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This is VAERS ID 241302

Case Details

VAERS ID: 241302 (history)  
Form: Version 1.0  
Age: 19.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2005-06-16
Onset:2005-06-16
   Days after vaccination:0
Submitted: 2005-06-27
   Days after onset:11
Entered: 2005-07-13
   Days after submission:16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1589AA / UNK RA / IM

Administered by: Public       Purchased by: Private
Symptoms: Hypoaesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (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: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine given on 06/16/2005, that night developed fever of 103.4. Febrile through the night, on 06/17/2005 patient described he could not feel his legs. Saw the doctor that evening of 06/17/2005. Took Tylenol as directed. Fever was not present by noon on 06/18/2005. Pt also reported shortness of breath. By Sunday 06/19/2005 he had no symptoms.


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