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This is VAERS ID 597863

Case Details

VAERS ID: 597863 (history)  
Form: Version 1.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
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 - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Bronchospasm
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)

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: 2015152174

Write-up: This is a spontaneous report from a contactable physician. A patient of unspecified age ethnicity and gender received TRUMENBA, via an unspecified route of administration at single dose on unknown date. The patient medical history and concomitant medications were not reported. The patient experienced bronchospasm on an unspecified date with outcome of unknown. Follow-up (26JUN2015): Follow-up attempts completed. No further information expected.


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