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This is VAERS ID 631794

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2016

VAERS ID: 631794
VAERS Form:
Age:19.0
Sex:Male
Location:South Carolina
Vaccinated:2016-04-13
Onset:2016-04-14
Submitted:2016-04-16
Entered:2016-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M35315 / 0 UN / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Headache

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

Write-up: Headaches, chills.


Changed on 9/14/2017

VAERS ID: 631794 Before After
VAERS Form:(blank) 1
Age:19.0
Sex:Male
Location:South Carolina
Vaccinated:2016-04-13
Onset:2016-04-14
Submitted:2016-04-16
Entered:2016-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M35315 / 0 1 UN / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Headache

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

Write-up: Headaches, chills.


Changed on 2/14/2018

VAERS ID: 631794 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:South Carolina
Vaccinated:2016-04-13
Onset:2016-04-14
Submitted:2016-04-16
Entered:2016-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M35315 / 1 UN / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Headache

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

Write-up: Headaches, chills.


Changed on 6/14/2018

VAERS ID: 631794 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:South Carolina
Vaccinated:2016-04-13
Onset:2016-04-14
Submitted:2016-04-16
Entered:2016-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M35315 / 1 UN / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Headache

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

Write-up: Headaches, chills.


Changed on 8/14/2018

VAERS ID: 631794 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:South Carolina
Vaccinated:2016-04-13
Onset:2016-04-14
Submitted:2016-04-16
Entered:2016-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M35315 / 1 UN / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Headache

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

Write-up: Headaches, chills.


Changed on 9/14/2018

VAERS ID: 631794 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:South Carolina
Vaccinated:2016-04-13
Onset:2016-04-14
Submitted:2016-04-16
Entered:2016-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M35315 / 1 UN / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Headache

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

Write-up: Headaches, chills.


Changed on 10/14/2018

VAERS ID: 631794 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:South Carolina
Vaccinated:2016-04-13
Onset:2016-04-14
Submitted:2016-04-16
Entered:2016-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M35315 / 1 UN / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Headache

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

Write-up: Headaches, chills.


Changed on 12/24/2020

VAERS ID: 631794 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:South Carolina
Vaccinated:2016-04-13
Onset:2016-04-14
Submitted:2016-04-16
Entered:2016-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M35315 / 1 UN / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Headache

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

Write-up: Headaches, chills.


Changed on 12/30/2020

VAERS ID: 631794 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:South Carolina
Vaccinated:2016-04-13
Onset:2016-04-14
Submitted:2016-04-16
Entered:2016-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M35315 / 1 UN / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Headache

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

Write-up: Headaches, chills.


Changed on 5/7/2021

VAERS ID: 631794 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:South Carolina
Vaccinated:2016-04-13
Onset:2016-04-14
Submitted:2016-04-16
Entered:2016-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M35315 / 1 UN / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Headache

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

Write-up: Headaches, chills.


Changed on 5/21/2021

VAERS ID: 631794 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:South Carolina
Vaccinated:2016-04-13
Onset:2016-04-14
Submitted:2016-04-16
Entered:2016-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M35315 / 1 UN / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Headache

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

Write-up: Headaches, chills.

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