National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 241188

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 241188
VAERS Form:
Age:19.0
Sex:Male
Location:Indiana
Vaccinated:2005-07-07
Onset:2005-07-08
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1656AC / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: RASH, ASTHENIA

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

Write-up: On 7/8, client noted /"rash at base of neck increasing in intensity on left shoulder/" with small 1/4/" diameter raised areas. Denies rapid heartbeat or respiratory symptoms, itching. On 7/11 rash less intense, client has been /"very tired, sleeping an e"xtra 2-3 hours per day. Mother reported event to Health Dept and physician''''s office.


Changed on 12/8/2009

VAERS ID: 241188 Before After
VAERS Form:
Age:19.0
Sex:Male
Location:Indiana
Vaccinated:2005-07-07
Onset:2005-07-08
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR U1656AC / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Rash, RASH, ASTHENIA

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

Write-up: On 7/8, client noted /"rash "rash at base of neck increasing in intensity on left shoulder/" shoulder" with small 1/4/" 1/4" diameter raised areas. Denies rapid heartbeat or respiratory symptoms, itching. On 7/11 rash less intense, client has been /"very "very tired, sleeping an e"xtra extra 2-3 hours per day. Mother reported event to Health Dept and physician''''s physician''s office.


Changed on 4/7/2010

VAERS ID: 241188 Before After
VAERS Form:
Age:19.0
Sex:Male
Location:Indiana
Vaccinated:2005-07-07
Onset:2005-07-08
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1656AC / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Rash

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

Write-up: On 7/8, client noted "rash at base of neck increasing in intensity on left shoulder" with small 1/4" diameter raised areas. Denies rapid heartbeat or respiratory symptoms, itching. On 7/11 rash less intense, client has been "very tired, sleeping an extra 2-3 hours per day. Mother reported event to Health Dept and physician''s office.


Changed on 5/14/2017

VAERS ID: 241188 Before After
VAERS Form:
Age:19.0
Sex:Male
Location:Indiana
Vaccinated:2005-07-07
Onset:2005-07-08
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1656AC / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Rash

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

Write-up: On 7/8, client noted "rash at base of neck increasing in intensity on left shoulder" with small 1/4" diameter raised areas. Denies rapid heartbeat or respiratory symptoms, itching. On 7/11 rash less intense, client has been "very tired, sleeping an extra 2-3 hours per day. Mother reported event to Health Dept and physician''s office.


Changed on 9/14/2017

VAERS ID: 241188 Before After
VAERS Form:(blank) 1
Age:19.0
Sex:Male
Location:Indiana
Vaccinated:2005-07-07
Onset:2005-07-08
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1656AC / 0 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Rash

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

Write-up: On 7/8, client noted "rash at base of neck increasing in intensity on left shoulder" with small 1/4" diameter raised areas. Denies rapid heartbeat or respiratory symptoms, itching. On 7/11 rash less intense, client has been "very tired, sleeping an extra 2-3 hours per day. Mother reported event to Health Dept and physician''s office.


Changed on 2/14/2018

VAERS ID: 241188 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Indiana
Vaccinated:2005-07-07
Onset:2005-07-08
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1656AC / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Rash

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

Write-up: On 7/8, client noted "rash at base of neck increasing in intensity on left shoulder" with small 1/4" diameter raised areas. Denies rapid heartbeat or respiratory symptoms, itching. On 7/11 rash less intense, client has been "very tired, sleeping an extra 2-3 hours per day. Mother reported event to Health Dept and physician''s office.


Changed on 6/14/2018

VAERS ID: 241188 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Indiana
Vaccinated:2005-07-07
Onset:2005-07-08
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1656AC / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Rash

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

Write-up: On 7/8, client noted "rash at base of neck increasing in intensity on left shoulder" with small 1/4" diameter raised areas. Denies rapid heartbeat or respiratory symptoms, itching. On 7/11 rash less intense, client has been "very tired, sleeping an extra 2-3 hours per day. Mother reported event to Health Dept and physician''s office.


Changed on 8/14/2018

VAERS ID: 241188 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Indiana
Vaccinated:2005-07-07
Onset:2005-07-08
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1656AC / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Rash

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

Write-up: On 7/8, client noted "rash at base of neck increasing in intensity on left shoulder" with small 1/4" diameter raised areas. Denies rapid heartbeat or respiratory symptoms, itching. On 7/11 rash less intense, client has been "very tired, sleeping an extra 2-3 hours per day. Mother reported event to Health Dept and physician''s office.


Changed on 9/14/2018

VAERS ID: 241188 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Indiana
Vaccinated:2005-07-07
Onset:2005-07-08
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1656AC / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Rash

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

Write-up: On 7/8, client noted "rash at base of neck increasing in intensity on left shoulder" with small 1/4" diameter raised areas. Denies rapid heartbeat or respiratory symptoms, itching. On 7/11 rash less intense, client has been "very tired, sleeping an extra 2-3 hours per day. Mother reported event to Health Dept and physician''s office.


Changed on 10/14/2018

VAERS ID: 241188 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Indiana
Vaccinated:2005-07-07
Onset:2005-07-08
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1656AC / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Rash

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

Write-up: On 7/8, client noted "rash at base of neck increasing in intensity on left shoulder" with small 1/4" diameter raised areas. Denies rapid heartbeat or respiratory symptoms, itching. On 7/11 rash less intense, client has been "very tired, sleeping an extra 2-3 hours per day. Mother reported event to Health Dept and physician''s office.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=241188&WAYBACKHISTORY=ON


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