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This is VAERS ID 629040

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/14/2016

VAERS ID: 629040
VAERS Form:
Age:17.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Pain in extremity

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': US2016GSK038898

Write-up: This case was reported by a other health professional and described the occurrence of pain in a 17-year-old female patient who received BEXSERO. On an unknown date, the patient received BEXSERO at an unknown dose. On an unknown date, an unknown time after receiving BEXSERO, the patient experienced pain in thigh. On an unknown date, the outcome of the pain in thigh was recovered/resolved. It was unknown if the reporter considered the pain in thigh to be related to BEXSERO. Additional details provided were as follows: The pain in thigh lasted for 8 days.


Changed on 9/14/2017

VAERS ID: 629040 Before After
VAERS Form:(blank) 1
Age:17.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Pain in extremity

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': US2016GSK038898

Write-up: This case was reported by a other health professional and described the occurrence of pain in a 17-year-old female patient who received BEXSERO. On an unknown date, the patient received BEXSERO at an unknown dose. On an unknown date, an unknown time after receiving BEXSERO, the patient experienced pain in thigh. On an unknown date, the outcome of the pain in thigh was recovered/resolved. It was unknown if the reporter considered the pain in thigh to be related to BEXSERO. Additional details provided were as follows: The pain in thigh lasted for 8 days.


Changed on 2/14/2018

VAERS ID: 629040 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Pain in extremity

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': US2016GSK038898

Write-up: This case was reported by a other health professional and described the occurrence of pain in a 17-year-old female patient who received BEXSERO. On an unknown date, the patient received BEXSERO at an unknown dose. On an unknown date, an unknown time after receiving BEXSERO, the patient experienced pain in thigh. On an unknown date, the outcome of the pain in thigh was recovered/resolved. It was unknown if the reporter considered the pain in thigh to be related to BEXSERO. Additional details provided were as follows: The pain in thigh lasted for 8 days.


Changed on 6/14/2018

VAERS ID: 629040 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Pain in extremity

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': US2016GSK038898

Write-up: This case was reported by a other health professional and described the occurrence of pain in a 17-year-old female patient who received BEXSERO. On an unknown date, the patient received BEXSERO at an unknown dose. On an unknown date, an unknown time after receiving BEXSERO, the patient experienced pain in thigh. On an unknown date, the outcome of the pain in thigh was recovered/resolved. It was unknown if the reporter considered the pain in thigh to be related to BEXSERO. Additional details provided were as follows: The pain in thigh lasted for 8 days.


Changed on 8/14/2018

VAERS ID: 629040 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Pain in extremity

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': US2016GSK038898

Write-up: This case was reported by a other health professional and described the occurrence of pain in a 17-year-old female patient who received BEXSERO. On an unknown date, the patient received BEXSERO at an unknown dose. On an unknown date, an unknown time after receiving BEXSERO, the patient experienced pain in thigh. On an unknown date, the outcome of the pain in thigh was recovered/resolved. It was unknown if the reporter considered the pain in thigh to be related to BEXSERO. Additional details provided were as follows: The pain in thigh lasted for 8 days.


Changed on 9/14/2018

VAERS ID: 629040 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Pain in extremity

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': US2016GSK038898

Write-up: This case was reported by a other health professional and described the occurrence of pain in a 17-year-old female patient who received BEXSERO. On an unknown date, the patient received BEXSERO at an unknown dose. On an unknown date, an unknown time after receiving BEXSERO, the patient experienced pain in thigh. On an unknown date, the outcome of the pain in thigh was recovered/resolved. It was unknown if the reporter considered the pain in thigh to be related to BEXSERO. Additional details provided were as follows: The pain in thigh lasted for 8 days.


Changed on 10/14/2018

VAERS ID: 629040 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Pain in extremity

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': US2016GSK038898

Write-up: This case was reported by a other health professional and described the occurrence of pain in a 17-year-old female patient who received BEXSERO. On an unknown date, the patient received BEXSERO at an unknown dose. On an unknown date, an unknown time after receiving BEXSERO, the patient experienced pain in thigh. On an unknown date, the outcome of the pain in thigh was recovered/resolved. It was unknown if the reporter considered the pain in thigh to be related to BEXSERO. Additional details provided were as follows: The pain in thigh lasted for 8 days.


