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This is VAERS ID 626962

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History of Changes from the VAERS Wayback Machine

First Appeared on 3/14/2016

VAERS ID: 626962
VAERS Form:
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:2015-12-17
Onset:2015-12-17
Submitted:2015-12-18
Entered:2016-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT) / MEDIMMUNE VACCINES, INC. FJ2099 / - - / IN
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L014415 / 1 RA / UN
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13514 / 0 LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5172BA / 1 LA / UN

Administered by: Private      Purchased by: Public
Symptoms: Crying, Fatigue, Abnormal behaviour

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:
Current Illness: None
Preexisting Conditions: RAD
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Mom states that pt was seen yesterday and received vaccines. Pt had very unusual behavior last night. He cried for hours for no reason. He was also very fatigued. Seems to be better today but still tired.


Changed on 9/14/2017

VAERS ID: 626962 Before After
VAERS Form:(blank) 1
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:2015-12-17
Onset:2015-12-17
Submitted:2015-12-18
Entered:2016-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT) / MEDIMMUNE VACCINES, INC. FJ2099 / - UNK - NS / IN
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L014415 / 1 2 RA / UN
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13514 / 0 1 LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5172BA / 1 2 LA / UN

Administered by: Private      Purchased by: Public
Symptoms: Crying, Fatigue, Abnormal behaviour

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:
Current Illness: None
Preexisting Conditions: RAD
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Mom states that pt was seen yesterday and received vaccines. Pt had very unusual behavior last night. He cried for hours for no reason. He was also very fatigued. Seems to be better today but still tired.


Changed on 2/14/2018

VAERS ID: 626962 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:2015-12-17
Onset:2015-12-17
Submitted:2015-12-18
Entered:2016-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT) / MEDIMMUNE VACCINES, INC. FJ2099 / UNK NS / IN
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L014415 / 2 RA / UN
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13514 / 1 LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5172BA / 2 LA / UN

Administered by: Private      Purchased by: Public
Symptoms: Crying, Fatigue, Abnormal behaviour

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:
Current Illness: None
Preexisting Conditions: RAD
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Mom states that pt was seen yesterday and received vaccines. Pt had very unusual behavior last night. He cried for hours for no reason. He was also very fatigued. Seems to be better today but still tired.


Changed on 6/14/2018

VAERS ID: 626962 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:2015-12-17
Onset:2015-12-17
Submitted:2015-12-18
Entered:2016-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT) / MEDIMMUNE VACCINES, INC. FJ2099 / UNK NS / IN
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L014415 / 2 RA / UN
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13514 / 1 LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5172BA / 2 LA / UN

Administered by: Private      Purchased by: Public
Symptoms: Crying, Fatigue, Abnormal behaviour

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:
Current Illness: None
Preexisting Conditions: RAD
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Mom states that pt was seen yesterday and received vaccines. Pt had very unusual behavior last night. He cried for hours for no reason. He was also very fatigued. Seems to be better today but still tired.


Changed on 8/14/2018

VAERS ID: 626962 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:2015-12-17
Onset:2015-12-17
Submitted:2015-12-18
Entered:2016-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT) / MEDIMMUNE VACCINES, INC. FJ2099 / UNK NS / IN
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L014415 / 2 RA / UN
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13514 / 1 LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5172BA / 2 LA / UN

Administered by: Private      Purchased by: Public
Symptoms: Crying, Fatigue, Abnormal behaviour

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:
Current Illness: None
Preexisting Conditions: RAD
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Mom states that pt was seen yesterday and received vaccines. Pt had very unusual behavior last night. He cried for hours for no reason. He was also very fatigued. Seems to be better today but still tired.


