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This is VAERS ID 615503

History of Changes from the VAERS Wayback Machine

First Appeared on 3/14/2016

VAERS ID: 615503
VAERS Form:
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-12-10
Entered:2015-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / - AR / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - AR / UN

Administered by: Other      Purchased by: Other
Symptoms: Chills, Pain, Pruritus, Swelling

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: Unknown
Current Illness: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2015SA182407

Write-up: Initial unsolicited report received from a non-healthcare professional on 10 November 2015. Case is linked to case 2015SA182410. This case involves a (age and gender unknown) patient who was vaccinated with a dose of [route and dose series not reported] MENACTRA (batch number, expiry date were not reported) and also TRUMENBA (batch number, expiry date were not reported) both received in arm on an unspecified date. Medical history and concomitant medications were not reported. On an unspecified date, following the vaccination patient experienced severe swelling, chills, pain and itchiness. Laboratory investigation and corrective treatment were not reported. The outcome of event was not reported. List of documents held by sender: none.


Changed on 9/14/2017

VAERS ID: 615503 Before After
VAERS Form:(blank) 1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-12-10
Entered:2015-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / - UNK AR / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UNK AR / UN

Administered by: Other      Purchased by: Other
Symptoms: Chills, Pain, Pruritus, Swelling

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: Unknown
Current Illness: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2015SA182407

Write-up: Initial unsolicited report received from a non-healthcare professional on 10 November 2015. Case is linked to case 2015SA182410. This case involves a (age and gender unknown) patient who was vaccinated with a dose of [route and dose series not reported] MENACTRA (batch number, expiry date were not reported) and also TRUMENBA (batch number, expiry date were not reported) both received in arm on an unspecified date. Medical history and concomitant medications were not reported. On an unspecified date, following the vaccination patient experienced severe swelling, chills, pain and itchiness. Laboratory investigation and corrective treatment were not reported. The outcome of event was not reported. List of documents held by sender: none.


Changed on 2/14/2018

VAERS ID: 615503 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-12-10
Entered:2015-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK AR / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / UNK AR / UN

Administered by: Other      Purchased by: Other
Symptoms: Chills, Pain, Pruritus, Swelling

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: Unknown
Current Illness: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2015SA182407

Write-up: Initial unsolicited report received from a non-healthcare professional on 10 November 2015. Case is linked to case 2015SA182410. This case involves a (age and gender unknown) patient who was vaccinated with a dose of [route and dose series not reported] MENACTRA (batch number, expiry date were not reported) and also TRUMENBA (batch number, expiry date were not reported) both received in arm on an unspecified date. Medical history and concomitant medications were not reported. On an unspecified date, following the vaccination patient experienced severe swelling, chills, pain and itchiness. Laboratory investigation and corrective treatment were not reported. The outcome of event was not reported. List of documents held by sender: none.


Changed on 6/14/2018

VAERS ID: 615503 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-12-10
Entered:2015-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK AR / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / UNK AR / UN

Administered by: Other      Purchased by: Other
Symptoms: Chills, Pain, Pruritus, Swelling

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: Unknown
Current Illness: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2015SA182407

Write-up: Initial unsolicited report received from a non-healthcare professional on 10 November 2015. Case is linked to case 2015SA182410. This case involves a (age and gender unknown) patient who was vaccinated with a dose of [route and dose series not reported] MENACTRA (batch number, expiry date were not reported) and also TRUMENBA (batch number, expiry date were not reported) both received in arm on an unspecified date. Medical history and concomitant medications were not reported. On an unspecified date, following the vaccination patient experienced severe swelling, chills, pain and itchiness. Laboratory investigation and corrective treatment were not reported. The outcome of event was not reported. List of documents held by sender: none.


Changed on 8/14/2018

VAERS ID: 615503 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-12-10
Entered:2015-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK AR / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / UNK AR / UN

Administered by: Other      Purchased by: Other
Symptoms: Chills, Pain, Pruritus, Swelling

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: Unknown
Current Illness: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2015SA182407

Write-up: Initial unsolicited report received from a non-healthcare professional on 10 November 2015. Case is linked to case 2015SA182410. This case involves a (age and gender unknown) patient who was vaccinated with a dose of [route and dose series not reported] MENACTRA (batch number, expiry date were not reported) and also TRUMENBA (batch number, expiry date were not reported) both received in arm on an unspecified date. Medical history and concomitant medications were not reported. On an unspecified date, following the vaccination patient experienced severe swelling, chills, pain and itchiness. Laboratory investigation and corrective treatment were not reported. The outcome of event was not reported. List of documents held by sender: none.


