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This is VAERS ID 629824

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/14/2016

VAERS ID: 629824
VAERS Form:
Age:17.0
Sex:Female
Location:New Mexico
Vaccinated:2016-03-25
Onset:2016-03-25
Submitted:2016-03-29
Entered:2016-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 0 LA / IM

Administered by: Unknown      Purchased by: Public
Symptoms: Injection site pain, Pain, Activities of daily living impaired

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: started augmentin later that day
Current Illness: Vaginitis
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Extreme pain at injection site and anterior to injection site. Unable to move arm without pain. Unable to perform ADLs days later - seen in office on 3/29/16 with extreme pain. Unable to swim (she is a swimmer).


Changed on 9/14/2017

VAERS ID: 629824 Before After
VAERS Form:(blank) 1
Age:17.0
Sex:Female
Location:New Mexico
Vaccinated:2016-03-25
Onset:2016-03-25
Submitted:2016-03-29
Entered:2016-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 0 1 LA / IM

Administered by: Unknown      Purchased by: Public
Symptoms: Injection site pain, Pain, Activities of daily living impaired

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: started augmentin later that day
Current Illness: Vaginitis
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Extreme pain at injection site and anterior to injection site. Unable to move arm without pain. Unable to perform ADLs days later - seen in office on 3/29/16 with extreme pain. Unable to swim (she is a swimmer).


Changed on 2/14/2018

VAERS ID: 629824 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:New Mexico
Vaccinated:2016-03-25
Onset:2016-03-25
Submitted:2016-03-29
Entered:2016-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 LA / IM

Administered by: Unknown      Purchased by: Public
Symptoms: Injection site pain, Pain, Activities of daily living impaired

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: started augmentin later that day
Current Illness: Vaginitis
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Extreme pain at injection site and anterior to injection site. Unable to move arm without pain. Unable to perform ADLs days later - seen in office on 3/29/16 with extreme pain. Unable to swim (she is a swimmer).


Changed on 6/14/2018

VAERS ID: 629824 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:New Mexico
Vaccinated:2016-03-25
Onset:2016-03-25
Submitted:2016-03-29
Entered:2016-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 LA / IM

Administered by: Unknown      Purchased by: Public
Symptoms: Injection site pain, Pain, Activities of daily living impaired

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: started augmentin later that day
Current Illness: Vaginitis
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Extreme pain at injection site and anterior to injection site. Unable to move arm without pain. Unable to perform ADLs days later - seen in office on 3/29/16 with extreme pain. Unable to swim (she is a swimmer).


Changed on 8/14/2018

VAERS ID: 629824 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:New Mexico
Vaccinated:2016-03-25
Onset:2016-03-25
Submitted:2016-03-29
Entered:2016-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 LA / IM

Administered by: Unknown      Purchased by: Public
Symptoms: Injection site pain, Pain, Activities of daily living impaired

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: started augmentin later that day
Current Illness: Vaginitis
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Extreme pain at injection site and anterior to injection site. Unable to move arm without pain. Unable to perform ADLs days later - seen in office on 3/29/16 with extreme pain. Unable to swim (she is a swimmer).


Changed on 9/14/2018

VAERS ID: 629824 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:New Mexico
Vaccinated:2016-03-25
Onset:2016-03-25
Submitted:2016-03-29
Entered:2016-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 LA / IM

Administered by: Unknown      Purchased by: Public
Symptoms: Injection site pain, Pain, Activities of daily living impaired

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: started augmentin later that day
Current Illness: Vaginitis
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Extreme pain at injection site and anterior to injection site. Unable to move arm without pain. Unable to perform ADLs days later - seen in office on 3/29/16 with extreme pain. Unable to swim (she is a swimmer).


Changed on 10/14/2018

VAERS ID: 629824 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:New Mexico
Vaccinated:2016-03-25
Onset:2016-03-25
Submitted:2016-03-29
Entered:2016-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 LA / IM

Administered by: Unknown      Purchased by: Public
Symptoms: Injection site pain, Pain, Activities of daily living impaired

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: started augmentin later that day
Current Illness: Vaginitis
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Extreme pain at injection site and anterior to injection site. Unable to move arm without pain. Unable to perform ADLs days later - seen in office on 3/29/16 with extreme pain. Unable to swim (she is a swimmer).


Changed on 12/24/2020

VAERS ID: 629824 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:New Mexico
Vaccinated:2016-03-25
Onset:2016-03-25
Submitted:2016-03-29
Entered:2016-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 LA / IM

Administered by: Unknown      Purchased by: Public
Symptoms: Injection site pain, Pain, Activities of daily living impaired

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: started augmentin later that day
Current Illness: Vaginitis
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Extreme pain at injection site and anterior to injection site. Unable to move arm without pain. Unable to perform ADLs days later - seen in office on 3/29/16 with extreme pain. Unable to swim (she is a swimmer).


Changed on 12/30/2020

VAERS ID: 629824 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:New Mexico
Vaccinated:2016-03-25
Onset:2016-03-25
Submitted:2016-03-29
Entered:2016-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 LA / IM

Administered by: Unknown      Purchased by: Public
Symptoms: Injection site pain, Pain, Activities of daily living impaired

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: started augmentin later that day
Current Illness: Vaginitis
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Extreme pain at injection site and anterior to injection site. Unable to move arm without pain. Unable to perform ADLs days later - seen in office on 3/29/16 with extreme pain. Unable to swim (she is a swimmer).


Changed on 5/7/2021

VAERS ID: 629824 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:New Mexico
Vaccinated:2016-03-25
Onset:2016-03-25
Submitted:2016-03-29
Entered:2016-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 LA / IM

Administered by: Unknown      Purchased by: Public
Symptoms: Injection site pain, Pain, Activities of daily living impaired

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: started augmentin later that day
Current Illness: Vaginitis
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Extreme pain at injection site and anterior to injection site. Unable to move arm without pain. Unable to perform ADLs days later - seen in office on 3/29/16 with extreme pain. Unable to swim (she is a swimmer).


Changed on 5/21/2021

VAERS ID: 629824 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:New Mexico
Vaccinated:2016-03-25
Onset:2016-03-25
Submitted:2016-03-29
Entered:2016-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 LA / IM

Administered by: Unknown      Purchased by: Public
Symptoms: Injection site pain, Pain, Activities of daily living impaired

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: started augmentin later that day
Current Illness: Vaginitis
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Extreme pain at injection site and anterior to injection site. Unable to move arm without pain. Unable to perform ADLs days later - seen in office on 3/29/16 with extreme pain. Unable to swim (she is a swimmer).

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