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This is VAERS ID 239876

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 239876
VAERS Form:
Age:18.0
Sex:Male
Location:Alabama
Vaccinated:2005-06-08
Onset:2005-06-08
Submitted:2005-06-09
Entered:2005-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, 01493AC / - LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, TWITCH, DYSPNEA, SPEECH DIS, MALAISE

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: PPD- Aventis C2114AB LFA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, CBC, CMP, UA- results not reported
CDC 'Split Type':

Write-up: Mom states pt came home at 7:00 from date not feeling well. Temp 100 F. Took ibuprofen. At 10:00 began to mumble and moan. c/o SOB. Then started twitching all over- 911 called. Pt taken to nearest hospital. Pt given IV fluids- Tordal and Ativan.


Changed on 12/8/2009

VAERS ID: 239876 Before After
VAERS Form:
Age:18.0
Sex:Male
Location:Alabama
Vaccinated:2005-06-08
Onset:2005-06-08
Submitted:2005-06-09
Entered:2005-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR 01493AC / - LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Body temperature increased, Dysarthria, Dyspnoea, Malaise, Muscle twitching, FEVER, TWITCH, DYSPNEA, SPEECH DIS, MALAISE

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: PPD- Aventis C2114AB LFA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, CBC, CMP, UA- results not reported
CDC 'Split Type':

Write-up: Mom states pt came home at 7:00 from date not feeling well. Temp 100 F. Took ibuprofen. At 10:00 began to mumble and moan. c/o SOB. Then started twitching all over- 911 called. Pt taken to nearest hospital. Pt given IV fluids- Tordal and Ativan.


Changed on 4/7/2010

VAERS ID: 239876 Before After
VAERS Form:
Age:18.0
Sex:Male
Location:Alabama
Vaccinated:2005-06-08
Onset:2005-06-08
Submitted:2005-06-09
Entered:2005-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR 01493AC / - LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Body temperature increased, Dysarthria, Dyspnoea, Malaise, Muscle twitching

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: PPD- Aventis C2114AB LFA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, CBC, CMP, UA- results not reported
CDC 'Split Type':

Write-up: Mom states pt came home at 7:00 from date not feeling well. Temp 100 F. Took ibuprofen. At 10:00 began to mumble and moan. c/o SOB. Then started twitching all over- 911 called. Pt taken to nearest hospital. Pt given IV fluids- Tordal and Ativan.


Changed on 5/14/2017

VAERS ID: 239876 Before After
VAERS Form:
Age:18.0
Sex:Male
Location:Alabama
Vaccinated:2005-06-08
Onset:2005-06-08
Submitted:2005-06-09
Entered:2005-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR 01493AC / - LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Body temperature increased, Dysarthria, Dyspnoea, Malaise, Muscle twitching

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: PPD- Aventis C2114AB LFA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, CBC, CMP, UA- results not reported
CDC 'Split Type':

Write-up: Mom states pt came home at 7:00 from date not feeling well. Temp 100 F. Took ibuprofen. At 10:00 began to mumble and moan. c/o SOB. Then started twitching all over- 911 called. Pt taken to nearest hospital. Pt given IV fluids- Tordal and Ativan.


Changed on 9/14/2017

VAERS ID: 239876 Before After
VAERS Form:(blank) 1
Age:18.0
Sex:Male
Location:Alabama
Vaccinated:2005-06-08
Onset:2005-06-08
Submitted:2005-06-09
Entered:2005-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 01493AC / - UNK LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Body temperature increased, Dysarthria, Dyspnoea, Malaise, Muscle twitching

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: PPD- Aventis C2114AB LFA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, CBC, CMP, UA- results not reported
CDC 'Split Type':

Write-up: Mom states pt came home at 7:00 from date not feeling well. Temp 100 F. Took ibuprofen. At 10:00 began to mumble and moan. c/o SOB. Then started twitching all over- 911 called. Pt taken to nearest hospital. Pt given IV fluids- Tordal and Ativan.


Changed on 2/14/2018

VAERS ID: 239876 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Alabama
Vaccinated:2005-06-08
Onset:2005-06-08
Submitted:2005-06-09
Entered:2005-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 01493AC / UNK LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Body temperature increased, Dysarthria, Dyspnoea, Malaise, Muscle twitching

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: PPD- Aventis C2114AB LFA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, CBC, CMP, UA- results not reported
CDC 'Split Type':

Write-up: Mom states pt came home at 7:00 from date not feeling well. Temp 100 F. Took ibuprofen. At 10:00 began to mumble and moan. c/o SOB. Then started twitching all over- 911 called. Pt taken to nearest hospital. Pt given IV fluids- Tordal and Ativan.


Changed on 6/14/2018

VAERS ID: 239876 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Alabama
Vaccinated:2005-06-08
Onset:2005-06-08
Submitted:2005-06-09
Entered:2005-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 01493AC / UNK LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Body temperature increased, Dysarthria, Dyspnoea, Malaise, Muscle twitching

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: PPD- Aventis C2114AB LFA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, CBC, CMP, UA- results not reported
CDC 'Split Type':

Write-up: Mom states pt came home at 7:00 from date not feeling well. Temp 100 F. Took ibuprofen. At 10:00 began to mumble and moan. c/o SOB. Then started twitching all over- 911 called. Pt taken to nearest hospital. Pt given IV fluids- Tordal and Ativan.


Changed on 8/14/2018

VAERS ID: 239876 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Alabama
Vaccinated:2005-06-08
Onset:2005-06-08
Submitted:2005-06-09
Entered:2005-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 01493AC / UNK LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Body temperature increased, Dysarthria, Dyspnoea, Malaise, Muscle twitching

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: PPD- Aventis C2114AB LFA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, CBC, CMP, UA- results not reported
CDC 'Split Type':

Write-up: Mom states pt came home at 7:00 from date not feeling well. Temp 100 F. Took ibuprofen. At 10:00 began to mumble and moan. c/o SOB. Then started twitching all over- 911 called. Pt taken to nearest hospital. Pt given IV fluids- Tordal and Ativan.


Changed on 9/14/2018

VAERS ID: 239876 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Alabama
Vaccinated:2005-06-08
Onset:2005-06-08
Submitted:2005-06-09
Entered:2005-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 01493AC / UNK LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Body temperature increased, Dysarthria, Dyspnoea, Malaise, Muscle twitching

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: PPD- Aventis C2114AB LFA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, CBC, CMP, UA- results not reported
CDC 'Split Type':

Write-up: Mom states pt came home at 7:00 from date not feeling well. Temp 100 F. Took ibuprofen. At 10:00 began to mumble and moan. c/o SOB. Then started twitching all over- 911 called. Pt taken to nearest hospital. Pt given IV fluids- Tordal and Ativan.


Changed on 10/14/2018

VAERS ID: 239876 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Alabama
Vaccinated:2005-06-08
Onset:2005-06-08
Submitted:2005-06-09
Entered:2005-06-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 01493AC / UNK LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Body temperature increased, Dysarthria, Dyspnoea, Malaise, Muscle twitching

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: PPD- Aventis C2114AB LFA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CXR, CBC, CMP, UA- results not reported
CDC 'Split Type':

Write-up: Mom states pt came home at 7:00 from date not feeling well. Temp 100 F. Took ibuprofen. At 10:00 began to mumble and moan. c/o SOB. Then started twitching all over- 911 called. Pt taken to nearest hospital. Pt given IV fluids- Tordal and Ativan.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=239876&WAYBACKHISTORY=ON


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