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This is VAERS ID 241261

Case Details

VAERS ID: 241261 (history)  
Form: Version 1.0  
Age: 23.0  
Sex: Female  
Location: Michigan  
Vaccinated:2005-07-01
Onset:2005-07-04
   Days after vaccination:3
Submitted: 2005-07-12
   Days after onset:8
Entered: 2005-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1657AA / 1 LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Headache, Musculoskeletal stiffness, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 7/4/05 Pt states c/o HA, stiff neck, joint pain, stomach pain and fever. Had MD visit 7/7/05. For these symptoms. HA persisted until 7/11/05. Fever was 102 at high point. Pt called the health dept to get advice regarding sx.


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