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This is VAERS ID 241130

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 241130
VAERS Form:
Age:16.0
Sex:Male
Location:California
Vaccinated:2005-07-08
Onset:2005-07-08
Submitted:2005-07-08
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1640AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: URTICARIA

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Facial and truncal urticaria, no signs of anaphylactic shock or asthma, within 1 hour of administration of vaccine.


Changed on 12/8/2009

VAERS ID: 241130 Before After
VAERS Form:
Age:16.0
Sex:Male
Location:California
Vaccinated:2005-07-08
Onset:2005-07-08
Submitted:2005-07-08
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR U1640AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Urticaria, URTICARIA

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Facial and truncal urticaria, no signs of anaphylactic shock or asthma, within 1 hour of administration of vaccine.


Changed on 4/7/2010

VAERS ID: 241130 Before After
VAERS Form:
Age:16.0
Sex:Male
Location:California
Vaccinated:2005-07-08
Onset:2005-07-08
Submitted:2005-07-08
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1640AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Urticaria

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Facial and truncal urticaria, no signs of anaphylactic shock or asthma, within 1 hour of administration of vaccine.


Changed on 5/14/2017

VAERS ID: 241130 Before After
VAERS Form:
Age:16.0
Sex:Male
Location:California
Vaccinated:2005-07-08
Onset:2005-07-08
Submitted:2005-07-08
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1640AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Urticaria

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Facial and truncal urticaria, no signs of anaphylactic shock or asthma, within 1 hour of administration of vaccine.


Changed on 9/14/2017

VAERS ID: 241130 Before After
VAERS Form:(blank) 1
Age:16.0
Sex:Male
Location:California
Vaccinated:2005-07-08
Onset:2005-07-08
Submitted:2005-07-08
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1640AA / 0 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Urticaria

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Facial and truncal urticaria, no signs of anaphylactic shock or asthma, within 1 hour of administration of vaccine.


Changed on 2/14/2018

VAERS ID: 241130 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:California
Vaccinated:2005-07-08
Onset:2005-07-08
Submitted:2005-07-08
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1640AA / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Urticaria

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Facial and truncal urticaria, no signs of anaphylactic shock or asthma, within 1 hour of administration of vaccine.


Changed on 6/14/2018

VAERS ID: 241130 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:California
Vaccinated:2005-07-08
Onset:2005-07-08
Submitted:2005-07-08
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1640AA / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Urticaria

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Facial and truncal urticaria, no signs of anaphylactic shock or asthma, within 1 hour of administration of vaccine.


Changed on 8/14/2018

VAERS ID: 241130 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:California
Vaccinated:2005-07-08
Onset:2005-07-08
Submitted:2005-07-08
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1640AA / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Urticaria

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Facial and truncal urticaria, no signs of anaphylactic shock or asthma, within 1 hour of administration of vaccine.


Changed on 9/14/2018

VAERS ID: 241130 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:California
Vaccinated:2005-07-08
Onset:2005-07-08
Submitted:2005-07-08
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1640AA / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Urticaria

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Facial and truncal urticaria, no signs of anaphylactic shock or asthma, within 1 hour of administration of vaccine.


Changed on 10/14/2018

VAERS ID: 241130 Before After
VAERS Form:1
Age:16.0
Sex:Male
Location:California
Vaccinated:2005-07-08
Onset:2005-07-08
Submitted:2005-07-08
Entered:2005-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1640AA / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Urticaria

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Facial and truncal urticaria, no signs of anaphylactic shock or asthma, within 1 hour of administration of vaccine.

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