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This is VAERS ID 241203

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 241203
VAERS Form:
Age:18.0
Sex:Male
Location:New York
Vaccinated:2005-07-06
Onset:2005-07-06
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1493AC / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: EDEMA INJECT SITE, DIZZINESS, FEVER, ATAXIA, DELIRIUM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: All blood work / urinalysis - normal.
CDC 'Split Type':

Write-up: high fever, delerious,went to the emergency room no symptoms at second day followup


Changed on 12/8/2009

VAERS ID: 241203 Before After
VAERS Form:
Age:18.0
Sex:Male
Location:New York
Vaccinated:2005-07-06
Onset:2005-07-06
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR U1493AC / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Delirium, Difficulty in walking, Dizziness, Headache, Hypokinesia, Hypotonia, Injection site hypersensitivity, Injection site oedema, Injection site pain, Muscle spasms, Pyrexia, Tremor, Balance disorder, EDEMA INJECT SITE, DIZZINESS, FEVER, ATAXIA, DELIRIUM

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: All blood work / urinalysis - normal.
CDC 'Split Type':

Write-up: high fever, delerious,went to the emergency room no symptoms at second day followup followup. Muscle spams - collapsed on floor, couldn''t walk. Still recovering.


Changed on 4/7/2010

VAERS ID: 241203 Before After
VAERS Form:
Age:18.0
Sex:Male
Location:New York
Vaccinated:2005-07-06
Onset:2005-07-06
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1493AC / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Delirium, Difficulty in walking, Dizziness, Headache, Hypokinesia, Hypotonia, Injection site hypersensitivity, Injection site oedema, Injection site pain, Muscle spasms, Pyrexia, Tremor, Balance disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: All blood work / urinalysis - normal.
CDC 'Split Type':

Write-up: high fever, delerious,went to the emergency room no symptoms at second day followup. Muscle spams - collapsed on floor, couldn''t walk. Still recovering.


Changed on 5/14/2017

VAERS ID: 241203 Before After
VAERS Form:
Age:18.0
Sex:Male
Location:New York
Vaccinated:2005-07-06
Onset:2005-07-06
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1493AC / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Delirium, Difficulty in walking, Dizziness, Headache, Hypokinesia, Hypotonia, Injection site hypersensitivity, Injection site oedema, Injection site pain, Muscle spasms, Pyrexia, Tremor, Balance disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: All blood work / urinalysis - normal.
CDC 'Split Type':

Write-up: high fever, delerious,went to the emergency room no symptoms at second day followup. Muscle spams - collapsed on floor, couldn''t walk. Still recovering.


Changed on 9/14/2017

VAERS ID: 241203 Before After
VAERS Form:(blank) 1
Age:18.0
Sex:Male
Location:New York
Vaccinated:2005-07-06
Onset:2005-07-06
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1493AC / 0 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Delirium, Difficulty in walking, Dizziness, Headache, Hypokinesia, Hypotonia, Injection site hypersensitivity, Injection site oedema, Injection site pain, Muscle spasms, Pyrexia, Tremor, Balance disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: All blood work / urinalysis - normal.
CDC 'Split Type':

Write-up: high fever, delerious,went to the emergency room no symptoms at second day followup. Muscle spams - collapsed on floor, couldn''t walk. Still recovering.


Changed on 2/14/2018

VAERS ID: 241203 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:New York
Vaccinated:2005-07-06
Onset:2005-07-06
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1493AC / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Delirium, Difficulty in walking, Dizziness, Headache, Hypokinesia, Hypotonia, Injection site hypersensitivity, Injection site oedema, Injection site pain, Muscle spasms, Pyrexia, Tremor, Balance disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: All blood work / urinalysis - normal.
CDC 'Split Type':

Write-up: high fever, delerious,went to the emergency room no symptoms at second day followup. Muscle spams - collapsed on floor, couldn''t walk. Still recovering.


Changed on 6/14/2018

VAERS ID: 241203 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:New York
Vaccinated:2005-07-06
Onset:2005-07-06
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1493AC / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Delirium, Difficulty in walking, Dizziness, Headache, Hypokinesia, Hypotonia, Injection site hypersensitivity, Injection site oedema, Injection site pain, Muscle spasms, Pyrexia, Tremor, Balance disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: All blood work / urinalysis - normal.
CDC 'Split Type':

Write-up: high fever, delerious,went to the emergency room no symptoms at second day followup. Muscle spams - collapsed on floor, couldn''t walk. Still recovering.


Changed on 8/14/2018

VAERS ID: 241203 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:New York
Vaccinated:2005-07-06
Onset:2005-07-06
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1493AC / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Delirium, Difficulty in walking, Dizziness, Headache, Hypokinesia, Hypotonia, Injection site hypersensitivity, Injection site oedema, Injection site pain, Muscle spasms, Pyrexia, Tremor, Balance disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: All blood work / urinalysis - normal.
CDC 'Split Type':

Write-up: high fever, delerious,went to the emergency room no symptoms at second day followup. Muscle spams - collapsed on floor, couldn''t walk. Still recovering.


Changed on 9/14/2018

VAERS ID: 241203 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:New York
Vaccinated:2005-07-06
Onset:2005-07-06
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1493AC / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Delirium, Difficulty in walking, Dizziness, Headache, Hypokinesia, Hypotonia, Injection site hypersensitivity, Injection site oedema, Injection site pain, Muscle spasms, Pyrexia, Tremor, Balance disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: All blood work / urinalysis - normal.
CDC 'Split Type':

Write-up: high fever, delerious,went to the emergency room no symptoms at second day followup. Muscle spams - collapsed on floor, couldn''t walk. Still recovering.


Changed on 10/14/2018

VAERS ID: 241203 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:New York
Vaccinated:2005-07-06
Onset:2005-07-06
Submitted:2005-07-11
Entered:2005-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1493AC / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Delirium, Difficulty in walking, Dizziness, Headache, Hypokinesia, Hypotonia, Injection site hypersensitivity, Injection site oedema, Injection site pain, Muscle spasms, Pyrexia, Tremor, Balance disorder

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: All blood work / urinalysis - normal.
CDC 'Split Type':

Write-up: high fever, delerious,went to the emergency room no symptoms at second day followup. Muscle spams - collapsed on floor, couldn''t walk. Still recovering.

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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=241203&WAYBACKHISTORY=ON


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