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This is VAERS ID 602499

Case Details

VAERS ID: 602499 (history)  
Form: Version 1.0  
Age: 14.0  
Sex: Female  
Location: Arizona  
Vaccinated:2015-10-07
Onset:2015-10-07
   Days after vaccination:0
Submitted: 2015-10-08
   Days after onset:1
Entered: 2015-10-12
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13514 / 1 LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Erythema, Headache, Induration, Injected limb mobility decreased
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Headache, erythema, induration, inability to lift left arm where injection was given.


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