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This is VAERS ID 597867

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

Case Details

VAERS ID: 597867 (history)  
Form: Version 1.0  
Age: 13.0  
Sex: Male  
Location: Unknown  
Vaccinated:2015-05-15
Onset:2015-05-15
   Days after vaccination:0
Submitted: 2015-08-13
   Days after onset:90
Entered: 2015-09-21
   Days after submission:39
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / 1 RA / UN

Administered by: Private       Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 2015173028

Write-up: This is a spontaneous report from a contactable consumer reporting on behalf of her son. A 13-year-old male patient received the first dose of TRUMENBA via an unspecified route of administration in the right on 15MAY2015 at around 4:45 PM at 0.5 ml single. No medical history, concomitant medications and relevant tests were reported. The patient experienced pain at injection site on 15MAY2015 at around 7 PM. The patient recovered on an unspecified date in MAY2015. According to the patient mother he would continue with the series of immunization. Follow-up (25JUN2015): Follow-up attempts completed. No further information expected.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180914&IDNUMBER=597867


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