National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 6/14/2018 release of VAERS data (an older release, current is 11/19/2021):

This is VAERS ID 615503

Government Disclaimer on use of this data



Case Details

VAERS ID: 615503 (history)  
Form: Version 1.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2015-12-10
Entered: 2015-12-17
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH - / UNK AR / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / UNK AR / UN

Administered by: Other       Purchased by: Other
Symptoms: Chills, Pain, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Unknown
Current Illness: UNK
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Lab tests unknown
CDC Split Type: 2015SA182407

Write-up: Initial unsolicited report received from a non-healthcare professional on 10 November 2015. Case is linked to case 2015SA182410. This case involves a (age and gender unknown) patient who was vaccinated with a dose of [route and dose series not reported] MENACTRA (batch number, expiry date were not reported) and also TRUMENBA (batch number, expiry date were not reported) both received in arm on an unspecified date. Medical history and concomitant medications were not reported. On an unspecified date, following the vaccination patient experienced severe swelling, chills, pain and itchiness. Laboratory investigation and corrective treatment were not reported. The outcome of event was not reported. List of documents held by sender: none.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180614&IDNUMBER=615503


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166