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This is VAERS ID 235862

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 235862
VAERS Form:
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2005-03-23
Onset:2005-03-24
Submitted:2005-04-01
Entered:2005-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1493AC / 0 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: EDEMA INJECT SITE, HYSN INJECT SITE, MED ERROR

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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':

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 ar"m 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.


Changed on 12/8/2009

VAERS ID: 235862 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2005-03-23
Onset:2005-03-24
Submitted:2005-04-01
Entered:2005-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR U1493AC / 0 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site oedema, Medication error, EDEMA INJECT SITE, HYSN INJECT SITE, MED ERROR

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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': (blank) 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 ar"m 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


Changed on 4/7/2010

VAERS ID: 235862 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2005-03-23
Onset:2005-03-24
Submitted:2005-04-01
Entered:2005-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1493AC / 0 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site oedema, Medication error

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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


Changed on 5/14/2017

VAERS ID: 235862 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2005-03-23
Onset:2005-03-24
Submitted:2005-04-01
Entered:2005-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1493AC / 0 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site oedema, Medication error

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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


Changed on 9/14/2017

VAERS ID: 235862 Before After
VAERS Form:(blank) 1
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2005-03-23
Onset:2005-03-24
Submitted:2005-04-01
Entered:2005-04-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1493AC / 0 1 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site oedema, Medication error

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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


Changed on 2/14/2018

VAERS ID: 235862 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2005-03-23
Onset:2005-03-24
Submitted:2005-04-01
Entered:2005-04-06
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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


Changed on 6/14/2018

VAERS ID: 235862 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2005-03-23
Onset:2005-03-24
Submitted:2005-04-01
Entered:2005-04-06
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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


Changed on 8/14/2018

VAERS ID: 235862 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2005-03-23
Onset:2005-03-24
Submitted:2005-04-01
Entered:2005-04-06
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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


Changed on 9/14/2018

VAERS ID: 235862 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2005-03-23
Onset:2005-03-24
Submitted:2005-04-01
Entered:2005-04-06
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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


Changed on 10/14/2018

VAERS ID: 235862 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2005-03-23
Onset:2005-03-24
Submitted:2005-04-01
Entered:2005-04-06
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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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