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This is VAERS ID 241092

Case Details

VAERS ID: 241092 (history)  
Form: Version 1.0  
Age: 19.0  
Sex: Female  
Location: Florida  
Vaccinated:2005-06-01
Onset:2005-06-02
   Days after vaccination:1
Submitted: 2005-06-09
   Days after onset:7
Entered: 2005-07-08
   Days after submission:29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1525AB / 1 LA / SC

Administered by: Private       Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Medication error
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Humalog, vasotec
Current Illness:
Preexisting Conditions: The pt has a past medical history of diabetes.
Allergies:
Diagnostic Lab Data:
CDC Split Type: 2005010520

Write-up: From initial info received on 6/3/05 from a health care professional regarding an adverse event occurring in the USA, it was reported that an 18 year old female pt received her 1st dose of Menactra vaccine on 6/1/05. The product was administered SC in error, in the back of the pt''s left arm. The next day, on 6/2/05, the pt developed a local reaction of redness, swelling and soreness at the site of injection. She was evaluated by a physician on 6/3/05. The pt was treated with ibuprofen and it is unknown whether she recovered from the events.


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