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This is VAERS ID 628777

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/14/2016

VAERS ID: 628777
VAERS Form:
Age:17.0
Sex:Female
Location:Michigan
Vaccinated:2016-03-07
Onset:2016-03-07
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / - RL / SYR

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain

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': US2016037775

Write-up: This case was reported by a other health professional via call center representative and described the occurrence of injection site pain in a 17-year-old female patient who received BEXSERO (batch number 149001, expiry date unknown). On 7th March 2016, the patient received BEXSERO .5 ml. On 7th March 2016, less than a day after receiving BEXSERO, the patient experienced injection site pain. The patient was treated with MOTRIN. On an unknown date, the outcome of the injection site pain was not recovered/not resolved. It was unknown if the reporter considered the injection site pain to be related to BEXSERO. Additional details were received as follows: This case was previously reported to a doctor. This case was reported by a certified medical assistant. The patient experienced pain at the injection site, for over 8 days. The patient had been taking over the counter MOTRIN to treat the pain. The reporter did not know the expiration date of the product. The reporter provided the 15th August 2015 as the revision date for the product.


Changed on 9/14/2017

VAERS ID: 628777 Before After
VAERS Form:(blank) 1
Age:17.0
Sex:Female
Location:Michigan
Vaccinated:2016-03-07
Onset:2016-03-07
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / - UNK RL / SYR

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain

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': US2016037775

Write-up: This case was reported by a other health professional via call center representative and described the occurrence of injection site pain in a 17-year-old female patient who received BEXSERO (batch number 149001, expiry date unknown). On 7th March 2016, the patient received BEXSERO .5 ml. On 7th March 2016, less than a day after receiving BEXSERO, the patient experienced injection site pain. The patient was treated with MOTRIN. On an unknown date, the outcome of the injection site pain was not recovered/not resolved. It was unknown if the reporter considered the injection site pain to be related to BEXSERO. Additional details were received as follows: This case was previously reported to a doctor. This case was reported by a certified medical assistant. The patient experienced pain at the injection site, for over 8 days. The patient had been taking over the counter MOTRIN to treat the pain. The reporter did not know the expiration date of the product. The reporter provided the 15th August 2015 as the revision date for the product.


Changed on 2/14/2018

VAERS ID: 628777 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Michigan
Vaccinated:2016-03-07
Onset:2016-03-07
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / UNK RL / SYR

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain

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': US2016037775

Write-up: This case was reported by a other health professional via call center representative and described the occurrence of injection site pain in a 17-year-old female patient who received BEXSERO (batch number 149001, expiry date unknown). On 7th March 2016, the patient received BEXSERO .5 ml. On 7th March 2016, less than a day after receiving BEXSERO, the patient experienced injection site pain. The patient was treated with MOTRIN. On an unknown date, the outcome of the injection site pain was not recovered/not resolved. It was unknown if the reporter considered the injection site pain to be related to BEXSERO. Additional details were received as follows: This case was previously reported to a doctor. This case was reported by a certified medical assistant. The patient experienced pain at the injection site, for over 8 days. The patient had been taking over the counter MOTRIN to treat the pain. The reporter did not know the expiration date of the product. The reporter provided the 15th August 2015 as the revision date for the product.


Changed on 6/14/2018

VAERS ID: 628777 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Michigan
Vaccinated:2016-03-07
Onset:2016-03-07
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / UNK RL / SYR

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain

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': US2016037775

Write-up: This case was reported by a other health professional via call center representative and described the occurrence of injection site pain in a 17-year-old female patient who received BEXSERO (batch number 149001, expiry date unknown). On 7th March 2016, the patient received BEXSERO .5 ml. On 7th March 2016, less than a day after receiving BEXSERO, the patient experienced injection site pain. The patient was treated with MOTRIN. On an unknown date, the outcome of the injection site pain was not recovered/not resolved. It was unknown if the reporter considered the injection site pain to be related to BEXSERO. Additional details were received as follows: This case was previously reported to a doctor. This case was reported by a certified medical assistant. The patient experienced pain at the injection site, for over 8 days. The patient had been taking over the counter MOTRIN to treat the pain. The reporter did not know the expiration date of the product. The reporter provided the 15th August 2015 as the revision date for the product.


Changed on 8/14/2018

VAERS ID: 628777 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Michigan
Vaccinated:2016-03-07
Onset:2016-03-07
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / UNK RL / SYR

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain

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': US2016037775

Write-up: This case was reported by a other health professional via call center representative and described the occurrence of injection site pain in a 17-year-old female patient who received BEXSERO (batch number 149001, expiry date unknown). On 7th March 2016, the patient received BEXSERO .5 ml. On 7th March 2016, less than a day after receiving BEXSERO, the patient experienced injection site pain. The patient was treated with MOTRIN. On an unknown date, the outcome of the injection site pain was not recovered/not resolved. It was unknown if the reporter considered the injection site pain to be related to BEXSERO. Additional details were received as follows: This case was previously reported to a doctor. This case was reported by a certified medical assistant. The patient experienced pain at the injection site, for over 8 days. The patient had been taking over the counter MOTRIN to treat the pain. The reporter did not know the expiration date of the product. The reporter provided the 15th August 2015 as the revision date for the product.


