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This is VAERS ID 236926

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 236926
VAERS Form:
Age:14.0
Sex:Male
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-26
Submitted:2005-04-28
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1493AC / - RA / IM
TD: TD ADSORBED, ADULT (NO BRAND NAME) / AVENTIS PASTEUR, U1221BA / - LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: URTICARIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Recurrent hives. Started 04/26/05- seen in office for hives 04/28/05. RX for Claritin and predinisone taper.


Changed on 12/8/2009

VAERS ID: 236926 Before After
VAERS Form:
Age:14.0
Sex:Male
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-26
Submitted:2005-04-28
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR U1493AC / - RA / IM
TD: TD ADSORBED, ADULT (NO BRAND NAME) TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR, AVENTIS PASTEUR U1221BA / - LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Urticaria, URTICARIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Recurrent hives. Started 04/26/05- seen in office for hives 04/28/05. RX for Claritin and predinisone taper.


Changed on 4/7/2010

VAERS ID: 236926 Before After
VAERS Form:
Age:14.0
Sex:Male
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-26
Submitted:2005-04-28
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1493AC / - RA / IM
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / - LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Recurrent hives. Started 04/26/05- seen in office for hives 04/28/05. RX for Claritin and predinisone taper.


Changed on 5/14/2017

VAERS ID: 236926 Before After
VAERS Form:
Age:14.0
Sex:Male
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-26
Submitted:2005-04-28
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1493AC / - RA / IM
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / - LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Recurrent hives. Started 04/26/05- seen in office for hives 04/28/05. RX for Claritin and predinisone taper.


Changed on 9/14/2017

VAERS ID: 236926 Before After
VAERS Form:(blank) 1
Age:14.0
Sex:Male
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-26
Submitted:2005-04-28
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1493AC / - UNK RA / IM
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / - UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Recurrent hives. Started 04/26/05- seen in office for hives 04/28/05. RX for Claritin and predinisone taper.


Changed on 2/14/2018

VAERS ID: 236926 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-26
Submitted:2005-04-28
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1493AC / UNK RA / IM
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Recurrent hives. Started 04/26/05- seen in office for hives 04/28/05. RX for Claritin and predinisone taper.


Changed on 6/14/2018

VAERS ID: 236926 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-26
Submitted:2005-04-28
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1493AC / UNK RA / IM
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Recurrent hives. Started 04/26/05- seen in office for hives 04/28/05. RX for Claritin and predinisone taper.


Changed on 8/14/2018

VAERS ID: 236926 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-26
Submitted:2005-04-28
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1493AC / UNK RA / IM
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Recurrent hives. Started 04/26/05- seen in office for hives 04/28/05. RX for Claritin and predinisone taper.


Changed on 9/14/2018

VAERS ID: 236926 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-26
Submitted:2005-04-28
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1493AC / UNK RA / IM
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Recurrent hives. Started 04/26/05- seen in office for hives 04/28/05. RX for Claritin and predinisone taper.


Changed on 10/14/2018

VAERS ID: 236926 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Ohio
Vaccinated:2005-04-25
Onset:2005-04-26
Submitted:2005-04-28
Entered:2005-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1493AC / UNK RA / IM
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Recurrent hives. Started 04/26/05- seen in office for hives 04/28/05. RX for Claritin and predinisone taper.

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