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This is VAERS ID 604548

Case Details

VAERS ID: 604548 (history)  
Form: Version 1.0  
Age: 16.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2015-10-21
Onset:2015-10-21
   Days after vaccination:0
Submitted: 2015-10-23
   Days after onset:2
Entered: 2015-10-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT) / MEDIMMUNE VACCINES, INC. FJ2235 / 3 NS / IN
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 146101D / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Immediate post-injection reaction, Injection site bruising, Injection site pain, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), 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: Ortho-cyclen, multivitamin, vit C, Miralax
Current Illness: No
Preexisting Conditions: Anxiety
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Severe arm swelling immediately, bruising at injection site the next day, painful to touch. No treatment except Tylenol, warm packs.


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