National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 597815

History of Changes from the VAERS Wayback Machine

First Appeared on 1/14/2016

VAERS ID: 597815
VAERS Form:
Age:19.0
Sex:Female
Location:California
Vaccinated:2015-05-19
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 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Vaccination site pain

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': 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.


Changed on 9/14/2017

VAERS ID: 597815 Before After
VAERS Form:(blank) 1
Age:19.0
Sex:Female
Location:California
Vaccinated:2015-05-19
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 / 1 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Vaccination site pain

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': 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.


Changed on 2/14/2018

VAERS ID: 597815 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:California
Vaccinated:2015-05-19
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 / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Vaccination site pain

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': 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.


Changed on 6/14/2018

VAERS ID: 597815 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:California
Vaccinated:2015-05-19
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 / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Vaccination site pain

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': 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.


Changed on 8/14/2018

VAERS ID: 597815 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:California
Vaccinated:2015-05-19
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 / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Vaccination site pain

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': 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.


Changed on 9/14/2018

VAERS ID: 597815 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:California
Vaccinated:2015-05-19
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 / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Vaccination site pain

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': 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.


Changed on 10/14/2018

VAERS ID: 597815 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:California
Vaccinated:2015-05-19
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 / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Vaccination site pain

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': 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.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=597815&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166