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This is VAERS ID 631647

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2016

VAERS ID: 631647
VAERS Form:
Age:20.0
Sex:Female
Location:Connecticut
Vaccinated:2016-03-30
Onset:2016-03-30
Submitted:2016-04-15
Entered:2016-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / 0 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Dizziness, Local reaction, Pyrexia, Urticaria

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: Cetirizine, Femhrt, Maxair, Bactroban ointment
Current Illness: None
Preexisting Conditions: Bacitracin, Ibuprofen, Morphine, Peanut and Tree Nut
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Large local reaction and hives occurring few hours after vaccine. Hives noted on neck, forearm and legs. States had 2 or 3 in each area. Felt lightheaded and feverish for 3 hours post vaccine.


Changed on 9/14/2017

VAERS ID: 631647 Before After
VAERS Form:(blank) 1
Age:20.0
Sex:Female
Location:Connecticut
Vaccinated:2016-03-30
Onset:2016-03-30
Submitted:2016-04-15
Entered:2016-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / 0 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Dizziness, Local reaction, Pyrexia, Urticaria

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: Cetirizine, Femhrt, Maxair, Bactroban ointment
Current Illness: None
Preexisting Conditions: Bacitracin, Ibuprofen, Morphine, Peanut and Tree Nut
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Large local reaction and hives occurring few hours after vaccine. Hives noted on neck, forearm and legs. States had 2 or 3 in each area. Felt lightheaded and feverish for 3 hours post vaccine.


Changed on 2/14/2018

VAERS ID: 631647 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Connecticut
Vaccinated:2016-03-30
Onset:2016-03-30
Submitted:2016-04-15
Entered:2016-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Dizziness, Local reaction, Pyrexia, Urticaria

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: Cetirizine, Femhrt, Maxair, Bactroban ointment
Current Illness: None
Preexisting Conditions: Bacitracin, Ibuprofen, Morphine, Peanut and Tree Nut
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Large local reaction and hives occurring few hours after vaccine. Hives noted on neck, forearm and legs. States had 2 or 3 in each area. Felt lightheaded and feverish for 3 hours post vaccine.


Changed on 6/14/2018

VAERS ID: 631647 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Connecticut
Vaccinated:2016-03-30
Onset:2016-03-30
Submitted:2016-04-15
Entered:2016-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Dizziness, Local reaction, Pyrexia, Urticaria

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: Cetirizine, Femhrt, Maxair, Bactroban ointment
Current Illness: None
Preexisting Conditions: Bacitracin, Ibuprofen, Morphine, Peanut and Tree Nut
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Large local reaction and hives occurring few hours after vaccine. Hives noted on neck, forearm and legs. States had 2 or 3 in each area. Felt lightheaded and feverish for 3 hours post vaccine.


Changed on 8/14/2018

VAERS ID: 631647 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Connecticut
Vaccinated:2016-03-30
Onset:2016-03-30
Submitted:2016-04-15
Entered:2016-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Dizziness, Local reaction, Pyrexia, Urticaria

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: Cetirizine, Femhrt, Maxair, Bactroban ointment
Current Illness: None
Preexisting Conditions: Bacitracin, Ibuprofen, Morphine, Peanut and Tree Nut
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Large local reaction and hives occurring few hours after vaccine. Hives noted on neck, forearm and legs. States had 2 or 3 in each area. Felt lightheaded and feverish for 3 hours post vaccine.


Changed on 9/14/2018

VAERS ID: 631647 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Connecticut
Vaccinated:2016-03-30
Onset:2016-03-30
Submitted:2016-04-15
Entered:2016-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Dizziness, Local reaction, Pyrexia, Urticaria

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: Cetirizine, Femhrt, Maxair, Bactroban ointment
Current Illness: None
Preexisting Conditions: Bacitracin, Ibuprofen, Morphine, Peanut and Tree Nut
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Large local reaction and hives occurring few hours after vaccine. Hives noted on neck, forearm and legs. States had 2 or 3 in each area. Felt lightheaded and feverish for 3 hours post vaccine.


