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This is VAERS ID 236925

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 236925
VAERS Form:
Age:14.0
Sex:Female
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-25
Submitted:2005-04-29
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, C11494AB / - RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, SYNCOPE, RASH, HEADACHE, PARESTHESIA

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: Diflucan 4/25/05
Current Illness: vaginal discharge
Preexisting Conditions: allergy to amoxicillin
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: HA, Skin feels like crawling, tingling on exam, very faint, lacy rash on trunk. Temp 97.8. RX: Zyrtec.

Changed on 12/8/2009

VAERS ID: 236925 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-25
Submitted:2005-04-29
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR C11494AB / - RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Body temperature increased, Headache, Paraesthesia, Rash, FEVER, SYNCOPE, RASH, HEADACHE, PARESTHESIA

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: Diflucan 4/25/05
Current Illness: vaginal discharge
Preexisting Conditions: allergy to amoxicillin
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: HA, Skin feels like crawling, tingling on exam, very faint, lacy rash on trunk. Temp 97.8. RX: Zyrtec.

Changed on 4/7/2010

VAERS ID: 236925 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-25
Submitted:2005-04-29
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR C11494AB / - RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Body temperature increased, Headache, Paraesthesia, Rash

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: Diflucan 4/25/05
Current Illness: vaginal discharge
Preexisting Conditions: allergy to amoxicillin
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: HA, Skin feels like crawling, tingling on exam, very faint, lacy rash on trunk. Temp 97.8. RX: Zyrtec.

Changed on 5/14/2017

VAERS ID: 236925 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-25
Submitted:2005-04-29
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR C11494AB / - RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Body temperature increased, Headache, Paraesthesia, Rash

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: Diflucan 4/25/05
Current Illness: vaginal discharge
Preexisting Conditions: allergy to amoxicillin
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: HA, Skin feels like crawling, tingling on exam, very faint, lacy rash on trunk. Temp 97.8. RX: Zyrtec.

Changed on 9/14/2017

VAERS ID: 236925 Before After
VAERS Form:(blank) 1
Age:14.0
Sex:Female
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-25
Submitted:2005-04-29
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR C11494AB / - UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Body temperature increased, Headache, Paraesthesia, Rash

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: Diflucan 4/25/05
Current Illness: vaginal discharge
Preexisting Conditions: allergy to amoxicillin
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: HA, Skin feels like crawling, tingling on exam, very faint, lacy rash on trunk. Temp 97.8. RX: Zyrtec.

Changed on 2/14/2018

VAERS ID: 236925 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-25
Submitted:2005-04-29
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR C11494AB / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Body temperature increased, Headache, Paraesthesia, Rash

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: Diflucan 4/25/05
Current Illness: vaginal discharge
Preexisting Conditions: allergy to amoxicillin
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: HA, Skin feels like crawling, tingling on exam, very faint, lacy rash on trunk. Temp 97.8. RX: Zyrtec.

Changed on 6/14/2018

VAERS ID: 236925 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-25
Submitted:2005-04-29
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR C11494AB / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Body temperature increased, Headache, Paraesthesia, Rash

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: Diflucan 4/25/05
Current Illness: vaginal discharge
Preexisting Conditions: allergy to amoxicillin
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: HA, Skin feels like crawling, tingling on exam, very faint, lacy rash on trunk. Temp 97.8. RX: Zyrtec.

Changed on 8/14/2018

VAERS ID: 236925 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-25
Submitted:2005-04-29
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR C11494AB / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Body temperature increased, Headache, Paraesthesia, Rash

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: Diflucan 4/25/05
Current Illness: vaginal discharge
Preexisting Conditions: allergy to amoxicillin
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: HA, Skin feels like crawling, tingling on exam, very faint, lacy rash on trunk. Temp 97.8. RX: Zyrtec.

Changed on 9/14/2018

VAERS ID: 236925 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-25
Submitted:2005-04-29
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR C11494AB / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Body temperature increased, Headache, Paraesthesia, Rash

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: Diflucan 4/25/05
Current Illness: vaginal discharge
Preexisting Conditions: allergy to amoxicillin
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: HA, Skin feels like crawling, tingling on exam, very faint, lacy rash on trunk. Temp 97.8. RX: Zyrtec.

Changed on 10/14/2018

VAERS ID: 236925 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-25
Submitted:2005-04-29
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR C11494AB / UNK RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Body temperature increased, Headache, Paraesthesia, Rash

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: Diflucan 4/25/05
Current Illness: vaginal discharge
Preexisting Conditions: allergy to amoxicillin
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: HA, Skin feels like crawling, tingling on exam, very faint, lacy rash on trunk. Temp 97.8. RX: Zyrtec.

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