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This is VAERS ID 631183

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2016

VAERS ID: 631183
VAERS Form:
Age:17.0
Sex:Female
Location:Arizona
Vaccinated:2016-04-06
Onset:2016-04-08
Submitted:2016-04-08
Entered:2016-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH U5185BA / 1 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR M37315 / 0 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Pruritus, Skin warm

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Red, warm and itchy.


Changed on 9/14/2017

VAERS ID: 631183 Before After
VAERS Form:(blank) 1
Age:17.0
Sex:Female
Location:Arizona
Vaccinated:2016-04-06
Onset:2016-04-08
Submitted:2016-04-08
Entered:2016-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH U5185BA / 1 2 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR M37315 / 0 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Pruritus, Skin warm

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Red, warm and itchy.


Changed on 2/14/2018

VAERS ID: 631183 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Arizona
Vaccinated:2016-04-06
Onset:2016-04-08
Submitted:2016-04-08
Entered:2016-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH U5185BA / 2 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR M37315 / 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Pruritus, Skin warm

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Red, warm and itchy.


Changed on 6/14/2018

VAERS ID: 631183 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Arizona
Vaccinated:2016-04-06
Onset:2016-04-08
Submitted:2016-04-08
Entered:2016-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH U5185BA / 2 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR M37315 / 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Pruritus, Skin warm

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Red, warm and itchy.


Changed on 8/14/2018

VAERS ID: 631183 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Arizona
Vaccinated:2016-04-06
Onset:2016-04-08
Submitted:2016-04-08
Entered:2016-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH U5185BA / 2 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR M37315 / 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Pruritus, Skin warm

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Red, warm and itchy.


Changed on 9/14/2018

VAERS ID: 631183 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Arizona
Vaccinated:2016-04-06
Onset:2016-04-08
Submitted:2016-04-08
Entered:2016-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH U5185BA / 2 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR M37315 / 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Pruritus, Skin warm

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Red, warm and itchy.


Changed on 10/14/2018

VAERS ID: 631183 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Arizona
Vaccinated:2016-04-06
Onset:2016-04-08
Submitted:2016-04-08
Entered:2016-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH U5185BA / 2 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR M37315 / 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Pruritus, Skin warm

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Red, warm and itchy.


Changed on 12/24/2020

VAERS ID: 631183 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Arizona
Vaccinated:2016-04-06
Onset:2016-04-08
Submitted:2016-04-08
Entered:2016-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH U5185BA / 2 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR M37315 / 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Pruritus, Skin warm

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Red, warm and itchy.


Changed on 12/30/2020

VAERS ID: 631183 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Arizona
Vaccinated:2016-04-06
Onset:2016-04-08
Submitted:2016-04-08
Entered:2016-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH U5185BA / 2 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR M37315 / 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Pruritus, Skin warm

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Red, warm and itchy.


Changed on 5/7/2021

VAERS ID: 631183 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Arizona
Vaccinated:2016-04-06
Onset:2016-04-08
Submitted:2016-04-08
Entered:2016-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH U5185BA / 2 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR M37315 / 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Pruritus, Skin warm

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Red, warm and itchy.


Changed on 5/21/2021

VAERS ID: 631183 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Arizona
Vaccinated:2016-04-06
Onset:2016-04-08
Submitted:2016-04-08
Entered:2016-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH U5185BA / 2 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR M37315 / 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Pruritus, Skin warm

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Red, warm and itchy.

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