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This is VAERS ID 629967

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/14/2016

VAERS ID: 629967
VAERS Form:
Age:23.0
Sex:Female
Location:Pennsylvania
Vaccinated:2016-03-29
Onset:2016-03-29
Submitted:2016-03-30
Entered:2016-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / - LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Pain, Skin warm, Tenderness

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: Acne
Preexisting Conditions: Shrimp; Melon; Chlorhexidine; Gluconate
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Soreness, tender, red, warm. TYLENOL, ice TID. Is on doxycycline for acne.


Changed on 9/14/2017

VAERS ID: 629967 Before After
VAERS Form:(blank) 1
Age:23.0
Sex:Female
Location:Pennsylvania
Vaccinated:2016-03-29
Onset:2016-03-29
Submitted:2016-03-30
Entered:2016-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / - UNK LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Pain, Skin warm, Tenderness

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: Acne
Preexisting Conditions: Shrimp; Melon; Chlorhexidine; Gluconate
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Soreness, tender, red, warm. TYLENOL, ice TID. Is on doxycycline for acne.


Changed on 2/14/2018

VAERS ID: 629967 Before After
VAERS Form:1
Age:23.0
Sex:Female
Location:Pennsylvania
Vaccinated:2016-03-29
Onset:2016-03-29
Submitted:2016-03-30
Entered:2016-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / UNK LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Pain, Skin warm, Tenderness

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: Acne
Preexisting Conditions: Shrimp; Melon; Chlorhexidine; Gluconate
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Soreness, tender, red, warm. TYLENOL, ice TID. Is on doxycycline for acne.


Changed on 6/14/2018

VAERS ID: 629967 Before After
VAERS Form:1
Age:23.0
Sex:Female
Location:Pennsylvania
Vaccinated:2016-03-29
Onset:2016-03-29
Submitted:2016-03-30
Entered:2016-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / UNK LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Pain, Skin warm, Tenderness

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: Acne
Preexisting Conditions: Shrimp; Melon; Chlorhexidine; Gluconate
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Soreness, tender, red, warm. TYLENOL, ice TID. Is on doxycycline for acne.


Changed on 8/14/2018

VAERS ID: 629967 Before After
VAERS Form:1
Age:23.0
Sex:Female
Location:Pennsylvania
Vaccinated:2016-03-29
Onset:2016-03-29
Submitted:2016-03-30
Entered:2016-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / UNK LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Pain, Skin warm, Tenderness

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: Acne
Preexisting Conditions: Shrimp; Melon; Chlorhexidine; Gluconate
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Soreness, tender, red, warm. TYLENOL, ice TID. Is on doxycycline for acne.


Changed on 9/14/2018

VAERS ID: 629967 Before After
VAERS Form:1
Age:23.0
Sex:Female
Location:Pennsylvania
Vaccinated:2016-03-29
Onset:2016-03-29
Submitted:2016-03-30
Entered:2016-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / UNK LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Pain, Skin warm, Tenderness

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: Acne
Preexisting Conditions: Shrimp; Melon; Chlorhexidine; Gluconate
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Soreness, tender, red, warm. TYLENOL, ice TID. Is on doxycycline for acne.


Changed on 10/14/2018

VAERS ID: 629967 Before After
VAERS Form:1
Age:23.0
Sex:Female
Location:Pennsylvania
Vaccinated:2016-03-29
Onset:2016-03-29
Submitted:2016-03-30
Entered:2016-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / UNK LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Pain, Skin warm, Tenderness

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: Acne
Preexisting Conditions: Shrimp; Melon; Chlorhexidine; Gluconate
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Soreness, tender, red, warm. TYLENOL, ice TID. Is on doxycycline for acne.


Changed on 12/24/2020

VAERS ID: 629967 Before After
VAERS Form:1
Age:23.0
Sex:Female
Location:Pennsylvania
Vaccinated:2016-03-29
Onset:2016-03-29
Submitted:2016-03-30
Entered:2016-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / UNK LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Pain, Skin warm, Tenderness

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: Acne
Preexisting Conditions: Shrimp; Melon; Chlorhexidine; Gluconate
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Soreness, tender, red, warm. TYLENOL, ice TID. Is on doxycycline for acne.


Changed on 12/30/2020

VAERS ID: 629967 Before After
VAERS Form:1
Age:23.0
Sex:Female
Location:Pennsylvania
Vaccinated:2016-03-29
Onset:2016-03-29
Submitted:2016-03-30
Entered:2016-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / UNK LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Pain, Skin warm, Tenderness

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: Acne
Preexisting Conditions: Shrimp; Melon; Chlorhexidine; Gluconate
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Soreness, tender, red, warm. TYLENOL, ice TID. Is on doxycycline for acne.


Changed on 5/7/2021

VAERS ID: 629967 Before After
VAERS Form:1
Age:23.0
Sex:Female
Location:Pennsylvania
Vaccinated:2016-03-29
Onset:2016-03-29
Submitted:2016-03-30
Entered:2016-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / UNK LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Pain, Skin warm, Tenderness

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: Acne
Preexisting Conditions: Shrimp; Melon; Chlorhexidine; Gluconate
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Soreness, tender, red, warm. TYLENOL, ice TID. Is on doxycycline for acne.


Changed on 5/21/2021

VAERS ID: 629967 Before After
VAERS Form:1
Age:23.0
Sex:Female
Location:Pennsylvania
Vaccinated:2016-03-29
Onset:2016-03-29
Submitted:2016-03-30
Entered:2016-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37315 / UNK LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Pain, Skin warm, Tenderness

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: Acne
Preexisting Conditions: Shrimp; Melon; Chlorhexidine; Gluconate
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Soreness, tender, red, warm. TYLENOL, ice TID. Is on doxycycline for acne.

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