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This is VAERS ID 617857

History of Changes from the VAERS Wayback Machine

First Appeared on 1/14/2016

VAERS ID: 617857
VAERS Form:
Age:19.0
Sex:Male
Location:Florida
Vaccinated:2015-12-14
Onset:2015-12-15
Submitted:2015-12-28
Entered:2016-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13515 / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray, Electrocardiogram, Palpitations, Tachycardia, Myocardial necrosis marker

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Prominent aortic root; Genetic testing done to rule out Marfan''s
Allergies:
Diagnostic Lab Data: EKG; Chest X-Ray; Cardiac enzymes
CDC 'Split Type':

Write-up: Patient experienced palpitations and tachycardia approximately 36 hrs after receiving TRUMENBA (meningitis B vaccine).


Changed on 9/14/2017

VAERS ID: 617857 Before After
VAERS Form:(blank) 1
Age:19.0
Sex:Male
Location:Florida
Vaccinated:2015-12-14
Onset:2015-12-15
Submitted:2015-12-28
Entered:2016-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13515 / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray, Electrocardiogram, Palpitations, Tachycardia, Myocardial necrosis marker

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Prominent aortic root; Genetic testing done to rule out Marfan''s
Allergies:
Diagnostic Lab Data: EKG; Chest X-Ray; Cardiac enzymes
CDC 'Split Type':

Write-up: Patient experienced palpitations and tachycardia approximately 36 hrs after receiving TRUMENBA (meningitis B vaccine).


Changed on 2/14/2018

VAERS ID: 617857 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Florida
Vaccinated:2015-12-14
Onset:2015-12-15
Submitted:2015-12-28
Entered:2016-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13515 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray, Electrocardiogram, Palpitations, Tachycardia, Myocardial necrosis marker

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Prominent aortic root; Genetic testing done to rule out Marfan''s
Allergies:
Diagnostic Lab Data: EKG; Chest X-Ray; Cardiac enzymes
CDC 'Split Type':

Write-up: Patient experienced palpitations and tachycardia approximately 36 hrs after receiving TRUMENBA (meningitis B vaccine).


Changed on 6/14/2018

VAERS ID: 617857 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Florida
Vaccinated:2015-12-14
Onset:2015-12-15
Submitted:2015-12-28
Entered:2016-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13515 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray, Electrocardiogram, Palpitations, Tachycardia, Myocardial necrosis marker

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Prominent aortic root; Genetic testing done to rule out Marfan''s
Allergies:
Diagnostic Lab Data: EKG; Chest X-Ray; Cardiac enzymes
CDC 'Split Type':

Write-up: Patient experienced palpitations and tachycardia approximately 36 hrs after receiving TRUMENBA (meningitis B vaccine).


Changed on 8/14/2018

VAERS ID: 617857 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Florida
Vaccinated:2015-12-14
Onset:2015-12-15
Submitted:2015-12-28
Entered:2016-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13515 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray, Electrocardiogram, Palpitations, Tachycardia, Myocardial necrosis marker

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Prominent aortic root; Genetic testing done to rule out Marfan''s
Allergies:
Diagnostic Lab Data: EKG; Chest X-Ray; Cardiac enzymes
CDC 'Split Type':

Write-up: Patient experienced palpitations and tachycardia approximately 36 hrs after receiving TRUMENBA (meningitis B vaccine).


Changed on 9/14/2018

VAERS ID: 617857 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Florida
Vaccinated:2015-12-14
Onset:2015-12-15
Submitted:2015-12-28
Entered:2016-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13515 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray, Electrocardiogram, Palpitations, Tachycardia, Myocardial necrosis marker

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Prominent aortic root; Genetic testing done to rule out Marfan''s
Allergies:
Diagnostic Lab Data: EKG; Chest X-Ray; Cardiac enzymes
CDC 'Split Type':

Write-up: Patient experienced palpitations and tachycardia approximately 36 hrs after receiving TRUMENBA (meningitis B vaccine).


Changed on 10/14/2018

VAERS ID: 617857 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Florida
Vaccinated:2015-12-14
Onset:2015-12-15
Submitted:2015-12-28
Entered:2016-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13515 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray, Electrocardiogram, Palpitations, Tachycardia, Myocardial necrosis marker

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Prominent aortic root; Genetic testing done to rule out Marfan''s
Allergies:
Diagnostic Lab Data: EKG; Chest X-Ray; Cardiac enzymes
CDC 'Split Type':

Write-up: Patient experienced palpitations and tachycardia approximately 36 hrs after receiving TRUMENBA (meningitis B vaccine).


Changed on 12/24/2020

VAERS ID: 617857 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Florida
Vaccinated:2015-12-14
Onset:2015-12-15
Submitted:2015-12-28
Entered:2016-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13515 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray, Electrocardiogram, Palpitations, Tachycardia, Myocardial necrosis marker

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Prominent aortic root; Genetic testing done to rule out Marfan''s
Allergies:
Diagnostic Lab Data: EKG; Chest X-Ray; Cardiac enzymes
CDC 'Split Type':

Write-up: Patient experienced palpitations and tachycardia approximately 36 hrs after receiving TRUMENBA (meningitis B vaccine).


Changed on 12/30/2020

VAERS ID: 617857 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Florida
Vaccinated:2015-12-14
Onset:2015-12-15
Submitted:2015-12-28
Entered:2016-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13515 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray, Electrocardiogram, Palpitations, Tachycardia, Myocardial necrosis marker

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Prominent aortic root; Genetic testing done to rule out Marfan''s
Allergies:
Diagnostic Lab Data: EKG; Chest X-Ray; Cardiac enzymes
CDC 'Split Type':

Write-up: Patient experienced palpitations and tachycardia approximately 36 hrs after receiving TRUMENBA (meningitis B vaccine).


Changed on 5/7/2021

VAERS ID: 617857 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Florida
Vaccinated:2015-12-14
Onset:2015-12-15
Submitted:2015-12-28
Entered:2016-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13515 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray, Electrocardiogram, Palpitations, Tachycardia, Myocardial necrosis marker

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Prominent aortic root; Genetic testing done to rule out Marfan''s
Allergies:
Diagnostic Lab Data: EKG; Chest X-Ray; Cardiac enzymes
CDC 'Split Type':

Write-up: Patient experienced palpitations and tachycardia approximately 36 hrs after receiving TRUMENBA (meningitis B vaccine).


Changed on 5/14/2021

VAERS ID: 617857 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Florida
Vaccinated:2015-12-14
Onset:2015-12-15
Submitted:2015-12-28
Entered:2016-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13515 / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest X-ray, Electrocardiogram, Palpitations, Tachycardia, Myocardial necrosis marker

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Prominent aortic root; Genetic testing done to rule out Marfan''s
Allergies:
Diagnostic Lab Data: EKG; Chest X-Ray; Cardiac enzymes
CDC 'Split Type':

Write-up: Patient experienced palpitations and tachycardia approximately 36 hrs after receiving TRUMENBA (meningitis B vaccine).

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=617857&WAYBACKHISTORY=ON

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