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This is VAERS ID 625935

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/14/2016

VAERS ID: 625935
VAERS Form:
Age:12.0
Sex:Male
Location:Unknown
Vaccinated:2016-01-17
Onset:2016-01-17
Submitted:2016-02-18
Entered:2016-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M13066 / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Headache, Injection site pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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': 2016032907

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A 12-year-old male patient, the doctor''s son, received one dose of TRUMENBA (lot M13066, Expiry Date: Sep2016), intramuscular on 17Jan2016 at 0.5 ml single dose for prevention of meningococcal disease. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced muscle pain at site, headache and low grade fever on 17Jan2016. The outcome of the events was reported as recovered. The events were assessed as non-serious.


Changed on 9/14/2017

VAERS ID: 625935 Before After
VAERS Form:(blank) 1
Age:12.0
Sex:Male
Location:Unknown
Vaccinated:2016-01-17
Onset:2016-01-17
Submitted:2016-02-18
Entered:2016-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M13066 / - UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Headache, Injection site pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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': 2016032907

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A 12-year-old male patient, the doctor''s son, received one dose of TRUMENBA (lot M13066, Expiry Date: Sep2016), intramuscular on 17Jan2016 at 0.5 ml single dose for prevention of meningococcal disease. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced muscle pain at site, headache and low grade fever on 17Jan2016. The outcome of the events was reported as recovered. The events were assessed as non-serious.


Changed on 2/14/2018

VAERS ID: 625935 Before After
VAERS Form:1
Age:12.0
Sex:Male
Location:Unknown
Vaccinated:2016-01-17
Onset:2016-01-17
Submitted:2016-02-18
Entered:2016-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M13066 / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Headache, Injection site pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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': 2016032907

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A 12-year-old male patient, the doctor''s son, received one dose of TRUMENBA (lot M13066, Expiry Date: Sep2016), intramuscular on 17Jan2016 at 0.5 ml single dose for prevention of meningococcal disease. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced muscle pain at site, headache and low grade fever on 17Jan2016. The outcome of the events was reported as recovered. The events were assessed as non-serious.


Changed on 6/14/2018

VAERS ID: 625935 Before After
VAERS Form:1
Age:12.0
Sex:Male
Location:Unknown
Vaccinated:2016-01-17
Onset:2016-01-17
Submitted:2016-02-18
Entered:2016-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M13066 / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Headache, Injection site pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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': 2016032907

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A 12-year-old male patient, the doctor''s son, received one dose of TRUMENBA (lot M13066, Expiry Date: Sep2016), intramuscular on 17Jan2016 at 0.5 ml single dose for prevention of meningococcal disease. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced muscle pain at site, headache and low grade fever on 17Jan2016. The outcome of the events was reported as recovered. The events were assessed as non-serious.


Changed on 8/14/2018

VAERS ID: 625935 Before After
VAERS Form:1
Age:12.0
Sex:Male
Location:Unknown
Vaccinated:2016-01-17
Onset:2016-01-17
Submitted:2016-02-18
Entered:2016-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M13066 / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Headache, Injection site pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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': 2016032907

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A 12-year-old male patient, the doctor''s son, received one dose of TRUMENBA (lot M13066, Expiry Date: Sep2016), intramuscular on 17Jan2016 at 0.5 ml single dose for prevention of meningococcal disease. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced muscle pain at site, headache and low grade fever on 17Jan2016. The outcome of the events was reported as recovered. The events were assessed as non-serious.


Changed on 9/14/2018

VAERS ID: 625935 Before After
VAERS Form:1
Age:12.0
Sex:Male
Location:Unknown
Vaccinated:2016-01-17
Onset:2016-01-17
Submitted:2016-02-18
Entered:2016-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M13066 / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Headache, Injection site pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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': 2016032907

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A 12-year-old male patient, the doctor''s son, received one dose of TRUMENBA (lot M13066, Expiry Date: Sep2016), intramuscular on 17Jan2016 at 0.5 ml single dose for prevention of meningococcal disease. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced muscle pain at site, headache and low grade fever on 17Jan2016. The outcome of the events was reported as recovered. The events were assessed as non-serious.


Changed on 10/14/2018

VAERS ID: 625935 Before After
VAERS Form:1
Age:12.0
Sex:Male
Location:Unknown
Vaccinated:2016-01-17
Onset:2016-01-17
Submitted:2016-02-18
Entered:2016-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M13066 / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Headache, Injection site pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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': 2016032907

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A 12-year-old male patient, the doctor''s son, received one dose of TRUMENBA (lot M13066, Expiry Date: Sep2016), intramuscular on 17Jan2016 at 0.5 ml single dose for prevention of meningococcal disease. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced muscle pain at site, headache and low grade fever on 17Jan2016. The outcome of the events was reported as recovered. The events were assessed as non-serious.


Changed on 12/24/2020

VAERS ID: 625935 Before After
VAERS Form:1
Age:12.0
Sex:Male
Location:Unknown
Vaccinated:2016-01-17
Onset:2016-01-17
Submitted:2016-02-18
Entered:2016-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M13066 / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Headache, Injection site pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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': 2016032907

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A 12-year-old male patient, the doctor''s son, received one dose of TRUMENBA (lot M13066, Expiry Date: Sep2016), intramuscular on 17Jan2016 at 0.5 ml single dose for prevention of meningococcal disease. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced muscle pain at site, headache and low grade fever on 17Jan2016. The outcome of the events was reported as recovered. The events were assessed as non-serious.


Changed on 12/30/2020

VAERS ID: 625935 Before After
VAERS Form:1
Age:12.0
Sex:Male
Location:Unknown
Vaccinated:2016-01-17
Onset:2016-01-17
Submitted:2016-02-18
Entered:2016-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M13066 / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Headache, Injection site pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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': 2016032907

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A 12-year-old male patient, the doctor''s son, received one dose of TRUMENBA (lot M13066, Expiry Date: Sep2016), intramuscular on 17Jan2016 at 0.5 ml single dose for prevention of meningococcal disease. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced muscle pain at site, headache and low grade fever on 17Jan2016. The outcome of the events was reported as recovered. The events were assessed as non-serious.


Changed on 5/7/2021

VAERS ID: 625935 Before After
VAERS Form:1
Age:12.0
Sex:Male
Location:Unknown
Vaccinated:2016-01-17
Onset:2016-01-17
Submitted:2016-02-18
Entered:2016-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M13066 / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Headache, Injection site pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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': 2016032907

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A 12-year-old male patient, the doctor''s son, received one dose of TRUMENBA (lot M13066, Expiry Date: Sep2016), intramuscular on 17Jan2016 at 0.5 ml single dose for prevention of meningococcal disease. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced muscle pain at site, headache and low grade fever on 17Jan2016. The outcome of the events was reported as recovered. The events were assessed as non-serious.


Changed on 5/21/2021

VAERS ID: 625935 Before After
VAERS Form:1
Age:12.0
Sex:Male
Location:Unknown
Vaccinated:2016-01-17
Onset:2016-01-17
Submitted:2016-02-18
Entered:2016-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M13066 / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Headache, Injection site pain, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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': 2016032907

Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A 12-year-old male patient, the doctor''s son, received one dose of TRUMENBA (lot M13066, Expiry Date: Sep2016), intramuscular on 17Jan2016 at 0.5 ml single dose for prevention of meningococcal disease. The patient medical history and the patient''s concomitant medications were not reported. The patient experienced muscle pain at site, headache and low grade fever on 17Jan2016. The outcome of the events was reported as recovered. The events were assessed as non-serious.

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