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This is VAERS ID 238226

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 238226
VAERS Form:
Age:13.0
Sex:Male
Location:Illinois
Vaccinated:2005-05-10
Onset:2005-05-11
Submitted:2005-05-17
Entered:2005-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0992P / 2 - / SC
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1572AC / 0 - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, HEADACHE

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC allergy medication; name unknown.
Current Illness: NONE
Preexisting Conditions: NONE
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.


Changed on 12/8/2009

VAERS ID: 238226 Before After
VAERS Form:
Age:13.0
Sex:Male
Location:Illinois
Vaccinated:2005-05-10
Onset:2005-05-11
Submitted:2005-05-17
Entered:2005-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0992P / 2 - / SC
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR U1572AC / 0 - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Headache, Pyrexia, FEVER, HEADACHE

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC allergy medication; name unknown.
Current Illness: NONE
Preexisting Conditions: NONE 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.


Changed on 4/7/2010

VAERS ID: 238226 Before After
VAERS Form:
Age:13.0
Sex:Male
Location:Illinois
Vaccinated:2005-05-10
Onset:2005-05-11
Submitted:2005-05-17
Entered:2005-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0992P / 2 - / SC
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1572AC / 0 - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Headache, 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)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 5/14/2017

VAERS ID: 238226 Before After
VAERS Form:
Age:13.0
Sex:Male
Location:Illinois
Vaccinated:2005-05-10
Onset:2005-05-11
Submitted:2005-05-17
Entered:2005-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0992P / 2 - / SC
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1572AC / 0 - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Headache, 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)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 9/14/2017

VAERS ID: 238226 Before After
VAERS Form:(blank) 1
Age:13.0
Sex:Male
Location:Illinois
Vaccinated:2005-05-10
Onset:2005-05-11
Submitted:2005-05-17
Entered:2005-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0992P / 2 3 - / SC
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1572AC / 0 1 - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Headache, 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)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 2/14/2018

VAERS ID: 238226 Before After
VAERS Form:1
Age:13.0
Sex:Male
Location:Illinois
Vaccinated:2005-05-10
Onset:2005-05-11
Submitted:2005-05-17
Entered:2005-05-26
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 6/14/2018

VAERS ID: 238226 Before After
VAERS Form:1
Age:13.0
Sex:Male
Location:Illinois
Vaccinated:2005-05-10
Onset:2005-05-11
Submitted:2005-05-17
Entered:2005-05-26
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 8/14/2018

VAERS ID: 238226 Before After
VAERS Form:1
Age:13.0
Sex:Male
Location:Illinois
Vaccinated:2005-05-10
Onset:2005-05-11
Submitted:2005-05-17
Entered:2005-05-26
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 9/14/2018

VAERS ID: 238226 Before After
VAERS Form:1
Age:13.0
Sex:Male
Location:Illinois
Vaccinated:2005-05-10
Onset:2005-05-11
Submitted:2005-05-17
Entered:2005-05-26
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 10/14/2018

VAERS ID: 238226 Before After
VAERS Form:1
Age:13.0
Sex:Male
Location:Illinois
Vaccinated:2005-05-10
Onset:2005-05-11
Submitted:2005-05-17
Entered:2005-05-26
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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=238226&WAYBACKHISTORY=ON


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