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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 236858 |
VAERS Form: | |
Age: | 19.0 |
Sex: | Male |
Location: | Pennsylvania |
Vaccinated: | 2005-04-11 |
Onset: | 2005-04-12 |
Submitted: | 2005-04-25 |
Entered: | 2005-05-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, | U1526AC / - | LA / IM |
Administered by: Private Purchased by: Unknown
Symptoms: CHILLS, FEVER, HEADACHE, MALAISE, ASTHENIA
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: HA, weakness, malaise, fatigue, fever, and chills per pt.
Vaccinated: | 2005-04-11 |
Onset: | 2005-04-12 |
Submitted: | 2005-04-25 |
Entered: | 2005-05-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR | U1526AC / - | LA / IM |
Administered by: Private Purchased by: Unknown Private
Symptoms: Asthenia, Chills, Headache, Malaise, Pyrexia, CHILLS, FEVER, HEADACHE, MALAISE, ASTHENIA
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: HA, weakness, malaise, fatigue, fever, and chills per pt.
Vaccinated: | 2005-04-11 |
Onset: | 2005-04-12 |
Submitted: | 2005-04-25 |
Entered: | 2005-05-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR | U1526AC / - | LA / IM |
Administered by: Private Purchased by: Private
Symptoms: Asthenia, Chills, Headache, Malaise, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: HA, weakness, malaise, fatigue, fever, and chills per pt.
Vaccinated: | 2005-04-11 |
Onset: | 2005-04-12 |
Submitted: | 2005-04-25 |
Entered: | 2005-05-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR | U1526AC / - | LA / IM |
Administered by: Private Purchased by: Private
Symptoms: Asthenia, Chills, Fatigue, Headache, Malaise, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: HA, weakness, malaise, fatigue, fever, and chills per pt.
Vaccinated: | 2005-04-11 |
Onset: | 2005-04-12 |
Submitted: | 2005-04-25 |
Entered: | 2005-05-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR | U1526AC / - UNK | LA / IM |
Administered by: Private Purchased by: Private
Symptoms: Asthenia, Chills, Fatigue, Headache, Malaise, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: HA, weakness, malaise, fatigue, fever, and chills per pt.
Vaccinated: | 2005-04-11 |
Onset: | 2005-04-12 |
Submitted: | 2005-04-25 |
Entered: | 2005-05-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR | U1526AC / UNK | LA / IM |
Administered by: Private Purchased by: Private
Symptoms: Asthenia, Chills, Fatigue, Headache, Malaise, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: HA, weakness, malaise, fatigue, fever, and chills per pt.
Vaccinated: | 2005-04-11 |
Onset: | 2005-04-12 |
Submitted: | 2005-04-25 |
Entered: | 2005-05-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR | U1526AC / UNK | LA / IM |
Administered by: Private Purchased by: Private
Symptoms: Asthenia, Chills, Fatigue, Headache, Malaise, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: HA, weakness, malaise, fatigue, fever, and chills per pt.
Vaccinated: | 2005-04-11 |
Onset: | 2005-04-12 |
Submitted: | 2005-04-25 |
Entered: | 2005-05-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR | U1526AC / UNK | LA / IM |
Administered by: Private Purchased by: Private
Symptoms: Asthenia, Chills, Fatigue, Headache, Malaise, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: HA, weakness, malaise, fatigue, fever, and chills per pt.
Vaccinated: | 2005-04-11 |
Onset: | 2005-04-12 |
Submitted: | 2005-04-25 |
Entered: | 2005-05-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR | U1526AC / UNK | LA / IM |
Administered by: Private Purchased by: Private
Symptoms: Asthenia, Chills, Fatigue, Headache, Malaise, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: HA, weakness, malaise, fatigue, fever, and chills per pt.
Vaccinated: | 2005-04-11 |
Onset: | 2005-04-12 |
Submitted: | 2005-04-25 |
Entered: | 2005-05-02 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR | U1526AC / UNK | LA / IM |
Administered by: Private Purchased by: Private
Symptoms: Asthenia, Chills, Fatigue, Headache, Malaise, Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':
Write-up: HA, weakness, malaise, fatigue, fever, and chills per pt.
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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=236858&WAYBACKHISTORY=ON
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