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This is VAERS ID 630713

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/14/2016

VAERS ID: 630713
VAERS Form:
Age:20.0
Sex:Male
Location:California
Vaccinated:2016-04-06
Onset:2016-04-07
Submitted:2016-04-08
Entered:2016-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / 1 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Delirium, Pain, Pain in extremity, Pyrexia, Vomiting, Vaccination site pain

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Body pain and aches at onset with extreme pain at and around vaccination site (unable to move arm at all without pain). Starting at 2:00 PM, fever and weakness began to develop. Fever grew to 105F in cyclic spurts with accompanying delirium and vomiting at the peak. All symptoms resolved by 9AM 04/08/2016.


Changed on 9/14/2017

VAERS ID: 630713 Before After
VAERS Form:(blank) 1
Age:20.0
Sex:Male
Location:California
Vaccinated:2016-04-06
Onset:2016-04-07
Submitted:2016-04-08
Entered:2016-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / 1 2 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Delirium, Pain, Pain in extremity, Pyrexia, Vomiting, Vaccination site pain

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Body pain and aches at onset with extreme pain at and around vaccination site (unable to move arm at all without pain). Starting at 2:00 PM, fever and weakness began to develop. Fever grew to 105F in cyclic spurts with accompanying delirium and vomiting at the peak. All symptoms resolved by 9AM 04/08/2016.


Changed on 2/14/2018

VAERS ID: 630713 Before After
VAERS Form:1
Age:20.0
Sex:Male
Location:California
Vaccinated:2016-04-06
Onset:2016-04-07
Submitted:2016-04-08
Entered:2016-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / 2 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Delirium, Pain, Pain in extremity, Pyrexia, Vomiting, Vaccination site pain

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Body pain and aches at onset with extreme pain at and around vaccination site (unable to move arm at all without pain). Starting at 2:00 PM, fever and weakness began to develop. Fever grew to 105F in cyclic spurts with accompanying delirium and vomiting at the peak. All symptoms resolved by 9AM 04/08/2016.


Changed on 6/14/2018

VAERS ID: 630713 Before After
VAERS Form:1
Age:20.0
Sex:Male
Location:California
Vaccinated:2016-04-06
Onset:2016-04-07
Submitted:2016-04-08
Entered:2016-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / 2 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Delirium, Pain, Pain in extremity, Pyrexia, Vomiting, Vaccination site pain

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Body pain and aches at onset with extreme pain at and around vaccination site (unable to move arm at all without pain). Starting at 2:00 PM, fever and weakness began to develop. Fever grew to 105F in cyclic spurts with accompanying delirium and vomiting at the peak. All symptoms resolved by 9AM 04/08/2016.


Changed on 8/14/2018

VAERS ID: 630713 Before After
VAERS Form:1
Age:20.0
Sex:Male
Location:California
Vaccinated:2016-04-06
Onset:2016-04-07
Submitted:2016-04-08
Entered:2016-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / 2 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Delirium, Pain, Pain in extremity, Pyrexia, Vomiting, Vaccination site pain

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Body pain and aches at onset with extreme pain at and around vaccination site (unable to move arm at all without pain). Starting at 2:00 PM, fever and weakness began to develop. Fever grew to 105F in cyclic spurts with accompanying delirium and vomiting at the peak. All symptoms resolved by 9AM 04/08/2016.


Changed on 9/14/2018

VAERS ID: 630713 Before After
VAERS Form:1
Age:20.0
Sex:Male
Location:California
Vaccinated:2016-04-06
Onset:2016-04-07
Submitted:2016-04-08
Entered:2016-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / 2 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Delirium, Pain, Pain in extremity, Pyrexia, Vomiting, Vaccination site pain

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Body pain and aches at onset with extreme pain at and around vaccination site (unable to move arm at all without pain). Starting at 2:00 PM, fever and weakness began to develop. Fever grew to 105F in cyclic spurts with accompanying delirium and vomiting at the peak. All symptoms resolved by 9AM 04/08/2016.


Changed on 10/14/2018

VAERS ID: 630713 Before After
VAERS Form:1
Age:20.0
Sex:Male
Location:California
Vaccinated:2016-04-06
Onset:2016-04-07
Submitted:2016-04-08
Entered:2016-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / 2 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Delirium, Pain, Pain in extremity, Pyrexia, Vomiting, Vaccination site pain

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Body pain and aches at onset with extreme pain at and around vaccination site (unable to move arm at all without pain). Starting at 2:00 PM, fever and weakness began to develop. Fever grew to 105F in cyclic spurts with accompanying delirium and vomiting at the peak. All symptoms resolved by 9AM 04/08/2016.


Changed on 12/24/2020

VAERS ID: 630713 Before After
VAERS Form:1
Age:20.0
Sex:Male
Location:California
Vaccinated:2016-04-06
Onset:2016-04-07
Submitted:2016-04-08
Entered:2016-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / 2 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Delirium, Pain, Pain in extremity, Pyrexia, Vomiting, Vaccination site pain

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Body pain and aches at onset with extreme pain at and around vaccination site (unable to move arm at all without pain). Starting at 2:00 PM, fever and weakness began to develop. Fever grew to 105F in cyclic spurts with accompanying delirium and vomiting at the peak. All symptoms resolved by 9AM 04/08/2016.


Changed on 12/30/2020

VAERS ID: 630713 Before After
VAERS Form:1
Age:20.0
Sex:Male
Location:California
Vaccinated:2016-04-06
Onset:2016-04-07
Submitted:2016-04-08
Entered:2016-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / 2 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Delirium, Pain, Pain in extremity, Pyrexia, Vomiting, Vaccination site pain

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Body pain and aches at onset with extreme pain at and around vaccination site (unable to move arm at all without pain). Starting at 2:00 PM, fever and weakness began to develop. Fever grew to 105F in cyclic spurts with accompanying delirium and vomiting at the peak. All symptoms resolved by 9AM 04/08/2016.


Changed on 5/7/2021

VAERS ID: 630713 Before After
VAERS Form:1
Age:20.0
Sex:Male
Location:California
Vaccinated:2016-04-06
Onset:2016-04-07
Submitted:2016-04-08
Entered:2016-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / 2 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Delirium, Pain, Pain in extremity, Pyrexia, Vomiting, Vaccination site pain

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Body pain and aches at onset with extreme pain at and around vaccination site (unable to move arm at all without pain). Starting at 2:00 PM, fever and weakness began to develop. Fever grew to 105F in cyclic spurts with accompanying delirium and vomiting at the peak. All symptoms resolved by 9AM 04/08/2016.


Changed on 5/21/2021

VAERS ID: 630713 Before After
VAERS Form:1
Age:20.0
Sex:Male
Location:California
Vaccinated:2016-04-06
Onset:2016-04-07
Submitted:2016-04-08
Entered:2016-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / 2 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Asthenia, Delirium, Pain, Pain in extremity, Pyrexia, Vomiting, Vaccination site pain

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Body pain and aches at onset with extreme pain at and around vaccination site (unable to move arm at all without pain). Starting at 2:00 PM, fever and weakness began to develop. Fever grew to 105F in cyclic spurts with accompanying delirium and vomiting at the peak. All symptoms resolved by 9AM 04/08/2016.

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