Changed on 5/14/2019

VAERS ID: 629040 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Unknown
Vaccinated:0000-00-00 2016-03-07
Onset:0000-00-00
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - 149001 / UNK UN / UN IM

Administered by: Other      Purchased by: Other
Symptoms: Pain in extremity

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': US2016GSK038898

Write-up: This case was reported by a other health professional and described the occurrence of pain in a 17-year-old female patient who received BEXSERO. On an unknown date, the patient received BEXSERO at an unknown dose. On an unknown date, an unknown time after receiving BEXSERO, the patient experienced pain in thigh. On an unknown date, the outcome of the pain in thigh was recovered/resolved. It was unknown if the reporter considered the pain in thigh to be related to BEXSERO. Additional details provided were as follows: The pain in thigh lasted for 8 days.


Changed on 12/10/2020

VAERS ID: 629040 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Unknown Michigan
Vaccinated:2016-03-07
Onset:0000-00-00
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain in extremity

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': US2016GSK038898

Write-up: This case was reported by a other health professional and described the occurrence of pain in a 17-year-old female patient who received BEXSERO. On an unknown date, the patient received BEXSERO at an unknown dose. On an unknown date, an unknown time after receiving BEXSERO, the patient experienced pain in thigh. On an unknown date, the outcome of the pain in thigh was recovered/resolved. It was unknown if the reporter considered the pain in thigh to be related to BEXSERO. Additional details provided were as follows: The pain in thigh lasted for 8 days.


Changed on 12/24/2020

VAERS ID: 629040 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Michigan
Vaccinated:2016-03-07
Onset:0000-00-00
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain in extremity

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': US2016GSK038898

Write-up: This case was reported by a other health professional and described the occurrence of pain in a 17-year-old female patient who received BEXSERO. On an unknown date, the patient received BEXSERO at an unknown dose. On an unknown date, an unknown time after receiving BEXSERO, the patient experienced pain in thigh. On an unknown date, the outcome of the pain in thigh was recovered/resolved. It was unknown if the reporter considered the pain in thigh to be related to BEXSERO. Additional details provided were as follows: The pain in thigh lasted for 8 days.


Changed on 12/30/2020

VAERS ID: 629040 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Michigan
Vaccinated:2016-03-07
Onset:0000-00-00
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain in extremity

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': US2016GSK038898

Write-up: This case was reported by a other health professional and described the occurrence of pain in a 17-year-old female patient who received BEXSERO. On an unknown date, the patient received BEXSERO at an unknown dose. On an unknown date, an unknown time after receiving BEXSERO, the patient experienced pain in thigh. On an unknown date, the outcome of the pain in thigh was recovered/resolved. It was unknown if the reporter considered the pain in thigh to be related to BEXSERO. Additional details provided were as follows: The pain in thigh lasted for 8 days.


Changed on 5/7/2021

VAERS ID: 629040 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Michigan
Vaccinated:2016-03-07
Onset:0000-00-00
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain in extremity

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': US2016GSK038898

Write-up: This case was reported by a other health professional and described the occurrence of pain in a 17-year-old female patient who received BEXSERO. On an unknown date, the patient received BEXSERO at an unknown dose. On an unknown date, an unknown time after receiving BEXSERO, the patient experienced pain in thigh. On an unknown date, the outcome of the pain in thigh was recovered/resolved. It was unknown if the reporter considered the pain in thigh to be related to BEXSERO. Additional details provided were as follows: The pain in thigh lasted for 8 days.


Changed on 5/21/2021

VAERS ID: 629040 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Michigan
Vaccinated:2016-03-07
Onset:0000-00-00
Submitted:2016-03-23
Entered:2016-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain in extremity

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': US2016GSK038898

Write-up: This case was reported by a other health professional and described the occurrence of pain in a 17-year-old female patient who received BEXSERO. On an unknown date, the patient received BEXSERO at an unknown dose. On an unknown date, an unknown time after receiving BEXSERO, the patient experienced pain in thigh. On an unknown date, the outcome of the pain in thigh was recovered/resolved. It was unknown if the reporter considered the pain in thigh to be related to BEXSERO. Additional details provided were as follows: The pain in thigh lasted for 8 days.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=629040&WAYBACKHISTORY=ON


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