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This is VAERS ID 236740

Case Details

VAERS ID: 236740 (history)  
Form: Version 1.0  
Age: 17.0  
Sex: Male  
Location: Maryland  
Vaccinated:2005-04-20
Onset:2005-04-21
   Days after vaccination:1
Submitted: 2005-04-28
   Days after onset:7
Entered: 2005-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1493AC / UNK LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Lymphadenopathy, Pain
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (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: Accutane
Current Illness:
Preexisting Conditions: Right side Hemiplegia, Acne
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Aching all over. Swollen nodes.


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