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This is VAERS ID 597815

Case Details

VAERS ID: 597815 (history)  
Form: Version 1.0  
Age: 19.0  
Sex: Female  
Location: California  
Vaccinated:2015-05-19
Onset:0000-00-00
Submitted: 2015-08-13
Entered: 2015-09-21
   Days after submission:39
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J28923 / 2 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Vaccination site pain
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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 2015099718

Write-up: The initial case was missing the following minimum criteria: Unidentifiable patient. Upon receipt of follow-up information on 15JUL2015, this case now contains all required information to be considered valid. This is a spontaneous report from a contactable physician. A 18 year old female patient received TRUMENBA (lot J28923, expiry date JUN2016) first single dose on 11MAR2015 and second single dose on 19MAY2015, both intramuscular in left arm. Medical history and concomitant medications were not provided. On unspecified dates in 2015, the patient experienced pain after administration of vaccine at the vaccine site after both firsts and second dose. The event did not require an emergency room or physician visit. Event outcome was unknown. The physician considered there was a reasonable possibility that the event was related to suspect product.


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