Changed on 9/14/2018

VAERS ID: 615503 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-12-10
Entered:2015-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK AR / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / UNK AR / UN

Administered by: Other      Purchased by: Other
Symptoms: Chills, Pain, Pruritus, Swelling

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: Unknown
Current Illness: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2015SA182407

Write-up: Initial unsolicited report received from a non-healthcare professional on 10 November 2015. Case is linked to case 2015SA182410. This case involves a (age and gender unknown) patient who was vaccinated with a dose of [route and dose series not reported] MENACTRA (batch number, expiry date were not reported) and also TRUMENBA (batch number, expiry date were not reported) both received in arm on an unspecified date. Medical history and concomitant medications were not reported. On an unspecified date, following the vaccination patient experienced severe swelling, chills, pain and itchiness. Laboratory investigation and corrective treatment were not reported. The outcome of event was not reported. List of documents held by sender: none.


Changed on 10/14/2018

VAERS ID: 615503 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-12-10
Entered:2015-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK AR / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / UNK AR / UN

Administered by: Other      Purchased by: Other
Symptoms: Chills, Pain, Pruritus, Swelling

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: Unknown
Current Illness: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2015SA182407

Write-up: Initial unsolicited report received from a non-healthcare professional on 10 November 2015. Case is linked to case 2015SA182410. This case involves a (age and gender unknown) patient who was vaccinated with a dose of [route and dose series not reported] MENACTRA (batch number, expiry date were not reported) and also TRUMENBA (batch number, expiry date were not reported) both received in arm on an unspecified date. Medical history and concomitant medications were not reported. On an unspecified date, following the vaccination patient experienced severe swelling, chills, pain and itchiness. Laboratory investigation and corrective treatment were not reported. The outcome of event was not reported. List of documents held by sender: none.


Changed on 12/24/2020

VAERS ID: 615503 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-12-10
Entered:2015-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK AR / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / UNK AR / UN

Administered by: Other      Purchased by: Other
Symptoms: Chills, Pain, Pruritus, Swelling

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: Unknown
Current Illness: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2015SA182407

Write-up: Initial unsolicited report received from a non-healthcare professional on 10 November 2015. Case is linked to case 2015SA182410. This case involves a (age and gender unknown) patient who was vaccinated with a dose of [route and dose series not reported] MENACTRA (batch number, expiry date were not reported) and also TRUMENBA (batch number, expiry date were not reported) both received in arm on an unspecified date. Medical history and concomitant medications were not reported. On an unspecified date, following the vaccination patient experienced severe swelling, chills, pain and itchiness. Laboratory investigation and corrective treatment were not reported. The outcome of event was not reported. List of documents held by sender: none.


Changed on 12/30/2020

VAERS ID: 615503 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-12-10
Entered:2015-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK AR / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / UNK AR / UN

Administered by: Other      Purchased by: Other
Symptoms: Chills, Pain, Pruritus, Swelling

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: Unknown
Current Illness: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2015SA182407

Write-up: Initial unsolicited report received from a non-healthcare professional on 10 November 2015. Case is linked to case 2015SA182410. This case involves a (age and gender unknown) patient who was vaccinated with a dose of [route and dose series not reported] MENACTRA (batch number, expiry date were not reported) and also TRUMENBA (batch number, expiry date were not reported) both received in arm on an unspecified date. Medical history and concomitant medications were not reported. On an unspecified date, following the vaccination patient experienced severe swelling, chills, pain and itchiness. Laboratory investigation and corrective treatment were not reported. The outcome of event was not reported. List of documents held by sender: none.


Changed on 5/7/2021

VAERS ID: 615503 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-12-10
Entered:2015-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK AR / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / UNK AR / UN

Administered by: Other      Purchased by: Other
Symptoms: Chills, Pain, Pruritus, Swelling

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: Unknown
Current Illness: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2015SA182407

Write-up: Initial unsolicited report received from a non-healthcare professional on 10 November 2015. Case is linked to case 2015SA182410. This case involves a (age and gender unknown) patient who was vaccinated with a dose of [route and dose series not reported] MENACTRA (batch number, expiry date were not reported) and also TRUMENBA (batch number, expiry date were not reported) both received in arm on an unspecified date. Medical history and concomitant medications were not reported. On an unspecified date, following the vaccination patient experienced severe swelling, chills, pain and itchiness. Laboratory investigation and corrective treatment were not reported. The outcome of event was not reported. List of documents held by sender: none.


Changed on 5/14/2021

VAERS ID: 615503 Before After
VAERS Form:1
Age:
Sex:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2015-12-10
Entered:2015-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK AR / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / UNK AR / UN

Administered by: Other      Purchased by: Other
Symptoms: Chills, Pain, Pruritus, Swelling

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: Unknown
Current Illness: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC 'Split Type': 2015SA182407

Write-up: Initial unsolicited report received from a non-healthcare professional on 10 November 2015. Case is linked to case 2015SA182410. This case involves a (age and gender unknown) patient who was vaccinated with a dose of [route and dose series not reported] MENACTRA (batch number, expiry date were not reported) and also TRUMENBA (batch number, expiry date were not reported) both received in arm on an unspecified date. Medical history and concomitant medications were not reported. On an unspecified date, following the vaccination patient experienced severe swelling, chills, pain and itchiness. Laboratory investigation and corrective treatment were not reported. The outcome of event was not reported. List of documents held by sender: none.

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