National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 616669

History of Changes from the VAERS Wayback Machine

First Appeared on 2/14/2016

VAERS ID: 616669
VAERS Form:
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2015-08-03
Onset:2015-08-03
Submitted:2015-10-29
Entered:2015-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 146101 / - LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain, 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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PHEH2015US016640

Write-up: Case number PHEH2015US016640, is an initial spontaneous report from a health care professional received on 24 Aug 2015.This report refers to an 18 years old female patient. Medical history and concomitant medications were not reported. She was vaccinated with BEXSERO, (batch number: 146101, expiry date: 30 Apr 2016) into left arm intramuscularly on 03 Aug 2015. On the same day following the vaccination the patient experienced pain and swelling. The outcome, seriousness and causality of the event were not reported.


Changed on 9/14/2017

VAERS ID: 616669 Before After
VAERS Form:(blank) 1
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2015-08-03
Onset:2015-08-03
Submitted:2015-10-29
Entered:2015-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 146101 / - UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain, 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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PHEH2015US016640

Write-up: Case number PHEH2015US016640, is an initial spontaneous report from a health care professional received on 24 Aug 2015.This report refers to an 18 years old female patient. Medical history and concomitant medications were not reported. She was vaccinated with BEXSERO, (batch number: 146101, expiry date: 30 Apr 2016) into left arm intramuscularly on 03 Aug 2015. On the same day following the vaccination the patient experienced pain and swelling. The outcome, seriousness and causality of the event were not reported.


Changed on 2/14/2018

VAERS ID: 616669 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2015-08-03
Onset:2015-08-03
Submitted:2015-10-29
Entered:2015-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 146101 / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain, 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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PHEH2015US016640

Write-up: Case number PHEH2015US016640, is an initial spontaneous report from a health care professional received on 24 Aug 2015.This report refers to an 18 years old female patient. Medical history and concomitant medications were not reported. She was vaccinated with BEXSERO, (batch number: 146101, expiry date: 30 Apr 2016) into left arm intramuscularly on 03 Aug 2015. On the same day following the vaccination the patient experienced pain and swelling. The outcome, seriousness and causality of the event were not reported.


Changed on 6/14/2018

VAERS ID: 616669 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2015-08-03
Onset:2015-08-03
Submitted:2015-10-29
Entered:2015-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 146101 / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain, 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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PHEH2015US016640

Write-up: Case number PHEH2015US016640, is an initial spontaneous report from a health care professional received on 24 Aug 2015.This report refers to an 18 years old female patient. Medical history and concomitant medications were not reported. She was vaccinated with BEXSERO, (batch number: 146101, expiry date: 30 Apr 2016) into left arm intramuscularly on 03 Aug 2015. On the same day following the vaccination the patient experienced pain and swelling. The outcome, seriousness and causality of the event were not reported.


Changed on 8/14/2018

VAERS ID: 616669 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2015-08-03
Onset:2015-08-03
Submitted:2015-10-29
Entered:2015-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 146101 / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain, 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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PHEH2015US016640

Write-up: Case number PHEH2015US016640, is an initial spontaneous report from a health care professional received on 24 Aug 2015.This report refers to an 18 years old female patient. Medical history and concomitant medications were not reported. She was vaccinated with BEXSERO, (batch number: 146101, expiry date: 30 Apr 2016) into left arm intramuscularly on 03 Aug 2015. On the same day following the vaccination the patient experienced pain and swelling. The outcome, seriousness and causality of the event were not reported.


Changed on 9/14/2018

VAERS ID: 616669 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2015-08-03
Onset:2015-08-03
Submitted:2015-10-29
Entered:2015-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 146101 / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain, 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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PHEH2015US016640

Write-up: Case number PHEH2015US016640, is an initial spontaneous report from a health care professional received on 24 Aug 2015.This report refers to an 18 years old female patient. Medical history and concomitant medications were not reported. She was vaccinated with BEXSERO, (batch number: 146101, expiry date: 30 Apr 2016) into left arm intramuscularly on 03 Aug 2015. On the same day following the vaccination the patient experienced pain and swelling. The outcome, seriousness and causality of the event were not reported.


Changed on 10/14/2018

VAERS ID: 616669 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2015-08-03
Onset:2015-08-03
Submitted:2015-10-29
Entered:2015-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 146101 / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain, 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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PHEH2015US016640

Write-up: Case number PHEH2015US016640, is an initial spontaneous report from a health care professional received on 24 Aug 2015.This report refers to an 18 years old female patient. Medical history and concomitant medications were not reported. She was vaccinated with BEXSERO, (batch number: 146101, expiry date: 30 Apr 2016) into left arm intramuscularly on 03 Aug 2015. On the same day following the vaccination the patient experienced pain and swelling. The outcome, seriousness and causality of the event were not reported.


Changed on 12/24/2020

VAERS ID: 616669 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2015-08-03
Onset:2015-08-03
Submitted:2015-10-29
Entered:2015-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 146101 / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain, 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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PHEH2015US016640

Write-up: Case number PHEH2015US016640, is an initial spontaneous report from a health care professional received on 24 Aug 2015.This report refers to an 18 years old female patient. Medical history and concomitant medications were not reported. She was vaccinated with BEXSERO, (batch number: 146101, expiry date: 30 Apr 2016) into left arm intramuscularly on 03 Aug 2015. On the same day following the vaccination the patient experienced pain and swelling. The outcome, seriousness and causality of the event were not reported.


Changed on 12/30/2020

VAERS ID: 616669 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2015-08-03
Onset:2015-08-03
Submitted:2015-10-29
Entered:2015-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 146101 / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain, 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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PHEH2015US016640

Write-up: Case number PHEH2015US016640, is an initial spontaneous report from a health care professional received on 24 Aug 2015.This report refers to an 18 years old female patient. Medical history and concomitant medications were not reported. She was vaccinated with BEXSERO, (batch number: 146101, expiry date: 30 Apr 2016) into left arm intramuscularly on 03 Aug 2015. On the same day following the vaccination the patient experienced pain and swelling. The outcome, seriousness and causality of the event were not reported.


Changed on 5/7/2021

VAERS ID: 616669 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2015-08-03
Onset:2015-08-03
Submitted:2015-10-29
Entered:2015-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 146101 / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain, 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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PHEH2015US016640

Write-up: Case number PHEH2015US016640, is an initial spontaneous report from a health care professional received on 24 Aug 2015.This report refers to an 18 years old female patient. Medical history and concomitant medications were not reported. She was vaccinated with BEXSERO, (batch number: 146101, expiry date: 30 Apr 2016) into left arm intramuscularly on 03 Aug 2015. On the same day following the vaccination the patient experienced pain and swelling. The outcome, seriousness and causality of the event were not reported.


Changed on 5/14/2021

VAERS ID: 616669 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Unknown
Vaccinated:2015-08-03
Onset:2015-08-03
Submitted:2015-10-29
Entered:2015-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 146101 / UNK LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain, 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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': PHEH2015US016640

Write-up: Case number PHEH2015US016640, is an initial spontaneous report from a health care professional received on 24 Aug 2015.This report refers to an 18 years old female patient. Medical history and concomitant medications were not reported. She was vaccinated with BEXSERO, (batch number: 146101, expiry date: 30 Apr 2016) into left arm intramuscularly on 03 Aug 2015. On the same day following the vaccination the patient experienced pain and swelling. The outcome, seriousness and causality of the event were not reported.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=616669&WAYBACKHISTORY=ON

Government Disclaimer on use of this data


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166