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This is VAERS ID 236858

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

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.


Changed on 12/8/2009

VAERS ID: 236858 Before After
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, 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.


Changed on 4/7/2010

VAERS ID: 236858 Before After
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) 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.


Changed on 5/14/2017

VAERS ID: 236858 Before After
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 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.


Changed on 9/14/2017

VAERS ID: 236858 Before After
VAERS Form:(blank) 1
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 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.


Changed on 2/14/2018

VAERS ID: 236858 Before After
VAERS Form:1
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 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.


Changed on 6/14/2018

VAERS ID: 236858 Before After
VAERS Form:1
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 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.


Changed on 8/14/2018

VAERS ID: 236858 Before After
VAERS Form:1
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 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.


Changed on 9/14/2018

VAERS ID: 236858 Before After
VAERS Form:1
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 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.


Changed on 10/14/2018

VAERS ID: 236858 Before After
VAERS Form:1
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 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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