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This is VAERS ID 241158

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 241158
VAERS Form:
Age:11.0
Sex:Female
Location:California
Vaccinated:2005-06-26
Onset:2005-06-26
Submitted:2005-06-29
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1573AC / 0 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: HEADACHE, PAIN CHEST, CHILLS FEVER

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Pt was seen for pain over R lower ribs but was afebrile and well; normal exam and no pain. Menactra was given around 09:54 AM on 9/26/05. Around 2 hrs later she came in complaining of headache (heavy head), chills and fever of 103.8. She was given Tylenol"and observed. Fever went up to 104-105 and ibuprofen was given about 1 1/2 hrs later and she was discharged soon after.


Changed on 12/8/2009

VAERS ID: 241158 Before After
VAERS Form:
Age:11.0
Sex:Female
Location:California
Vaccinated:2005-06-26
Onset:2005-06-26
Submitted:2005-06-29
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR U1573AC / 0 - / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Chest pain, Headache, Pyrexia, HEADACHE, PAIN CHEST, CHILLS FEVER

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Pt was seen for pain over R lower ribs but was afebrile and well; normal exam and no pain. Menactra was given around 09:54 AM on 9/26/05. Around 2 hrs later she came in complaining of headache (heavy head), chills and fever of 103.8. She was given Tylenol"and Tylenol and observed. Fever went up to 104-105 and ibuprofen was given about 1 1/2 hrs later and she was discharged soon after.


Changed on 4/7/2010

VAERS ID: 241158 Before After
VAERS Form:
Age:11.0
Sex:Female
Location:California
Vaccinated:2005-06-26
Onset:2005-06-26
Submitted:2005-06-29
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1573AC / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest pain, Headache, Pyrexia

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Pt was seen for pain over R lower ribs but was afebrile and well; normal exam and no pain. Menactra was given around 09:54 AM on 9/26/05. Around 2 hrs later she came in complaining of headache (heavy head), chills and fever of 103.8. She was given Tylenol and observed. Fever went up to 104-105 and ibuprofen was given about 1 1/2 hrs later and she was discharged soon after.


Changed on 5/14/2017

VAERS ID: 241158 Before After
VAERS Form:
Age:11.0
Sex:Female
Location:California
Vaccinated:2005-06-26
Onset:2005-06-26
Submitted:2005-06-29
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1573AC / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest pain, Headache, Pyrexia

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Pt was seen for pain over R lower ribs but was afebrile and well; normal exam and no pain. Menactra was given around 09:54 AM on 9/26/05. Around 2 hrs later she came in complaining of headache (heavy head), chills and fever of 103.8. She was given Tylenol and observed. Fever went up to 104-105 and ibuprofen was given about 1 1/2 hrs later and she was discharged soon after.


Changed on 9/14/2017

VAERS ID: 241158 Before After
VAERS Form:(blank) 1
Age:11.0
Sex:Female
Location:California
Vaccinated:2005-06-26
Onset:2005-06-26
Submitted:2005-06-29
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1573AC / 0 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest pain, Headache, Pyrexia

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Pt was seen for pain over R lower ribs but was afebrile and well; normal exam and no pain. Menactra was given around 09:54 AM on 9/26/05. Around 2 hrs later she came in complaining of headache (heavy head), chills and fever of 103.8. She was given Tylenol and observed. Fever went up to 104-105 and ibuprofen was given about 1 1/2 hrs later and she was discharged soon after.


Changed on 2/14/2018

VAERS ID: 241158 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:California
Vaccinated:2005-06-26
Onset:2005-06-26
Submitted:2005-06-29
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1573AC / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest pain, Headache, Pyrexia

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Pt was seen for pain over R lower ribs but was afebrile and well; normal exam and no pain. Menactra was given around 09:54 AM on 9/26/05. Around 2 hrs later she came in complaining of headache (heavy head), chills and fever of 103.8. She was given Tylenol and observed. Fever went up to 104-105 and ibuprofen was given about 1 1/2 hrs later and she was discharged soon after.


Changed on 6/14/2018

VAERS ID: 241158 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:California
Vaccinated:2005-06-26
Onset:2005-06-26
Submitted:2005-06-29
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1573AC / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest pain, Headache, Pyrexia

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Pt was seen for pain over R lower ribs but was afebrile and well; normal exam and no pain. Menactra was given around 09:54 AM on 9/26/05. Around 2 hrs later she came in complaining of headache (heavy head), chills and fever of 103.8. She was given Tylenol and observed. Fever went up to 104-105 and ibuprofen was given about 1 1/2 hrs later and she was discharged soon after.


Changed on 8/14/2018

VAERS ID: 241158 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:California
Vaccinated:2005-06-26
Onset:2005-06-26
Submitted:2005-06-29
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1573AC / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest pain, Headache, Pyrexia

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Pt was seen for pain over R lower ribs but was afebrile and well; normal exam and no pain. Menactra was given around 09:54 AM on 9/26/05. Around 2 hrs later she came in complaining of headache (heavy head), chills and fever of 103.8. She was given Tylenol and observed. Fever went up to 104-105 and ibuprofen was given about 1 1/2 hrs later and she was discharged soon after.


Changed on 9/14/2018

VAERS ID: 241158 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:California
Vaccinated:2005-06-26
Onset:2005-06-26
Submitted:2005-06-29
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1573AC / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest pain, Headache, Pyrexia

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Pt was seen for pain over R lower ribs but was afebrile and well; normal exam and no pain. Menactra was given around 09:54 AM on 9/26/05. Around 2 hrs later she came in complaining of headache (heavy head), chills and fever of 103.8. She was given Tylenol and observed. Fever went up to 104-105 and ibuprofen was given about 1 1/2 hrs later and she was discharged soon after.


Changed on 10/14/2018

VAERS ID: 241158 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:California
Vaccinated:2005-06-26
Onset:2005-06-26
Submitted:2005-06-29
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1573AC / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest pain, Headache, Pyrexia

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: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Pt was seen for pain over R lower ribs but was afebrile and well; normal exam and no pain. Menactra was given around 09:54 AM on 9/26/05. Around 2 hrs later she came in complaining of headache (heavy head), chills and fever of 103.8. She was given Tylenol and observed. Fever went up to 104-105 and ibuprofen was given about 1 1/2 hrs later and she was discharged soon after.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=241158&WAYBACKHISTORY=ON


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