National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 241222

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 241222
VAERS Form:
Age:14.0
Sex:Male
Location:Virginia
Vaccinated:2005-06-29
Onset:2005-06-30
Submitted:2005-07-07
Entered:2005-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1575AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1110P / 0 RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: EDEMA INJECT SITE, HYSN INJECT SITE, PRURITUS

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: PPD, Aventis, C2677AA, ID, LA, 0 previously; Augmentin
Current Illness: Furuncle
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Local swelling, redness and itching on left upper arm. Was improving when seen in office on 7/1/05.


Changed on 12/8/2009

VAERS ID: 241222 Before After
VAERS Form:
Age:14.0
Sex:Male
Location:Virginia
Vaccinated:2005-06-29
Onset:2005-06-30
Submitted:2005-07-07
Entered:2005-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR U1575AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) VARICELLA (VARIVAX) / MERCK & CO. INC. 1110P / 0 RA / SC

Administered by: Private      Purchased by: Unknown Private
Symptoms: Injection site erythema, Pruritus, Injection site swelling, EDEMA INJECT SITE, HYSN INJECT SITE, PRURITUS

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: PPD, Aventis, C2677AA, ID, LA, 0 previously; Augmentin
Current Illness: Furuncle
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Local swelling, redness and itching on left upper arm. Was improving when seen in office on 7/1/05.


Changed on 4/7/2010

VAERS ID: 241222 Before After
VAERS Form:
Age:14.0
Sex:Male
Location:Virginia
Vaccinated:2005-06-29
Onset:2005-06-30
Submitted:2005-07-07
Entered:2005-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1575AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1110P / 0 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Pruritus, Injection site swelling

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: PPD, Aventis, C2677AA, ID, LA, 0 previously; Augmentin
Current Illness: Furuncle
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Local swelling, redness and itching on left upper arm. Was improving when seen in office on 7/1/05.


Changed on 5/14/2017

VAERS ID: 241222 Before After
VAERS Form:
Age:14.0
Sex:Male
Location:Virginia
Vaccinated:2005-06-29
Onset:2005-06-30
Submitted:2005-07-07
Entered:2005-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1575AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1110P / 0 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Pruritus, Injection site swelling

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: PPD, Aventis, C2677AA, ID, LA, 0 previously; Augmentin
Current Illness: Furuncle
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Local swelling, redness and itching on left upper arm. Was improving when seen in office on 7/1/05.


Changed on 9/14/2017

VAERS ID: 241222 Before After
VAERS Form:(blank) 1
Age:14.0
Sex:Male
Location:Virginia
Vaccinated:2005-06-29
Onset:2005-06-30
Submitted:2005-07-07
Entered:2005-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 0 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1110P / 0 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Pruritus, Injection site swelling

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: PPD, Aventis, C2677AA, ID, LA, 0 previously; Augmentin
Current Illness: Furuncle
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Local swelling, redness and itching on left upper arm. Was improving when seen in office on 7/1/05.


Changed on 2/14/2018

VAERS ID: 241222 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Virginia
Vaccinated:2005-06-29
Onset:2005-06-30
Submitted:2005-07-07
Entered:2005-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1110P / 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Pruritus, Injection site swelling

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: PPD, Aventis, C2677AA, ID, LA, 0 previously; Augmentin
Current Illness: Furuncle
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Local swelling, redness and itching on left upper arm. Was improving when seen in office on 7/1/05.


Changed on 6/14/2018

VAERS ID: 241222 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Virginia
Vaccinated:2005-06-29
Onset:2005-06-30
Submitted:2005-07-07
Entered:2005-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1110P / 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Pruritus, Injection site swelling

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: PPD, Aventis, C2677AA, ID, LA, 0 previously; Augmentin
Current Illness: Furuncle
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Local swelling, redness and itching on left upper arm. Was improving when seen in office on 7/1/05.


Changed on 8/14/2018

VAERS ID: 241222 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Virginia
Vaccinated:2005-06-29
Onset:2005-06-30
Submitted:2005-07-07
Entered:2005-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1110P / 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Pruritus, Injection site swelling

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: PPD, Aventis, C2677AA, ID, LA, 0 previously; Augmentin
Current Illness: Furuncle
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Local swelling, redness and itching on left upper arm. Was improving when seen in office on 7/1/05.


Changed on 9/14/2018

VAERS ID: 241222 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Virginia
Vaccinated:2005-06-29
Onset:2005-06-30
Submitted:2005-07-07
Entered:2005-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1110P / 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Pruritus, Injection site swelling

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: PPD, Aventis, C2677AA, ID, LA, 0 previously; Augmentin
Current Illness: Furuncle
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Local swelling, redness and itching on left upper arm. Was improving when seen in office on 7/1/05.


Changed on 10/14/2018

VAERS ID: 241222 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Virginia
Vaccinated:2005-06-29
Onset:2005-06-30
Submitted:2005-07-07
Entered:2005-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1575AA / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1110P / 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Pruritus, Injection site swelling

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: PPD, Aventis, C2677AA, ID, LA, 0 previously; Augmentin
Current Illness: Furuncle
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up: Local swelling, redness and itching on left upper arm. Was improving when seen in office on 7/1/05.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=241222&WAYBACKHISTORY=ON


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