New information from the same contactable physician includes: patient date in Birth, age and gender, vaccinations dates, lot number, expiry date, route of administration, anatomical location, reporter causality assessment.


Changed on 10/14/2018

VAERS ID: 597810 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:California
Vaccinated:2015-03-11
Onset:0000-00-00
Submitted:2015-08-13
Entered:2015-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J28923 / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Mobility decreased, Vaccination site pain, Vaccination site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015163601

Write-up: This is a spontaneous report from a contactable physician through via a Pfizer Vaccine Sales Representative. A 14 years old female patient received a single dose of TRUMEMBA (lot J28923, expiry date Jun2016) on 11Mar2015 and on 15May2015, at single dose. Medical history and concomitant medications were not provided. The patient experienced on unspecified dates in 2015, after both vaccinations, limited arm movements, severe pain, swelling after the administration of the vaccine. The events occurred at vaccine site. Events outcome was not provided. The events did not require an emergency room or physician visit. The patient was not admitted to hospital. No specified tests and/or treatment were required. The physician considered there was a reasonable possibility that the event was related to suspect product. Follow-up (09Jul2015): Follow-up attempts completed. No further information expected. Follow-up (15Jul2015): New information from the same contactable physician includes: patient date in Birth, age and gender, vaccinations dates, lot number, expiry date, route of administration, anatomical location, reporter causality assessment.

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