This is VAERS ID 570819

(NOTE: This result is from the 10/14/2018 version of the VAERS database)

Case Details

VAERS ID:	570819 (history)
Form:	Version 1.0
Age:	21.0
Sex:	Female
Location:	Unknown

Vaccinated:	2015-02-08
Onset:	2015-02-08
Days after vaccination:	0
Submitted:	2015-02-08
Days after onset:	0
Entered:	2015-03-18
Days after submission:	37

Vaccination / Manufacturer	Lot / Dose	Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH	J29203 / 1	UN / UN

Administered by: Other Purchased by: Unknown
Symptoms: Erythema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Rapid onset of hives/redness on arms following injection-hives bilaterally down arms, (-) torso or lower extrem. No lip, tongue or face swelling.

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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20181014&IDNUMBER=570819