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This is VAERS ID 238226

Case Details

VAERS ID: 238226 (history)  
Form: Version 1.0  
Age: 13.0  
Sex: Male  
Location: Illinois  
Vaccinated:2005-05-10
Onset:2005-05-11
   Days after vaccination:1
Submitted: 2005-05-17
   Days after onset:6
Entered: 2005-05-26
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0992P / 3 - / SC
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1572AC / 1 - / SC

Administered by: Private       Purchased by: Unknown
Symptoms: Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC allergy medication; name unknown.
Current Illness: NONE
Preexisting Conditions: NONE; Seasonal allergies
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Patient received MMR and Menactra 5/10/05. Then seen 5/12/05, 24 hours later developed high fever 104. Seen 5/12/05 P/E were normal. Febrile illness. Resolved in 36 hours. Follow up on 7/19/05: Also complained of new onset headache associated with AE.


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