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This is VAERS ID 236787

Case Details

VAERS ID: 236787 (history)  
Form: Version 1.0  
Age: 13.0  
Sex: Female  
Location: Georgia  
Vaccinated:2005-04-22
Onset:2005-04-22
   Days after vaccination:0
Submitted: 2005-04-25
   Days after onset:3
Entered: 2005-04-29
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1526AC / UNK LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Myalgia, Nasopharyngitis, Pharyngolaryngeal pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received Menactra 4/22/05 @ 2 PM- at 6 PM pt developed fever 101.0, muscle aches, sore throat. SX x2 days. RX Advil. 04/25/05- Pt better but now has cold.


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