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This is VAERS ID 241157

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 241157
VAERS Form:
Age:18.0
Sex:Female
Location:Virginia
Vaccinated:2005-06-28
Onset:2005-06-30
Submitted:2005-07-01
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1656AC / 0 LA / SC
TD: TD ADSORBED, ADULT (NO BRAND NAME) / AVENTIS PASTEUR, U1221BA / 0 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: PAIN, PAIN NECK

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: PPD, Aventis, C2077AA, LA, 0 previously
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: TD and MMR given 6/28/05 in L deltoid. Swelling developed between L shoulder and neck area on 6/30/05. Slight pain upon palpation of area. No fever. No redness.


Changed on 12/8/2009

VAERS ID: 241157 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Virginia
Vaccinated:2005-06-28
Onset:2005-06-30
Submitted:2005-07-01
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR U1656AC / 0 LA / SC
TD: TD ADSORBED, ADULT (NO BRAND NAME) TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR, AVENTIS PASTEUR U1221BA / 0 LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Neck pain, Shoulder pain, PAIN, PAIN NECK

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: PPD, Aventis, C2077AA, LA, 0 previously
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: TD and MMR given 6/28/05 in L deltoid. Swelling developed between L shoulder and neck area on 6/30/05. Slight pain upon palpation of area. No fever. No redness.


Changed on 4/7/2010

VAERS ID: 241157 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Virginia
Vaccinated:2005-06-28
Onset:2005-06-30
Submitted:2005-07-01
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1656AC / 0 LA / SC
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Neck pain, Shoulder pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: PPD, Aventis, C2077AA, LA, 0 previously
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: TD and MMR given 6/28/05 in L deltoid. Swelling developed between L shoulder and neck area on 6/30/05. Slight pain upon palpation of area. No fever. No redness.


Changed on 5/14/2017

VAERS ID: 241157 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Virginia
Vaccinated:2005-06-28
Onset:2005-06-30
Submitted:2005-07-01
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1656AC / 0 LA / SC
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Neck pain, Shoulder pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: PPD, Aventis, C2077AA, LA, 0 previously
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: TD and MMR given 6/28/05 in L deltoid. Swelling developed between L shoulder and neck area on 6/30/05. Slight pain upon palpation of area. No fever. No redness.


Changed on 9/14/2017

VAERS ID: 241157 Before After
VAERS Form:(blank) 1
Age:18.0
Sex:Female
Location:Virginia
Vaccinated:2005-06-28
Onset:2005-06-30
Submitted:2005-07-01
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1656AC / 0 1 LA / SC
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / 0 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Neck pain, Shoulder pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: PPD, Aventis, C2077AA, LA, 0 previously
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: TD and MMR given 6/28/05 in L deltoid. Swelling developed between L shoulder and neck area on 6/30/05. Slight pain upon palpation of area. No fever. No redness.


Changed on 2/14/2018

VAERS ID: 241157 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Virginia
Vaccinated:2005-06-28
Onset:2005-06-30
Submitted:2005-07-01
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1656AC / 1 LA / SC
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Neck pain, Shoulder pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: PPD, Aventis, C2077AA, LA, 0 previously
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: TD and MMR given 6/28/05 in L deltoid. Swelling developed between L shoulder and neck area on 6/30/05. Slight pain upon palpation of area. No fever. No redness.


Changed on 6/14/2018

VAERS ID: 241157 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Virginia
Vaccinated:2005-06-28
Onset:2005-06-30
Submitted:2005-07-01
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1656AC / 1 LA / SC
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Neck pain, Shoulder pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: PPD, Aventis, C2077AA, LA, 0 previously
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: TD and MMR given 6/28/05 in L deltoid. Swelling developed between L shoulder and neck area on 6/30/05. Slight pain upon palpation of area. No fever. No redness.


Changed on 8/14/2018

VAERS ID: 241157 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Virginia
Vaccinated:2005-06-28
Onset:2005-06-30
Submitted:2005-07-01
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1656AC / 1 LA / SC
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Neck pain, Shoulder pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: PPD, Aventis, C2077AA, LA, 0 previously
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: TD and MMR given 6/28/05 in L deltoid. Swelling developed between L shoulder and neck area on 6/30/05. Slight pain upon palpation of area. No fever. No redness.


Changed on 9/14/2018

VAERS ID: 241157 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Virginia
Vaccinated:2005-06-28
Onset:2005-06-30
Submitted:2005-07-01
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1656AC / 1 LA / SC
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Neck pain, Shoulder pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: PPD, Aventis, C2077AA, LA, 0 previously
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: TD and MMR given 6/28/05 in L deltoid. Swelling developed between L shoulder and neck area on 6/30/05. Slight pain upon palpation of area. No fever. No redness.


Changed on 10/14/2018

VAERS ID: 241157 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Virginia
Vaccinated:2005-06-28
Onset:2005-06-30
Submitted:2005-07-01
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1656AC / 1 LA / SC
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Neck pain, Shoulder pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: PPD, Aventis, C2077AA, LA, 0 previously
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: TD and MMR given 6/28/05 in L deltoid. Swelling developed between L shoulder and neck area on 6/30/05. Slight pain upon palpation of area. No fever. No redness.

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