National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 241092

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 241092
VAERS Form:
Age:19.0
Sex:Female
Location:Florida
Vaccinated:2005-06-01
Onset:2005-06-02
Submitted:2005-06-09
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1525AB / 0 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: EDEMA INJECT SITE, PAIN INJECT SITE, HYSN INJECT SITE, MED ERROR

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: Humalog, vasotec
Current Illness:
Preexisting Conditions: The pt has a past medical history of diabetes.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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 err"or, 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 w


Changed on 12/8/2009

VAERS ID: 241092 Before After
VAERS Form:
Age:19.0
Sex:Female
Location:Florida
Vaccinated:2005-06-01
Onset:2005-06-02
Submitted:2005-06-09
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR U1525AB / 0 LA / SC

Administered by: Private      Purchased by: Unknown Other
Symptoms: Injection site erythema, Injection site pain, Medication error, Injection site swelling, EDEMA INJECT SITE, PAIN INJECT SITE, HYSN INJECT SITE, MED ERROR

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: Humalog, vasotec
Current Illness:
Preexisting Conditions: The pt has a past medical history of diabetes.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 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 err"or, error, in the back of the pt''''s 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 w whether she recovered from the events.


Changed on 4/7/2010

VAERS ID: 241092 Before After
VAERS Form:
Age:19.0
Sex:Female
Location:Florida
Vaccinated:2005-06-01
Onset:2005-06-02
Submitted:2005-06-09
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1525AB / 0 LA / SC

Administered by: Private      Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Medication error, Injection site swelling

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: 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.


Changed on 5/14/2017

VAERS ID: 241092 Before After
VAERS Form:
Age:19.0
Sex:Female
Location:Florida
Vaccinated:2005-06-01
Onset:2005-06-02
Submitted:2005-06-09
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1525AB / 0 LA / SC

Administered by: Private      Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Medication error, Injection site swelling

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: 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.


Changed on 9/14/2017

VAERS ID: 241092 Before After
VAERS Form:(blank) 1
Age:19.0
Sex:Female
Location:Florida
Vaccinated:2005-06-01
Onset:2005-06-02
Submitted:2005-06-09
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1525AB / 0 1 LA / SC

Administered by: Private      Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Medication error, Injection site swelling

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: 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.


Changed on 2/14/2018

VAERS ID: 241092 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Florida
Vaccinated:2005-06-01
Onset:2005-06-02
Submitted:2005-06-09
Entered:2005-07-08
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, Medication error, Injection site swelling

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: 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.


Changed on 6/14/2018

VAERS ID: 241092 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Florida
Vaccinated:2005-06-01
Onset:2005-06-02
Submitted:2005-06-09
Entered:2005-07-08
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, Medication error, Injection site swelling

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: 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.


Changed on 8/14/2018

VAERS ID: 241092 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Florida
Vaccinated:2005-06-01
Onset:2005-06-02
Submitted:2005-06-09
Entered:2005-07-08
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, Medication error, Injection site swelling

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: 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.


Changed on 9/14/2018

VAERS ID: 241092 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Florida
Vaccinated:2005-06-01
Onset:2005-06-02
Submitted:2005-06-09
Entered:2005-07-08
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, Medication error, Injection site swelling

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: 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.


Changed on 10/14/2018

VAERS ID: 241092 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Florida
Vaccinated:2005-06-01
Onset:2005-06-02
Submitted:2005-06-09
Entered:2005-07-08
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, Medication error, Injection site swelling

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: 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.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=241092&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166