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This is VAERS ID 597873

History of Changes from the VAERS Wayback Machine

First Appeared on 1/14/2016

VAERS ID: 597873
VAERS Form:
Age:
Sex:Female
Location:Kansas
Vaccinated:2015-07-02
Onset:2015-07-02
Submitted:2015-08-13
Entered:2015-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J29203 / - LG / IM

Administered by: Private      Purchased by: Private
Symptoms: Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015228034

Write-up: This is a spontaneous report obtained from a contactable nurse through a sales representative. This nurse reported about two different children. This is the second of two reports. A female child of an unspecified age and ethnicity received on 02JUL2015 at 11:29, TRUMENBA; (Lot J29203; Ex 30JUN2016) 0.5 ml at single dose, IM (intramuscularly), on the right UOQ in upper leg. Relevant medical history and concomitant medications were unknown. On an 02JUL2015, the patient experienced extreme pain. Clinical outcome of the event was recovered on 06JUL2015. Follow-up (11AUG2015): New information received from the same contactable nurse includes: product data, reaction data and outcome.


Changed on 9/14/2017

VAERS ID: 597873 Before After
VAERS Form:(blank) 1
Age:
Sex:Female
Location:Kansas
Vaccinated:2015-07-02
Onset:2015-07-02
Submitted:2015-08-13
Entered:2015-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J29203 / - UNK LG / IM

Administered by: Private      Purchased by: Private
Symptoms: Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015228034

Write-up: This is a spontaneous report obtained from a contactable nurse through a sales representative. This nurse reported about two different children. This is the second of two reports. A female child of an unspecified age and ethnicity received on 02JUL2015 at 11:29, TRUMENBA; (Lot J29203; Ex 30JUN2016) 0.5 ml at single dose, IM (intramuscularly), on the right UOQ in upper leg. Relevant medical history and concomitant medications were unknown. On an 02JUL2015, the patient experienced extreme pain. Clinical outcome of the event was recovered on 06JUL2015. Follow-up (11AUG2015): New information received from the same contactable nurse includes: product data, reaction data and outcome.


Changed on 2/14/2018

VAERS ID: 597873 Before After
VAERS Form:1
Age:
Sex:Female
Location:Kansas
Vaccinated:2015-07-02
Onset:2015-07-02
Submitted:2015-08-13
Entered:2015-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J29203 / UNK LG / IM

Administered by: Private      Purchased by: Private
Symptoms: Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015228034

Write-up: This is a spontaneous report obtained from a contactable nurse through a sales representative. This nurse reported about two different children. This is the second of two reports. A female child of an unspecified age and ethnicity received on 02JUL2015 at 11:29, TRUMENBA; (Lot J29203; Ex 30JUN2016) 0.5 ml at single dose, IM (intramuscularly), on the right UOQ in upper leg. Relevant medical history and concomitant medications were unknown. On an 02JUL2015, the patient experienced extreme pain. Clinical outcome of the event was recovered on 06JUL2015. Follow-up (11AUG2015): New information received from the same contactable nurse includes: product data, reaction data and outcome.


Changed on 6/14/2018

VAERS ID: 597873 Before After
VAERS Form:1
Age:
Sex:Female
Location:Kansas
Vaccinated:2015-07-02
Onset:2015-07-02
Submitted:2015-08-13
Entered:2015-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J29203 / UNK LG / IM

Administered by: Private      Purchased by: Private
Symptoms: Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015228034

Write-up: This is a spontaneous report obtained from a contactable nurse through a sales representative. This nurse reported about two different children. This is the second of two reports. A female child of an unspecified age and ethnicity received on 02JUL2015 at 11:29, TRUMENBA; (Lot J29203; Ex 30JUN2016) 0.5 ml at single dose, IM (intramuscularly), on the right UOQ in upper leg. Relevant medical history and concomitant medications were unknown. On an 02JUL2015, the patient experienced extreme pain. Clinical outcome of the event was recovered on 06JUL2015. Follow-up (11AUG2015): New information received from the same contactable nurse includes: product data, reaction data and outcome.


Changed on 8/14/2018

VAERS ID: 597873 Before After
VAERS Form:1
Age:
Sex:Female
Location:Kansas
Vaccinated:2015-07-02
Onset:2015-07-02
Submitted:2015-08-13
Entered:2015-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J29203 / UNK LG / IM

Administered by: Private      Purchased by: Private
Symptoms: Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015228034

Write-up: This is a spontaneous report obtained from a contactable nurse through a sales representative. This nurse reported about two different children. This is the second of two reports. A female child of an unspecified age and ethnicity received on 02JUL2015 at 11:29, TRUMENBA; (Lot J29203; Ex 30JUN2016) 0.5 ml at single dose, IM (intramuscularly), on the right UOQ in upper leg. Relevant medical history and concomitant medications were unknown. On an 02JUL2015, the patient experienced extreme pain. Clinical outcome of the event was recovered on 06JUL2015. Follow-up (11AUG2015): New information received from the same contactable nurse includes: product data, reaction data and outcome.


Changed on 9/14/2018

VAERS ID: 597873 Before After
VAERS Form:1
Age:
Sex:Female
Location:Kansas
Vaccinated:2015-07-02
Onset:2015-07-02
Submitted:2015-08-13
Entered:2015-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J29203 / UNK LG / IM

Administered by: Private      Purchased by: Private
Symptoms: Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015228034

Write-up: This is a spontaneous report obtained from a contactable nurse through a sales representative. This nurse reported about two different children. This is the second of two reports. A female child of an unspecified age and ethnicity received on 02JUL2015 at 11:29, TRUMENBA; (Lot J29203; Ex 30JUN2016) 0.5 ml at single dose, IM (intramuscularly), on the right UOQ in upper leg. Relevant medical history and concomitant medications were unknown. On an 02JUL2015, the patient experienced extreme pain. Clinical outcome of the event was recovered on 06JUL2015. Follow-up (11AUG2015): New information received from the same contactable nurse includes: product data, reaction data and outcome.


Changed on 10/14/2018

VAERS ID: 597873 Before After
VAERS Form:1
Age:
Sex:Female
Location:Kansas
Vaccinated:2015-07-02
Onset:2015-07-02
Submitted:2015-08-13
Entered:2015-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J29203 / UNK LG / IM

Administered by: Private      Purchased by: Private
Symptoms: Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015228034

Write-up: This is a spontaneous report obtained from a contactable nurse through a sales representative. This nurse reported about two different children. This is the second of two reports. A female child of an unspecified age and ethnicity received on 02JUL2015 at 11:29, TRUMENBA; (Lot J29203; Ex 30JUN2016) 0.5 ml at single dose, IM (intramuscularly), on the right UOQ in upper leg. Relevant medical history and concomitant medications were unknown. On an 02JUL2015, the patient experienced extreme pain. Clinical outcome of the event was recovered on 06JUL2015. Follow-up (11AUG2015): New information received from the same contactable nurse includes: product data, reaction data and outcome.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=597873&WAYBACKHISTORY=ON


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