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This is VAERS ID 602815

Case Details

VAERS ID: 602815 (history)  
Form: Version 1.0  
Age: 13.0  
Sex: Female  
Location: Oregon  
Vaccinated:2015-08-04
Onset:2015-08-04
   Days after vaccination:0
Submitted: 2015-10-15
   Days after onset:72
Entered: 2015-10-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J29203 / UNK LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Headache, Injection site rash, Injection site swelling, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient reported headache, body aches, rash and swelling at injection site.


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