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This is VAERS ID 629289

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/14/2016

VAERS ID: 629289
VAERS Form:
Age:17.0
Sex:Female
Location:South Carolina
Vaccinated:2016-03-22
Onset:2016-03-22
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / 0 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Fatigue, Headache, Nausea

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:
Current Illness: None
Preexisting Conditions: ADHD; Depresssion
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The evening after vaccine, pt started with fatigue, chills, HA, and nausea.


Changed on 9/14/2017

VAERS ID: 629289 Before After
VAERS Form:(blank) 1
Age:17.0
Sex:Female
Location:South Carolina
Vaccinated:2016-03-22
Onset:2016-03-22
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / 0 1 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Fatigue, Headache, Nausea

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:
Current Illness: None
Preexisting Conditions: ADHD; Depresssion
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The evening after vaccine, pt started with fatigue, chills, HA, and nausea.


Changed on 2/14/2018

VAERS ID: 629289 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:South Carolina
Vaccinated:2016-03-22
Onset:2016-03-22
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / 1 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Fatigue, Headache, Nausea

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:
Current Illness: None
Preexisting Conditions: ADHD; Depresssion
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The evening after vaccine, pt started with fatigue, chills, HA, and nausea.


Changed on 6/14/2018

VAERS ID: 629289 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:South Carolina
Vaccinated:2016-03-22
Onset:2016-03-22
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / 1 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Fatigue, Headache, Nausea

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:
Current Illness: None
Preexisting Conditions: ADHD; Depresssion
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The evening after vaccine, pt started with fatigue, chills, HA, and nausea.


Changed on 8/14/2018

VAERS ID: 629289 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:South Carolina
Vaccinated:2016-03-22
Onset:2016-03-22
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / 1 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Fatigue, Headache, Nausea

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:
Current Illness: None
Preexisting Conditions: ADHD; Depresssion
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The evening after vaccine, pt started with fatigue, chills, HA, and nausea.


Changed on 9/14/2018

VAERS ID: 629289 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:South Carolina
Vaccinated:2016-03-22
Onset:2016-03-22
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / 1 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Fatigue, Headache, Nausea

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:
Current Illness: None
Preexisting Conditions: ADHD; Depresssion
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The evening after vaccine, pt started with fatigue, chills, HA, and nausea.


Changed on 10/14/2018

VAERS ID: 629289 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:South Carolina
Vaccinated:2016-03-22
Onset:2016-03-22
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / 1 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Fatigue, Headache, Nausea

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:
Current Illness: None
Preexisting Conditions: ADHD; Depresssion
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The evening after vaccine, pt started with fatigue, chills, HA, and nausea.


Changed on 12/10/2020

VAERS ID: 629289 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:South Carolina D.C.
Vaccinated:2016-03-22
Onset:2016-03-22
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / 1 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Fatigue, Headache, Nausea

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:
Current Illness: None
Preexisting Conditions: ADHD; Depresssion
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The evening after vaccine, pt started with fatigue, chills, HA, and nausea.


Changed on 12/24/2020

VAERS ID: 629289 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:D.C.
Vaccinated:2016-03-22
Onset:2016-03-22
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / 1 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Fatigue, Headache, Nausea

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:
Current Illness: None
Preexisting Conditions: ADHD; Depresssion
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The evening after vaccine, pt started with fatigue, chills, HA, and nausea.


Changed on 12/30/2020

VAERS ID: 629289 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:D.C.
Vaccinated:2016-03-22
Onset:2016-03-22
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / 1 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Fatigue, Headache, Nausea

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:
Current Illness: None
Preexisting Conditions: ADHD; Depresssion
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The evening after vaccine, pt started with fatigue, chills, HA, and nausea.


Changed on 5/7/2021

VAERS ID: 629289 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:D.C.
Vaccinated:2016-03-22
Onset:2016-03-22
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / 1 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Fatigue, Headache, Nausea

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:
Current Illness: None
Preexisting Conditions: ADHD; Depresssion
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The evening after vaccine, pt started with fatigue, chills, HA, and nausea.


Changed on 5/21/2021

VAERS ID: 629289 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:D.C.
Vaccinated:2016-03-22
Onset:2016-03-22
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / 1 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Fatigue, Headache, Nausea

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:
Current Illness: None
Preexisting Conditions: ADHD; Depresssion
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The evening after vaccine, pt started with fatigue, chills, HA, and nausea.

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