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This is VAERS ID 235879

Case Details

VAERS ID: 235879 (history)  
Form: Version 1.0  
Age: 19.0  
Sex: Female  
Location: Michigan  
Vaccinated:2005-03-29
Onset:2005-03-29
   Days after vaccination:0
Submitted: 2005-03-30
   Days after onset:1
Entered: 2005-04-07
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1494AB / 1 LA / IM

Administered by: Other       Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Malaise, Myalgia, Nausea, Pyrexia, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (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: Synthroid
Current Illness: NONE
Preexisting Conditions: Hypothyroidism
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Menactra 0.5cc administered at 11:30AM. Pt states approx 2 hrs later began to feel ill. Injection site sore. 3/30/05 c/o temp 99.6, nauseated, body aches, injection site sore and red, pt instr. to use ice on site and ibuprofen or Tylenol. 3/31 pt phoned, states much improved. Only symptom tenderness around injection site.


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