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This is VAERS ID 239856

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 239856
VAERS Form:
Age:18.0
Sex:Female
Location:Kansas
Vaccinated:2005-06-13
Onset:2005-06-13
Submitted:2005-06-14
Entered:2005-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0635P / - RA / SC
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1589AA / - GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: DIZZINESS, DYSPNEA, URTICARIA, PRURITUS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Ortho-Tri-Cyclen
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12:45 pm MMR & Menactra vaccine given. 1:15 pm Pt. c/o itching and hives all over, difficulty breathing, feeling faint. 911 called. 1:20 pm Epinephrine 1:1000 1mg/ml 0.3cc SQ LUO Arm. 1:25 Con''''t difficutly breathingm, hives, itching, Epi 0.3 cc SQ R UOAr"m. 1:30 pm Paramedics arrived, pt transported to hospital.


Changed on 12/8/2009

VAERS ID: 239856 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Kansas
Vaccinated:2005-06-13
Onset:2005-06-13
Submitted:2005-06-14
Entered:2005-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0635P / - RA / SC
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR U1589AA / - GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dizziness, Dyspnoea, Pruritus, Urticaria, DIZZINESS, DYSPNEA, URTICARIA, PRURITUS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Ortho-Tri-Cyclen
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12:45 pm MMR & Menactra vaccine given. 1:15 pm Pt. c/o itching and hives all over, difficulty breathing, feeling faint. 911 called. 1:20 pm Epinephrine 1:1000 1mg/ml 0.3cc SQ LUO Arm. 1:25 Con''''t Con''t difficutly breathingm, hives, itching, Epi 0.3 cc SQ R UOAr"m. UOArm. 1:30 pm Paramedics arrived, pt transported to hospital.


Changed on 4/7/2010

VAERS ID: 239856 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Kansas
Vaccinated:2005-06-13
Onset:2005-06-13
Submitted:2005-06-14
Entered:2005-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0635P / - RA / SC
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1589AA / - GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dizziness, Dyspnoea, Pruritus, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho-Tri-Cyclen
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12:45 pm MMR & Menactra vaccine given. 1:15 pm Pt. c/o itching and hives all over, difficulty breathing, feeling faint. 911 called. 1:20 pm Epinephrine 1:1000 1mg/ml 0.3cc SQ LUO Arm. 1:25 Con''t difficutly breathingm, hives, itching, Epi 0.3 cc SQ R UOArm. 1:30 pm Paramedics arrived, pt transported to hospital.


Changed on 5/14/2017

VAERS ID: 239856 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Kansas
Vaccinated:2005-06-13
Onset:2005-06-13
Submitted:2005-06-14
Entered:2005-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0635P / - RA / SC
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1589AA / - GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dizziness, Dyspnoea, Pruritus, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho-Tri-Cyclen
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12:45 pm MMR & Menactra vaccine given. 1:15 pm Pt. c/o itching and hives all over, difficulty breathing, feeling faint. 911 called. 1:20 pm Epinephrine 1:1000 1mg/ml 0.3cc SQ LUO Arm. 1:25 Con''t difficutly breathingm, hives, itching, Epi 0.3 cc SQ R UOArm. 1:30 pm Paramedics arrived, pt transported to hospital.


Changed on 9/14/2017

VAERS ID: 239856 Before After
VAERS Form:(blank) 1
Age:18.0
Sex:Female
Location:Kansas
Vaccinated:2005-06-13
Onset:2005-06-13
Submitted:2005-06-14
Entered:2005-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0635P / - UNK RA / SC
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1589AA / - UNK GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dizziness, Dyspnoea, Pruritus, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho-Tri-Cyclen
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12:45 pm MMR & Menactra vaccine given. 1:15 pm Pt. c/o itching and hives all over, difficulty breathing, feeling faint. 911 called. 1:20 pm Epinephrine 1:1000 1mg/ml 0.3cc SQ LUO Arm. 1:25 Con''t difficutly breathingm, hives, itching, Epi 0.3 cc SQ R UOArm. 1:30 pm Paramedics arrived, pt transported to hospital.


