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This is VAERS ID 611804

History of Changes from the VAERS Wayback Machine

First Appeared on 1/14/2016

VAERS ID: 611804
VAERS Form:
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-11-11
Entered:2015-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Influenza like illness, Lip blister

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015270181

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A male patient of an unspecified age and ethnicity received TRUMENBA, via an unspecified route of administration on an unspecified date, single dose. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced flu like symptoms and blister around his lips after taking this vaccine on an unspecified date with outcome of unknown. Follow-up (08SEP2015): Follow-up attempts completed. No further information expected.


Changed on 9/14/2017

VAERS ID: 611804 Before After
VAERS Form:(blank) 1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-11-11
Entered:2015-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Influenza like illness, Lip blister

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015270181

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A male patient of an unspecified age and ethnicity received TRUMENBA, via an unspecified route of administration on an unspecified date, single dose. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced flu like symptoms and blister around his lips after taking this vaccine on an unspecified date with outcome of unknown. Follow-up (08SEP2015): Follow-up attempts completed. No further information expected.


Changed on 2/14/2018

VAERS ID: 611804 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-11-11
Entered:2015-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Influenza like illness, Lip blister

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015270181

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A male patient of an unspecified age and ethnicity received TRUMENBA, via an unspecified route of administration on an unspecified date, single dose. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced flu like symptoms and blister around his lips after taking this vaccine on an unspecified date with outcome of unknown. Follow-up (08SEP2015): Follow-up attempts completed. No further information expected.


Changed on 6/14/2018

VAERS ID: 611804 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-11-11
Entered:2015-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Influenza like illness, Lip blister

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015270181

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A male patient of an unspecified age and ethnicity received TRUMENBA, via an unspecified route of administration on an unspecified date, single dose. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced flu like symptoms and blister around his lips after taking this vaccine on an unspecified date with outcome of unknown. Follow-up (08SEP2015): Follow-up attempts completed. No further information expected.


Changed on 8/14/2018

VAERS ID: 611804 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-11-11
Entered:2015-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Influenza like illness, Lip blister

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015270181

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A male patient of an unspecified age and ethnicity received TRUMENBA, via an unspecified route of administration on an unspecified date, single dose. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced flu like symptoms and blister around his lips after taking this vaccine on an unspecified date with outcome of unknown. Follow-up (08SEP2015): Follow-up attempts completed. No further information expected.


Changed on 9/14/2018

VAERS ID: 611804 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-11-11
Entered:2015-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Influenza like illness, Lip blister

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015270181

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A male patient of an unspecified age and ethnicity received TRUMENBA, via an unspecified route of administration on an unspecified date, single dose. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced flu like symptoms and blister around his lips after taking this vaccine on an unspecified date with outcome of unknown. Follow-up (08SEP2015): Follow-up attempts completed. No further information expected.


Changed on 10/14/2018

VAERS ID: 611804 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-11-11
Entered:2015-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Influenza like illness, Lip blister

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015270181

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A male patient of an unspecified age and ethnicity received TRUMENBA, via an unspecified route of administration on an unspecified date, single dose. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced flu like symptoms and blister around his lips after taking this vaccine on an unspecified date with outcome of unknown. Follow-up (08SEP2015): Follow-up attempts completed. No further information expected.


Changed on 12/24/2020

VAERS ID: 611804 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-11-11
Entered:2015-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Influenza like illness, Lip blister

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015270181

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A male patient of an unspecified age and ethnicity received TRUMENBA, via an unspecified route of administration on an unspecified date, single dose. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced flu like symptoms and blister around his lips after taking this vaccine on an unspecified date with outcome of unknown. Follow-up (08SEP2015): Follow-up attempts completed. No further information expected.


Changed on 12/30/2020

VAERS ID: 611804 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-11-11
Entered:2015-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Influenza like illness, Lip blister

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015270181

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A male patient of an unspecified age and ethnicity received TRUMENBA, via an unspecified route of administration on an unspecified date, single dose. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced flu like symptoms and blister around his lips after taking this vaccine on an unspecified date with outcome of unknown. Follow-up (08SEP2015): Follow-up attempts completed. No further information expected.


Changed on 5/7/2021

VAERS ID: 611804 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-11-11
Entered:2015-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Influenza like illness, Lip blister

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015270181

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A male patient of an unspecified age and ethnicity received TRUMENBA, via an unspecified route of administration on an unspecified date, single dose. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced flu like symptoms and blister around his lips after taking this vaccine on an unspecified date with outcome of unknown. Follow-up (08SEP2015): Follow-up attempts completed. No further information expected.


Changed on 5/14/2021

VAERS ID: 611804 Before After
VAERS Form:1
Age:
Sex:Male
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-11-11
Entered:2015-11-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Influenza like illness, Lip blister

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 2015270181

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A male patient of an unspecified age and ethnicity received TRUMENBA, via an unspecified route of administration on an unspecified date, single dose. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced flu like symptoms and blister around his lips after taking this vaccine on an unspecified date with outcome of unknown. Follow-up (08SEP2015): Follow-up attempts completed. No further information expected.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=611804&WAYBACKHISTORY=ON


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