Changed on 9/14/2018

VAERS ID: 628777 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Michigan
Vaccinated:2016-03-07
Onset:2016-03-07
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / UNK RL / SYR

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain

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': US2016037775

Write-up: This case was reported by a other health professional via call center representative and described the occurrence of injection site pain in a 17-year-old female patient who received BEXSERO (batch number 149001, expiry date unknown). On 7th March 2016, the patient received BEXSERO .5 ml. On 7th March 2016, less than a day after receiving BEXSERO, the patient experienced injection site pain. The patient was treated with MOTRIN. On an unknown date, the outcome of the injection site pain was not recovered/not resolved. It was unknown if the reporter considered the injection site pain to be related to BEXSERO. Additional details were received as follows: This case was previously reported to a doctor. This case was reported by a certified medical assistant. The patient experienced pain at the injection site, for over 8 days. The patient had been taking over the counter MOTRIN to treat the pain. The reporter did not know the expiration date of the product. The reporter provided the 15th August 2015 as the revision date for the product.


Changed on 10/14/2018

VAERS ID: 628777 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Michigan
Vaccinated:2016-03-07
Onset:2016-03-07
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / UNK RL / SYR

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain

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': US2016037775

Write-up: This case was reported by a other health professional via call center representative and described the occurrence of injection site pain in a 17-year-old female patient who received BEXSERO (batch number 149001, expiry date unknown). On 7th March 2016, the patient received BEXSERO .5 ml. On 7th March 2016, less than a day after receiving BEXSERO, the patient experienced injection site pain. The patient was treated with MOTRIN. On an unknown date, the outcome of the injection site pain was not recovered/not resolved. It was unknown if the reporter considered the injection site pain to be related to BEXSERO. Additional details were received as follows: This case was previously reported to a doctor. This case was reported by a certified medical assistant. The patient experienced pain at the injection site, for over 8 days. The patient had been taking over the counter MOTRIN to treat the pain. The reporter did not know the expiration date of the product. The reporter provided the 15th August 2015 as the revision date for the product.


Changed on 12/24/2020

VAERS ID: 628777 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Michigan
Vaccinated:2016-03-07
Onset:2016-03-07
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / UNK RL / SYR

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain

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': US2016037775

Write-up: This case was reported by a other health professional via call center representative and described the occurrence of injection site pain in a 17-year-old female patient who received BEXSERO (batch number 149001, expiry date unknown). On 7th March 2016, the patient received BEXSERO .5 ml. On 7th March 2016, less than a day after receiving BEXSERO, the patient experienced injection site pain. The patient was treated with MOTRIN. On an unknown date, the outcome of the injection site pain was not recovered/not resolved. It was unknown if the reporter considered the injection site pain to be related to BEXSERO. Additional details were received as follows: This case was previously reported to a doctor. This case was reported by a certified medical assistant. The patient experienced pain at the injection site, for over 8 days. The patient had been taking over the counter MOTRIN to treat the pain. The reporter did not know the expiration date of the product. The reporter provided the 15th August 2015 as the revision date for the product.


Changed on 12/30/2020

VAERS ID: 628777 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Michigan
Vaccinated:2016-03-07
Onset:2016-03-07
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / UNK RL / SYR

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain

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': US2016037775

Write-up: This case was reported by a other health professional via call center representative and described the occurrence of injection site pain in a 17-year-old female patient who received BEXSERO (batch number 149001, expiry date unknown). On 7th March 2016, the patient received BEXSERO .5 ml. On 7th March 2016, less than a day after receiving BEXSERO, the patient experienced injection site pain. The patient was treated with MOTRIN. On an unknown date, the outcome of the injection site pain was not recovered/not resolved. It was unknown if the reporter considered the injection site pain to be related to BEXSERO. Additional details were received as follows: This case was previously reported to a doctor. This case was reported by a certified medical assistant. The patient experienced pain at the injection site, for over 8 days. The patient had been taking over the counter MOTRIN to treat the pain. The reporter did not know the expiration date of the product. The reporter provided the 15th August 2015 as the revision date for the product.


Changed on 5/7/2021

VAERS ID: 628777 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Michigan
Vaccinated:2016-03-07
Onset:2016-03-07
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / UNK RL / SYR

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain

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': US2016037775

Write-up: This case was reported by a other health professional via call center representative and described the occurrence of injection site pain in a 17-year-old female patient who received BEXSERO (batch number 149001, expiry date unknown). On 7th March 2016, the patient received BEXSERO .5 ml. On 7th March 2016, less than a day after receiving BEXSERO, the patient experienced injection site pain. The patient was treated with MOTRIN. On an unknown date, the outcome of the injection site pain was not recovered/not resolved. It was unknown if the reporter considered the injection site pain to be related to BEXSERO. Additional details were received as follows: This case was previously reported to a doctor. This case was reported by a certified medical assistant. The patient experienced pain at the injection site, for over 8 days. The patient had been taking over the counter MOTRIN to treat the pain. The reporter did not know the expiration date of the product. The reporter provided the 15th August 2015 as the revision date for the product.


Changed on 5/21/2021

VAERS ID: 628777 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Michigan
Vaccinated:2016-03-07
Onset:2016-03-07
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / UNK RL / SYR

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain

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': US2016037775

Write-up: This case was reported by a other health professional via call center representative and described the occurrence of injection site pain in a 17-year-old female patient who received BEXSERO (batch number 149001, expiry date unknown). On 7th March 2016, the patient received BEXSERO .5 ml. On 7th March 2016, less than a day after receiving BEXSERO, the patient experienced injection site pain. The patient was treated with MOTRIN. On an unknown date, the outcome of the injection site pain was not recovered/not resolved. It was unknown if the reporter considered the injection site pain to be related to BEXSERO. Additional details were received as follows: This case was previously reported to a doctor. This case was reported by a certified medical assistant. The patient experienced pain at the injection site, for over 8 days. The patient had been taking over the counter MOTRIN to treat the pain. The reporter did not know the expiration date of the product. The reporter provided the 15th August 2015 as the revision date for the product.

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