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This is VAERS ID 597810

(NOTE: This result is from the 9/14/2018 version of the VAERS database)

Case Details

VAERS ID: 597810 (history)  
Form: Version 1.0  
Age: 14.0  
Sex: Female  
Location: California  
Vaccinated:2015-03-11
Onset:0000-00-00
Submitted: 2015-08-13
Entered: 2015-09-21
   Days after submission:39
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J28923 / UNK LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Mobility decreased, Vaccination site pain, Vaccination site swelling
SMQs:, Parkinson-like events (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 2015163601

Write-up: This is a spontaneous report from a contactable physician through via a Pfizer Vaccine Sales Representative. A 14 years old female patient received a single dose of TRUMEMBA (lot J28923, expiry date Jun2016) on 11Mar2015 and on 15May2015, at single dose. Medical history and concomitant medications were not provided. The patient experienced on unspecified dates in 2015, after both vaccinations, limited arm movements, severe pain, swelling after the administration of the vaccine. The events occurred at vaccine site. Events outcome was not provided. The events did not require an emergency room or physician visit. The patient was not admitted to hospital. No specified tests and/or treatment were required. The physician considered there was a reasonable possibility that the event was related to suspect product. Follow-up (09Jul2015): Follow-up attempts completed. No further information expected. Follow-up (15Jul2015): New information from the same contactable physician includes: patient date in Birth, age and gender, vaccinations dates, lot number, expiry date, route of administration, anatomical location, reporter causality assessment.


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