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This is VAERS ID 241093

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 241093
VAERS Form:
Age:
Sex:Female
Location:South Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2005-06-28
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1575AA / 0 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The pt did not have any pre-existing allergies or medical conditions. There is no illnesses or medications at the time of vaccination.
Allergies:
Diagnostic Lab Data: No lab test performed.
CDC 'Split Type':

Write-up: From initial info received on 6/13/05 from a health care professional regarding an adverse event occurring in the USA, it was reported that a female pt received a dose of Menactra vaccine, lot U1575AA, SC instead of IM, in the left upper arm on an unspeci"fied date. An unspecified amount of time later, the pt developed large redness of her left upper arm. At the time of this report, the pt recovered from these events.


Changed on 12/8/2009

VAERS ID: 241093 Before After
VAERS Form:
Age:
Sex:Female
Location:South Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2005-06-28
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR U1575AA / 0 LA / SC

Administered by: Private      Purchased by: Unknown Private
Symptoms: Injection site erythema, Medication error, HYSN INJECT SITE, MED ERROR

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The pt did not have any pre-existing allergies or medical conditions. There is no illnesses or medications at the time of vaccination.
Allergies:
Diagnostic Lab Data: No lab test performed.
CDC 'Split Type': (blank) 2005011440

Write-up: From initial info received on 6/13/05 from a health care professional regarding an adverse event occurring in the USA, it was reported that a female pt received a dose of Menactra vaccine, lot U1575AA, SC instead of IM, in the left upper arm on an unspeci"fied unspecified date. An unspecified amount of time later, the pt developed large redness of her left upper arm. At the time of this report, the pt recovered from these events.


Changed on 4/7/2010

VAERS ID: 241093 Before After
VAERS Form:
Age:
Sex:Female
Location:South Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2005-06-28
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1575AA / 0 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The pt did not have any pre-existing allergies or medical conditions. There is no illnesses or medications at the time of vaccination.
Allergies:
Diagnostic Lab Data: No lab test performed.
CDC 'Split Type': 2005011440

Write-up: From initial info received on 6/13/05 from a health care professional regarding an adverse event occurring in the USA, it was reported that a female pt received a dose of Menactra vaccine, lot U1575AA, SC instead of IM, in the left upper arm on an unspecified date. An unspecified amount of time later, the pt developed large redness of her left upper arm. At the time of this report, the pt recovered from these events.


Changed on 5/14/2017

VAERS ID: 241093 Before After
VAERS Form:
Age:
Sex:Female
Location:South Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2005-06-28
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1575AA / 0 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The pt did not have any pre-existing allergies or medical conditions. There is no illnesses or medications at the time of vaccination.
Allergies:
Diagnostic Lab Data: No lab test performed.
CDC 'Split Type': 2005011440

Write-up: From initial info received on 6/13/05 from a health care professional regarding an adverse event occurring in the USA, it was reported that a female pt received a dose of Menactra vaccine, lot U1575AA, SC instead of IM, in the left upper arm on an unspecified date. An unspecified amount of time later, the pt developed large redness of her left upper arm. At the time of this report, the pt recovered from these events.


Changed on 9/14/2017

VAERS ID: 241093 Before After
VAERS Form:(blank) 1
Age:
Sex:Female
Location:South Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2005-06-28
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 0 1 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The pt did not have any pre-existing allergies or medical conditions. There is no illnesses or medications at the time of vaccination.
Allergies:
Diagnostic Lab Data: No lab test performed.
CDC 'Split Type': 2005011440

Write-up: From initial info received on 6/13/05 from a health care professional regarding an adverse event occurring in the USA, it was reported that a female pt received a dose of Menactra vaccine, lot U1575AA, SC instead of IM, in the left upper arm on an unspecified date. An unspecified amount of time later, the pt developed large redness of her left upper arm. At the time of this report, the pt recovered from these events.


Changed on 2/14/2018

VAERS ID: 241093 Before After
VAERS Form:1
Age:
Sex:Female
Location:South Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2005-06-28
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 1 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The pt did not have any pre-existing allergies or medical conditions. There is no illnesses or medications at the time of vaccination.
Allergies:
Diagnostic Lab Data: No lab test performed.
CDC 'Split Type': 2005011440

Write-up: From initial info received on 6/13/05 from a health care professional regarding an adverse event occurring in the USA, it was reported that a female pt received a dose of Menactra vaccine, lot U1575AA, SC instead of IM, in the left upper arm on an unspecified date. An unspecified amount of time later, the pt developed large redness of her left upper arm. At the time of this report, the pt recovered from these events.


Changed on 6/14/2018

VAERS ID: 241093 Before After
VAERS Form:1
Age:
Sex:Female
Location:South Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2005-06-28
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 1 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The pt did not have any pre-existing allergies or medical conditions. There is no illnesses or medications at the time of vaccination.
Allergies:
Diagnostic Lab Data: No lab test performed.
CDC 'Split Type': 2005011440

Write-up: From initial info received on 6/13/05 from a health care professional regarding an adverse event occurring in the USA, it was reported that a female pt received a dose of Menactra vaccine, lot U1575AA, SC instead of IM, in the left upper arm on an unspecified date. An unspecified amount of time later, the pt developed large redness of her left upper arm. At the time of this report, the pt recovered from these events.


Changed on 8/14/2018

VAERS ID: 241093 Before After
VAERS Form:1
Age:
Sex:Female
Location:South Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2005-06-28
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 1 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The pt did not have any pre-existing allergies or medical conditions. There is no illnesses or medications at the time of vaccination.
Allergies:
Diagnostic Lab Data: No lab test performed.
CDC 'Split Type': 2005011440

Write-up: From initial info received on 6/13/05 from a health care professional regarding an adverse event occurring in the USA, it was reported that a female pt received a dose of Menactra vaccine, lot U1575AA, SC instead of IM, in the left upper arm on an unspecified date. An unspecified amount of time later, the pt developed large redness of her left upper arm. At the time of this report, the pt recovered from these events.


Changed on 9/14/2018

VAERS ID: 241093 Before After
VAERS Form:1
Age:
Sex:Female
Location:South Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2005-06-28
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 1 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The pt did not have any pre-existing allergies or medical conditions. There is no illnesses or medications at the time of vaccination.
Allergies:
Diagnostic Lab Data: No lab test performed.
CDC 'Split Type': 2005011440

Write-up: From initial info received on 6/13/05 from a health care professional regarding an adverse event occurring in the USA, it was reported that a female pt received a dose of Menactra vaccine, lot U1575AA, SC instead of IM, in the left upper arm on an unspecified date. An unspecified amount of time later, the pt developed large redness of her left upper arm. At the time of this report, the pt recovered from these events.


Changed on 10/14/2018

VAERS ID: 241093 Before After
VAERS Form:1
Age:
Sex:Female
Location:South Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2005-06-28
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 1 LA / SC

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The pt did not have any pre-existing allergies or medical conditions. There is no illnesses or medications at the time of vaccination.
Allergies:
Diagnostic Lab Data: No lab test performed.
CDC 'Split Type': 2005011440

Write-up: From initial info received on 6/13/05 from a health care professional regarding an adverse event occurring in the USA, it was reported that a female pt received a dose of Menactra vaccine, lot U1575AA, SC instead of IM, in the left upper arm on an unspecified date. An unspecified amount of time later, the pt developed large redness of her left upper arm. At the time of this report, the pt recovered from these events.

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