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This is VAERS ID 630835

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2016

VAERS ID: 630835
VAERS Form:
Age:16.0
Sex:Female
Location:California
Vaccinated:2016-04-04
Onset:2016-04-07
Submitted:2016-04-07
Entered:2016-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / - UN / IM

Administered by: Public      Purchased by: Public
Symptoms: No adverse event, Drug administered to patient of inappropriate age

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: rash~Meningococcal B (Trumenba)~1~16.00~Patient
Other Medications: Benzoyl peroxide
Current Illness: None
Preexisting Conditions: No known allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. waited 15 min no reaction.


Changed on 9/14/2017

VAERS ID: 630835 Before After
VAERS Form:(blank) 1
Age:16.0
Sex:Female
Location:California
Vaccinated:2016-04-04
Onset:2016-04-07
Submitted:2016-04-07
Entered:2016-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / - UNK UN / IM

Administered by: Public      Purchased by: Public
Symptoms: No adverse event, Drug administered to patient of inappropriate age

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: rash~Meningococcal B (Trumenba)~1~16.00~Patient
Other Medications: Benzoyl peroxide
Current Illness: None
Preexisting Conditions: No known allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. waited 15 min no reaction.


Changed on 2/14/2018

VAERS ID: 630835 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:California
Vaccinated:2016-04-04
Onset:2016-04-07
Submitted:2016-04-07
Entered:2016-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / UNK UN / IM

Administered by: Public      Purchased by: Public
Symptoms: No adverse event, Drug administered to patient of inappropriate age

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: rash~Meningococcal B (Trumenba)~1~16.00~Patient
Other Medications: Benzoyl peroxide
Current Illness: None
Preexisting Conditions: No known allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. waited 15 min no reaction.


Changed on 6/14/2018

VAERS ID: 630835 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:California
Vaccinated:2016-04-04
Onset:2016-04-07
Submitted:2016-04-07
Entered:2016-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / UNK UN / IM

Administered by: Public      Purchased by: Public
Symptoms: No adverse event, Drug administered to patient of inappropriate age

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: rash~Meningococcal B (Trumenba)~1~16.00~Patient
Other Medications: Benzoyl peroxide
Current Illness: None
Preexisting Conditions: No known allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. waited 15 min no reaction.


Changed on 8/14/2018

VAERS ID: 630835 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:California
Vaccinated:2016-04-04
Onset:2016-04-07
Submitted:2016-04-07
Entered:2016-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / UNK UN / IM

Administered by: Public      Purchased by: Public
Symptoms: No adverse event, Drug administered to patient of inappropriate age

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: rash~Meningococcal B (Trumenba)~1~16.00~Patient
Other Medications: Benzoyl peroxide
Current Illness: None
Preexisting Conditions: No known allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. waited 15 min no reaction.


Changed on 9/14/2018

VAERS ID: 630835 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:California
Vaccinated:2016-04-04
Onset:2016-04-07
Submitted:2016-04-07
Entered:2016-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / UNK UN / IM

Administered by: Public      Purchased by: Public
Symptoms: No adverse event, Drug administered to patient of inappropriate age

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: rash~Meningococcal B (Trumenba)~1~16.00~Patient
Other Medications: Benzoyl peroxide
Current Illness: None
Preexisting Conditions: No known allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. waited 15 min no reaction.


Changed on 10/14/2018

VAERS ID: 630835 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:California
Vaccinated:2016-04-04
Onset:2016-04-07
Submitted:2016-04-07
Entered:2016-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / UNK UN / IM

Administered by: Public      Purchased by: Public
Symptoms: No adverse event, Drug administered to patient of inappropriate age

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: rash~Meningococcal B (Trumenba)~1~16.00~Patient
Other Medications: Benzoyl peroxide
Current Illness: None
Preexisting Conditions: No known allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. waited 15 min no reaction.


Changed on 12/24/2020

VAERS ID: 630835 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:California
Vaccinated:2016-04-04
Onset:2016-04-07
Submitted:2016-04-07
Entered:2016-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / UNK UN / IM

Administered by: Public      Purchased by: Public
Symptoms: No adverse event, Drug administered to patient of inappropriate age

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: rash~Meningococcal B (Trumenba)~1~16.00~Patient
Other Medications: Benzoyl peroxide
Current Illness: None
Preexisting Conditions: No known allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. waited 15 min no reaction.


Changed on 12/30/2020

VAERS ID: 630835 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:California
Vaccinated:2016-04-04
Onset:2016-04-07
Submitted:2016-04-07
Entered:2016-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / UNK UN / IM

Administered by: Public      Purchased by: Public
Symptoms: No adverse event, Drug administered to patient of inappropriate age

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: rash~Meningococcal B (Trumenba)~1~16.00~Patient
Other Medications: Benzoyl peroxide
Current Illness: None
Preexisting Conditions: No known allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. waited 15 min no reaction.


Changed on 5/7/2021

VAERS ID: 630835 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:California
Vaccinated:2016-04-04
Onset:2016-04-07
Submitted:2016-04-07
Entered:2016-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / UNK UN / IM

Administered by: Public      Purchased by: Public
Symptoms: No adverse event, Drug administered to patient of inappropriate age

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: rash~Meningococcal B (Trumenba)~1~16.00~Patient
Other Medications: Benzoyl peroxide
Current Illness: None
Preexisting Conditions: No known allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. waited 15 min no reaction.


Changed on 5/21/2021

VAERS ID: 630835 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:California
Vaccinated:2016-04-04
Onset:2016-04-07
Submitted:2016-04-07
Entered:2016-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / UNK UN / IM

Administered by: Public      Purchased by: Public
Symptoms: No adverse event, Drug administered to patient of inappropriate age

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: rash~Meningococcal B (Trumenba)~1~16.00~Patient
Other Medications: Benzoyl peroxide
Current Illness: None
Preexisting Conditions: No known allergies
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt. waited 15 min no reaction.

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