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This is VAERS ID 238085

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 238085
VAERS Form:
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2005-05-16
Onset:0000-00-00
Submitted:2005-05-19
Entered:2005-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE AHBVB074AA / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1575AA / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, NAUSEA, HEADACHE, MYALGIA, ASTHENIA

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Came in the next day with myalgias, fever 99.3, nasal congestion; lasted 24-48 hours.
CDC 'Split Type':

Write-up: Immediately following administration of second vaccine, patient became nauseated, weak, color paled, assisted to exam table; laid down, given sips of soda and was feeling better within 5-10 minutes after sitting up and feeling better approximately 10 minu"tes. Home with mom. Returned next day with complaints of fever, headache, and weakness. Advised fluids, rest and monitor.


Changed on 12/8/2009

VAERS ID: 238085 Before After
VAERS Form:
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2005-05-16
Onset:0000-00-00
Submitted:2005-05-19
Entered:2005-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE GLAXOSMITHKLINE BIOLOGICALS AHBVB074AA / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR U1575AA / 0 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Asthenia, Headache, Myalgia, Nasal congestion, Nausea, Pallor, Pyrexia, FEVER, NAUSEA, HEADACHE, MYALGIA, ASTHENIA

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Came in the next day with myalgias, fever 99.3, nasal congestion; lasted 24-48 hours.
CDC 'Split Type':

Write-up: Immediately following administration of second vaccine, patient became nauseated, weak, color paled, assisted to exam table; laid down, given sips of soda and was feeling better within 5-10 minutes after sitting up and feeling better approximately 10 minu"tes. minutes. Home with mom. Returned next day with complaints of fever, headache, and weakness. Advised fluids, rest and monitor.


Changed on 4/7/2010

VAERS ID: 238085 Before After
VAERS Form:
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2005-05-16
Onset:0000-00-00
Submitted:2005-05-19
Entered:2005-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB074AA / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1575AA / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Headache, Myalgia, Nasal congestion, Nausea, Pallor, Pyrexia

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Came in the next day with myalgias, fever 99.3, nasal congestion; lasted 24-48 hours.
CDC 'Split Type':

Write-up: Immediately following administration of second vaccine, patient became nauseated, weak, color paled, assisted to exam table; laid down, given sips of soda and was feeling better within 5-10 minutes after sitting up and feeling better approximately 10 minutes. Home with mom. Returned next day with complaints of fever, headache, and weakness. Advised fluids, rest and monitor.


Changed on 2/14/2017

VAERS ID: 238085 Before After
VAERS Form:
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2005-05-16
Onset:0000-00-00
Submitted:2005-05-19
Entered:2005-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB074AA / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1575AA / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Headache, Myalgia, Nasal congestion, Nausea, Pallor, Pyrexia

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Came in the next day with myalgias, fever 99.3, nasal congestion; lasted 24-48 hours.
CDC 'Split Type':

Write-up: Immediately following administration of second vaccine, patient became nauseated, weak, color paled, assisted to exam table; laid down, given sips of soda and was feeling better within 5-10 minutes after sitting up and feeling better approximately 10 minutes. Home with mom. Returned next day with complaints of fever, headache, and weakness. Advised fluids, rest and monitor.


Changed on 9/14/2017

VAERS ID: 238085 Before After
VAERS Form:(blank) 1
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2005-05-16
Onset:0000-00-00
Submitted:2005-05-19
Entered:2005-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB074AA / 0 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 0 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Headache, Myalgia, Nasal congestion, Nausea, Pallor, Pyrexia

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Came in the next day with myalgias, fever 99.3, nasal congestion; lasted 24-48 hours.
CDC 'Split Type':

Write-up: Immediately following administration of second vaccine, patient became nauseated, weak, color paled, assisted to exam table; laid down, given sips of soda and was feeling better within 5-10 minutes after sitting up and feeling better approximately 10 minutes. Home with mom. Returned next day with complaints of fever, headache, and weakness. Advised fluids, rest and monitor.


Changed on 2/14/2018

VAERS ID: 238085 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2005-05-16
Onset:0000-00-00
Submitted:2005-05-19
Entered:2005-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB074AA / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Headache, Myalgia, Nasal congestion, Nausea, Pallor, Pyrexia

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Came in the next day with myalgias, fever 99.3, nasal congestion; lasted 24-48 hours.
CDC 'Split Type':

Write-up: Immediately following administration of second vaccine, patient became nauseated, weak, color paled, assisted to exam table; laid down, given sips of soda and was feeling better within 5-10 minutes after sitting up and feeling better approximately 10 minutes. Home with mom. Returned next day with complaints of fever, headache, and weakness. Advised fluids, rest and monitor.


Changed on 6/14/2018

VAERS ID: 238085 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2005-05-16
Onset:0000-00-00
Submitted:2005-05-19
Entered:2005-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB074AA / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Headache, Myalgia, Nasal congestion, Nausea, Pallor, Pyrexia

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Came in the next day with myalgias, fever 99.3, nasal congestion; lasted 24-48 hours.
CDC 'Split Type':

Write-up: Immediately following administration of second vaccine, patient became nauseated, weak, color paled, assisted to exam table; laid down, given sips of soda and was feeling better within 5-10 minutes after sitting up and feeling better approximately 10 minutes. Home with mom. Returned next day with complaints of fever, headache, and weakness. Advised fluids, rest and monitor.


Changed on 8/14/2018

VAERS ID: 238085 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2005-05-16
Onset:0000-00-00
Submitted:2005-05-19
Entered:2005-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB074AA / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Headache, Myalgia, Nasal congestion, Nausea, Pallor, Pyrexia

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Came in the next day with myalgias, fever 99.3, nasal congestion; lasted 24-48 hours.
CDC 'Split Type':

Write-up: Immediately following administration of second vaccine, patient became nauseated, weak, color paled, assisted to exam table; laid down, given sips of soda and was feeling better within 5-10 minutes after sitting up and feeling better approximately 10 minutes. Home with mom. Returned next day with complaints of fever, headache, and weakness. Advised fluids, rest and monitor.


Changed on 9/14/2018

VAERS ID: 238085 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2005-05-16
Onset:0000-00-00
Submitted:2005-05-19
Entered:2005-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB074AA / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Headache, Myalgia, Nasal congestion, Nausea, Pallor, Pyrexia

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Came in the next day with myalgias, fever 99.3, nasal congestion; lasted 24-48 hours.
CDC 'Split Type':

Write-up: Immediately following administration of second vaccine, patient became nauseated, weak, color paled, assisted to exam table; laid down, given sips of soda and was feeling better within 5-10 minutes after sitting up and feeling better approximately 10 minutes. Home with mom. Returned next day with complaints of fever, headache, and weakness. Advised fluids, rest and monitor.


Changed on 10/14/2018

VAERS ID: 238085 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Ohio
Vaccinated:2005-05-16
Onset:0000-00-00
Submitted:2005-05-19
Entered:2005-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB074AA / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Headache, Myalgia, Nasal congestion, Nausea, Pallor, Pyrexia

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Came in the next day with myalgias, fever 99.3, nasal congestion; lasted 24-48 hours.
CDC 'Split Type':

Write-up: Immediately following administration of second vaccine, patient became nauseated, weak, color paled, assisted to exam table; laid down, given sips of soda and was feeling better within 5-10 minutes after sitting up and feeling better approximately 10 minutes. Home with mom. Returned next day with complaints of fever, headache, and weakness. Advised fluids, rest and monitor.

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