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This is VAERS ID 241066

Case Details

VAERS ID: 241066 (history)  
Form: Version 1.0  
Age: 9.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2005-06-29
Onset:2005-06-30
   Days after vaccination:1
Submitted: 2005-07-06
   Days after onset:6
Entered: 2005-07-07
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR UE289AA / 1 LA / SC
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF) / BERNA BIOTECH, LTD. 3000808 / 1 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Abdominal pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 7/5/05 Received message from parent, patient experiencing abdominal cramping. Taken dose 1 and 2. Parent stopping 3 and 4. Started morning after dose 1.


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