Changed on 2/14/2018

VAERS ID: 239856 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Kansas
Vaccinated:2005-06-13
Onset:2005-06-13
Submitted:2005-06-14
Entered:2005-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0635P / UNK RA / SC
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1589AA / UNK GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dizziness, Dyspnoea, Pruritus, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho-Tri-Cyclen
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12:45 pm MMR & Menactra vaccine given. 1:15 pm Pt. c/o itching and hives all over, difficulty breathing, feeling faint. 911 called. 1:20 pm Epinephrine 1:1000 1mg/ml 0.3cc SQ LUO Arm. 1:25 Con''t difficutly breathingm, hives, itching, Epi 0.3 cc SQ R UOArm. 1:30 pm Paramedics arrived, pt transported to hospital.


Changed on 6/14/2018

VAERS ID: 239856 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Kansas
Vaccinated:2005-06-13
Onset:2005-06-13
Submitted:2005-06-14
Entered:2005-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0635P / UNK RA / SC
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1589AA / UNK GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dizziness, Dyspnoea, Pruritus, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho-Tri-Cyclen
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12:45 pm MMR & Menactra vaccine given. 1:15 pm Pt. c/o itching and hives all over, difficulty breathing, feeling faint. 911 called. 1:20 pm Epinephrine 1:1000 1mg/ml 0.3cc SQ LUO Arm. 1:25 Con''t difficutly breathingm, hives, itching, Epi 0.3 cc SQ R UOArm. 1:30 pm Paramedics arrived, pt transported to hospital.


Changed on 8/14/2018

VAERS ID: 239856 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Kansas
Vaccinated:2005-06-13
Onset:2005-06-13
Submitted:2005-06-14
Entered:2005-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0635P / UNK RA / SC
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1589AA / UNK GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dizziness, Dyspnoea, Pruritus, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho-Tri-Cyclen
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12:45 pm MMR & Menactra vaccine given. 1:15 pm Pt. c/o itching and hives all over, difficulty breathing, feeling faint. 911 called. 1:20 pm Epinephrine 1:1000 1mg/ml 0.3cc SQ LUO Arm. 1:25 Con''t difficutly breathingm, hives, itching, Epi 0.3 cc SQ R UOArm. 1:30 pm Paramedics arrived, pt transported to hospital.


Changed on 9/14/2018

VAERS ID: 239856 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Kansas
Vaccinated:2005-06-13
Onset:2005-06-13
Submitted:2005-06-14
Entered:2005-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0635P / UNK RA / SC
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1589AA / UNK GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dizziness, Dyspnoea, Pruritus, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho-Tri-Cyclen
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12:45 pm MMR & Menactra vaccine given. 1:15 pm Pt. c/o itching and hives all over, difficulty breathing, feeling faint. 911 called. 1:20 pm Epinephrine 1:1000 1mg/ml 0.3cc SQ LUO Arm. 1:25 Con''t difficutly breathingm, hives, itching, Epi 0.3 cc SQ R UOArm. 1:30 pm Paramedics arrived, pt transported to hospital.


Changed on 10/14/2018

VAERS ID: 239856 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Kansas
Vaccinated:2005-06-13
Onset:2005-06-13
Submitted:2005-06-14
Entered:2005-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0635P / UNK RA / SC
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1589AA / UNK GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dizziness, Dyspnoea, Pruritus, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho-Tri-Cyclen
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 12:45 pm MMR & Menactra vaccine given. 1:15 pm Pt. c/o itching and hives all over, difficulty breathing, feeling faint. 911 called. 1:20 pm Epinephrine 1:1000 1mg/ml 0.3cc SQ LUO Arm. 1:25 Con''t difficutly breathingm, hives, itching, Epi 0.3 cc SQ R UOArm. 1:30 pm Paramedics arrived, pt transported to hospital.

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