Changed on 9/14/2018

VAERS ID: 626962 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:2015-12-17
Onset:2015-12-17
Submitted:2015-12-18
Entered:2016-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT) / MEDIMMUNE VACCINES, INC. FJ2099 / UNK NS / IN
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L014415 / 2 RA / UN
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13514 / 1 LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5172BA / 2 LA / UN

Administered by: Private      Purchased by: Public
Symptoms: Crying, Fatigue, Abnormal behaviour

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:
Current Illness: None
Preexisting Conditions: RAD
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Mom states that pt was seen yesterday and received vaccines. Pt had very unusual behavior last night. He cried for hours for no reason. He was also very fatigued. Seems to be better today but still tired.


Changed on 10/14/2018

VAERS ID: 626962 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:2015-12-17
Onset:2015-12-17
Submitted:2015-12-18
Entered:2016-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT) / MEDIMMUNE VACCINES, INC. FJ2099 / UNK NS / IN
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L014415 / 2 RA / UN
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13514 / 1 LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5172BA / 2 LA / UN

Administered by: Private      Purchased by: Public
Symptoms: Crying, Fatigue, Abnormal behaviour

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:
Current Illness: None
Preexisting Conditions: RAD
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Mom states that pt was seen yesterday and received vaccines. Pt had very unusual behavior last night. He cried for hours for no reason. He was also very fatigued. Seems to be better today but still tired.


Changed on 12/24/2020

VAERS ID: 626962 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:2015-12-17
Onset:2015-12-17
Submitted:2015-12-18
Entered:2016-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT) / MEDIMMUNE VACCINES, INC. FJ2099 / UNK NS / IN
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L014415 / 2 RA / UN
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13514 / 1 LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5172BA / 2 LA / UN

Administered by: Private      Purchased by: Public
Symptoms: Crying, Fatigue, Abnormal behaviour

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:
Current Illness: None
Preexisting Conditions: RAD
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Mom states that pt was seen yesterday and received vaccines. Pt had very unusual behavior last night. He cried for hours for no reason. He was also very fatigued. Seems to be better today but still tired.


Changed on 12/30/2020

VAERS ID: 626962 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:2015-12-17
Onset:2015-12-17
Submitted:2015-12-18
Entered:2016-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT) / MEDIMMUNE VACCINES, INC. FJ2099 / UNK NS / IN
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L014415 / 2 RA / UN
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13514 / 1 LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5172BA / 2 LA / UN

Administered by: Private      Purchased by: Public
Symptoms: Crying, Fatigue, Abnormal behaviour

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:
Current Illness: None
Preexisting Conditions: RAD
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Mom states that pt was seen yesterday and received vaccines. Pt had very unusual behavior last night. He cried for hours for no reason. He was also very fatigued. Seems to be better today but still tired.


Changed on 5/7/2021

VAERS ID: 626962 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:2015-12-17
Onset:2015-12-17
Submitted:2015-12-18
Entered:2016-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT) / MEDIMMUNE VACCINES, INC. FJ2099 / UNK NS / IN
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L014415 / 2 RA / UN
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13514 / 1 LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5172BA / 2 LA / UN

Administered by: Private      Purchased by: Public
Symptoms: Crying, Fatigue, Abnormal behaviour

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:
Current Illness: None
Preexisting Conditions: RAD
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Mom states that pt was seen yesterday and received vaccines. Pt had very unusual behavior last night. He cried for hours for no reason. He was also very fatigued. Seems to be better today but still tired.


Changed on 5/21/2021

VAERS ID: 626962 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:South Carolina
Vaccinated:2015-12-17
Onset:2015-12-17
Submitted:2015-12-18
Entered:2016-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT) / MEDIMMUNE VACCINES, INC. FJ2099 / UNK NS / IN
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L014415 / 2 RA / UN
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH L13514 / 1 LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5172BA / 2 LA / UN

Administered by: Private      Purchased by: Public
Symptoms: Crying, Fatigue, Abnormal behaviour

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:
Current Illness: None
Preexisting Conditions: RAD
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Mom states that pt was seen yesterday and received vaccines. Pt had very unusual behavior last night. He cried for hours for no reason. He was also very fatigued. Seems to be better today but still tired.

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