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This is VAERS ID 239998

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 239998
VAERS Form:
Age:18.0
Sex:Female
Location:Nebraska
Vaccinated:2005-06-15
Onset:2005-06-15
Submitted:2005-06-17
Entered:2005-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1639AA / 0 RA / IM
PPV: PNEUMO, 23-VALENT (PNEUMOVAX) / MERCK & CO. INC. 0490P / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: MASS INJECT SITE, RASH, HYSN INJECT SITE, EDEMA, PAIN

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:
Current Illness: NONE
Preexisting Conditions: Hodgkins Lymphoma; Asthma; Allergic rhinitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Left deltoid local reaction. Erythema, induration 8cmx6cm, edema, tenderness, warmth at site. Erythematous rash around site. No other urticaria, fever, or pruritus. No arthralgia.


Changed on 12/8/2009

VAERS ID: 239998 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Nebraska
Vaccinated:2005-06-15
Onset:2005-06-15
Submitted:2005-06-17
Entered:2005-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR U1639AA / 0 RA / IM
PPV: PNEUMO, 23-VALENT (PNEUMOVAX) PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0490P / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Injection site erythema, Injection site induration, Injection site warmth, Oedema, Rash erythematous, Tenderness, MASS INJECT SITE, RASH, HYSN INJECT SITE, EDEMA, PAIN

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:
Current Illness: NONE
Preexisting Conditions: Hodgkins Lymphoma; Asthma; Allergic rhinitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Left deltoid local reaction. Erythema, induration 8cmx6cm, edema, tenderness, warmth at site. Erythematous rash around site. No other urticaria, fever, or pruritus. No arthralgia.


Changed on 4/7/2010

VAERS ID: 239998 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Nebraska
Vaccinated:2005-06-15
Onset:2005-06-15
Submitted:2005-06-17
Entered:2005-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1639AA / 0 RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0490P / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site warmth, Oedema, Rash erythematous, Tenderness

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:
Current Illness: NONE
Preexisting Conditions: Hodgkins Lymphoma; Asthma; Allergic rhinitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Left deltoid local reaction. Erythema, induration 8cmx6cm, edema, tenderness, warmth at site. Erythematous rash around site. No other urticaria, fever, or pruritus. No arthralgia.


Changed on 5/14/2017

VAERS ID: 239998 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Nebraska
Vaccinated:2005-06-15
Onset:2005-06-15
Submitted:2005-06-17
Entered:2005-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1639AA / 0 RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0490P / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site warmth, Oedema, Rash erythematous, Tenderness

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:
Current Illness: NONE
Preexisting Conditions: Hodgkins Lymphoma; Asthma; Allergic rhinitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Left deltoid local reaction. Erythema, induration 8cmx6cm, edema, tenderness, warmth at site. Erythematous rash around site. No other urticaria, fever, or pruritus. No arthralgia.


Changed on 9/14/2017

VAERS ID: 239998 Before After
VAERS Form:(blank) 1
Age:18.0
Sex:Female
Location:Nebraska
Vaccinated:2005-06-15
Onset:2005-06-15
Submitted:2005-06-17
Entered:2005-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1639AA / 0 1 RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0490P / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site warmth, Oedema, Rash erythematous, Tenderness

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:
Current Illness: NONE
Preexisting Conditions: Hodgkins Lymphoma; Asthma; Allergic rhinitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Left deltoid local reaction. Erythema, induration 8cmx6cm, edema, tenderness, warmth at site. Erythematous rash around site. No other urticaria, fever, or pruritus. No arthralgia.


Changed on 2/14/2018

VAERS ID: 239998 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Nebraska
Vaccinated:2005-06-15
Onset:2005-06-15
Submitted:2005-06-17
Entered:2005-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1639AA / 1 RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0490P / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site warmth, Oedema, Rash erythematous, Tenderness

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:
Current Illness: NONE
Preexisting Conditions: Hodgkins Lymphoma; Asthma; Allergic rhinitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Left deltoid local reaction. Erythema, induration 8cmx6cm, edema, tenderness, warmth at site. Erythematous rash around site. No other urticaria, fever, or pruritus. No arthralgia.


Changed on 6/14/2018

VAERS ID: 239998 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Nebraska
Vaccinated:2005-06-15
Onset:2005-06-15
Submitted:2005-06-17
Entered:2005-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1639AA / 1 RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0490P / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site warmth, Oedema, Rash erythematous, Tenderness

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:
Current Illness: NONE
Preexisting Conditions: Hodgkins Lymphoma; Asthma; Allergic rhinitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Left deltoid local reaction. Erythema, induration 8cmx6cm, edema, tenderness, warmth at site. Erythematous rash around site. No other urticaria, fever, or pruritus. No arthralgia.


Changed on 8/14/2018

VAERS ID: 239998 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Nebraska
Vaccinated:2005-06-15
Onset:2005-06-15
Submitted:2005-06-17
Entered:2005-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1639AA / 1 RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0490P / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site warmth, Oedema, Rash erythematous, Tenderness

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:
Current Illness: NONE
Preexisting Conditions: Hodgkins Lymphoma; Asthma; Allergic rhinitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Left deltoid local reaction. Erythema, induration 8cmx6cm, edema, tenderness, warmth at site. Erythematous rash around site. No other urticaria, fever, or pruritus. No arthralgia.


Changed on 9/14/2018

VAERS ID: 239998 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Nebraska
Vaccinated:2005-06-15
Onset:2005-06-15
Submitted:2005-06-17
Entered:2005-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1639AA / 1 RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0490P / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site warmth, Oedema, Rash erythematous, Tenderness

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:
Current Illness: NONE
Preexisting Conditions: Hodgkins Lymphoma; Asthma; Allergic rhinitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Left deltoid local reaction. Erythema, induration 8cmx6cm, edema, tenderness, warmth at site. Erythematous rash around site. No other urticaria, fever, or pruritus. No arthralgia.


Changed on 10/14/2018

VAERS ID: 239998 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Nebraska
Vaccinated:2005-06-15
Onset:2005-06-15
Submitted:2005-06-17
Entered:2005-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1639AA / 1 RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0490P / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site warmth, Oedema, Rash erythematous, Tenderness

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:
Current Illness: NONE
Preexisting Conditions: Hodgkins Lymphoma; Asthma; Allergic rhinitis.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Left deltoid local reaction. Erythema, induration 8cmx6cm, edema, tenderness, warmth at site. Erythematous rash around site. No other urticaria, fever, or pruritus. No arthralgia.

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