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This is VAERS ID 597864

Case Details

VAERS ID: 597864 (history)  
Form: Version 1.0  
Age: 22.0  
Sex: Female  
Location: New Jersey  
Submitted: 2015-08-13
Entered: 2015-09-21
   Days after submission:39
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Private
Symptoms: Fatigue, Full blood count normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: EFFEXOR
Current Illness: None
Preexisting Conditions: Anxiety
Diagnostic Lab Data: Full blood count, normal
CDC Split Type: 2015241192

Write-up: This is a spontaneous report from a contactable physician. A 22-year-old female patient received TRUMENBA, (lot number J28923, Expiry Date JUN2016), intramuscular on 27JUN2015 at 11:05 AM at 0.5 ml, single in the left deltoid. No other vaccines were administered on the same date or within four weeks. Medical history included anxiety from an unknown date and unknown if ongoing. Concomitant medication included EFFEXOR for anxiety from FEB2015 to 23JUL2015 at 37.5 mg once a day orally. The patient experienced extreme fatigue on an unknown date in 2015. Outcome as recovered after 3 weeks on unspecified date in 2015. The patient underwent lab tests and procedures which included full blood count: normal in JUL2015. No treatment was provided. The physician considered that TRUMENBA had not a casual effect to the adverse event. Follow-up (04AUG2015): New information received from the same contactable physician includes: route, vaccination time, anatomical location of vaccination, casual relationship, outcome and information on treatment and concomitant medication. Follow-up attempts completed. No further information expected.

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