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This is VAERS ID 235862

Case Details

VAERS ID: 235862 (history)  
Form: Version 1.0  
Age: 18.0  
Sex: Female  
Location: Florida  
Vaccinated:2005-03-23
Onset:2005-03-24
   Days after vaccination:1
Submitted: 2005-04-01
   Days after onset:8
Entered: 2005-04-06
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1493AC / 1 LA / SC

Administered by: Private       Purchased by: Unknown
Symptoms: Injection site erythema, Injection site oedema, Medication error
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The pt has no allergies or medical conditions. She did not have any illnesses and was on no medications at the time of vaccination.
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: 200500636

Write-up: From initial information received on 28Mar05 from a health care professional regarding an adverse event occurring, it was reported that an 18 year old female pt received a first dose of Menactra, lot number U1493AC, administered SC in error in her left arm on 23Mar05. One day later, on 24Mar05, the pt developed a local reaction of redness and swelling at the site of injection. She was seen in an ER on 26Mar05 and was treated with Clindamycin. She has recovered from these events. OMIC


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