Changed on 10/14/2018

VAERS ID: 631647 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Connecticut
Vaccinated:2016-03-30
Onset:2016-03-30
Submitted:2016-04-15
Entered:2016-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Dizziness, Local reaction, Pyrexia, Urticaria

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: Cetirizine, Femhrt, Maxair, Bactroban ointment
Current Illness: None
Preexisting Conditions: Bacitracin, Ibuprofen, Morphine, Peanut and Tree Nut
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Large local reaction and hives occurring few hours after vaccine. Hives noted on neck, forearm and legs. States had 2 or 3 in each area. Felt lightheaded and feverish for 3 hours post vaccine.


Changed on 12/10/2020

VAERS ID: 631647 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Connecticut Minnesota
Vaccinated:2016-03-30
Onset:2016-03-30
Submitted:2016-04-15
Entered:2016-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Dizziness, Local reaction, Pyrexia, Urticaria

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: Cetirizine, Femhrt, Maxair, Bactroban ointment
Current Illness: None
Preexisting Conditions: Bacitracin, Ibuprofen, Morphine, Peanut and Tree Nut
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Large local reaction and hives occurring few hours after vaccine. Hives noted on neck, forearm and legs. States had 2 or 3 in each area. Felt lightheaded and feverish for 3 hours post vaccine.


Changed on 12/24/2020

VAERS ID: 631647 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Minnesota
Vaccinated:2016-03-30
Onset:2016-03-30
Submitted:2016-04-15
Entered:2016-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Dizziness, Local reaction, Pyrexia, Urticaria

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: Cetirizine, Femhrt, Maxair, Bactroban ointment
Current Illness: None
Preexisting Conditions: Bacitracin, Ibuprofen, Morphine, Peanut and Tree Nut
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Large local reaction and hives occurring few hours after vaccine. Hives noted on neck, forearm and legs. States had 2 or 3 in each area. Felt lightheaded and feverish for 3 hours post vaccine.


Changed on 12/30/2020

VAERS ID: 631647 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Minnesota
Vaccinated:2016-03-30
Onset:2016-03-30
Submitted:2016-04-15
Entered:2016-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Dizziness, Local reaction, Pyrexia, Urticaria

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: Cetirizine, Femhrt, Maxair, Bactroban ointment
Current Illness: None
Preexisting Conditions: Bacitracin, Ibuprofen, Morphine, Peanut and Tree Nut
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Large local reaction and hives occurring few hours after vaccine. Hives noted on neck, forearm and legs. States had 2 or 3 in each area. Felt lightheaded and feverish for 3 hours post vaccine.


Changed on 5/7/2021

VAERS ID: 631647 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Minnesota
Vaccinated:2016-03-30
Onset:2016-03-30
Submitted:2016-04-15
Entered:2016-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Dizziness, Local reaction, Pyrexia, Urticaria

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: Cetirizine, Femhrt, Maxair, Bactroban ointment
Current Illness: None
Preexisting Conditions: Bacitracin, Ibuprofen, Morphine, Peanut and Tree Nut
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Large local reaction and hives occurring few hours after vaccine. Hives noted on neck, forearm and legs. States had 2 or 3 in each area. Felt lightheaded and feverish for 3 hours post vaccine.


Changed on 5/21/2021

VAERS ID: 631647 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Minnesota
Vaccinated:2016-03-30
Onset:2016-03-30
Submitted:2016-04-15
Entered:2016-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 149001 / 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Dizziness, Local reaction, Pyrexia, Urticaria

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: Cetirizine, Femhrt, Maxair, Bactroban ointment
Current Illness: None
Preexisting Conditions: Bacitracin, Ibuprofen, Morphine, Peanut and Tree Nut
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Large local reaction and hives occurring few hours after vaccine. Hives noted on neck, forearm and legs. States had 2 or 3 in each area. Felt lightheaded and feverish for 3 hours post vaccine.

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