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This is VAERS ID 241509

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 241509
VAERS Form:
Age:19.0
Sex:Male
Location:Pennsylvania
Vaccinated:2005-06-10
Onset:2005-06-25
Submitted:2005-07-18
Entered:2005-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1494AB / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: GUILLAIN BARRE SYND, SPEECH DIS, MYASTHENIA

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tubersol
Current Illness:
Preexisting Conditions: The patient has no significant past medical history and did not have any illnesses at the time of vaccination.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Initial report received from a health care professional on 7/14/05. An 18 year old male patient received an IM left deltoid injection of Menactra, lot number U1494AB, and an ID right forearm injection of Tubersol 5 TU., lot number C2116AA, on 6/10/05. 15"days later he experienced intermittent tingling in his feet. He was seen by a physician on 6/26/05 and was admitted to the hospital to rule out Guillain-Barre Syndrome. He was released from the hospital on 6/29/05, but was re-admitted on 7/1/05 with facia


Changed on 12/8/2009

VAERS ID: 241509 Before After
VAERS Form:
Age:19.0 18.0
Sex:Male
Location:Pennsylvania
Vaccinated:2005-06-10
Onset:2005-06-25
Submitted:2005-07-18
Entered:2005-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, SANOFI PASTEUR U1494AB / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Dysarthria, Guillain-Barre syndrome, Muscular weakness, GUILLAIN BARRE SYND, SPEECH DIS, MYASTHENIA

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tubersol
Current Illness:
Preexisting Conditions: The patient has no significant past medical history and did not have any illnesses at the time of vaccination.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 200501360

Write-up: Initial report received from a health care professional on 7/14/05. An 18 year old male patient received an IM left deltoid injection of Menactra, lot number U1494AB, and an ID right forearm injection of Tubersol 5 TU., lot number C2116AA, on 6/10/05. 15"days 15 days later he experienced intermittent tingling in his feet. He was seen by a physician on 6/26/05 and was admitted to the hospital to rule out Guillain-Barre Syndrome. He was released from the hospital on 6/29/05, but was re-admitted on 7/1/05 with facia facial weakness and slurred speech. He was diagnosed with Guillain-Barre Syndrome. The patient received treatment with plasmaphoresis and was discharged on 7/8/05. As per the reporter, the patient''s recovery status is unknown.


Changed on 4/7/2010

VAERS ID: 241509 Before After
VAERS Form:
Age:18.0
Sex:Male
Location:Pennsylvania
Vaccinated:2005-06-10
Onset:2005-06-25
Submitted:2005-07-18
Entered:2005-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1494AB / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Dysarthria, Guillain-Barre syndrome, Muscular weakness

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tubersol
Current Illness:
Preexisting Conditions: The patient has no significant past medical history and did not have any illnesses at the time of vaccination.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501360

Write-up: Initial report received from a health care professional on 7/14/05. An 18 year old male patient received an IM left deltoid injection of Menactra, lot number U1494AB, and an ID right forearm injection of Tubersol 5 TU., lot number C2116AA, on 6/10/05. 15 days later he experienced intermittent tingling in his feet. He was seen by a physician on 6/26/05 and was admitted to the hospital to rule out Guillain-Barre Syndrome. He was released from the hospital on 6/29/05, but was re-admitted on 7/1/05 with facial weakness and slurred speech. He was diagnosed with Guillain-Barre Syndrome. The patient received treatment with plasmaphoresis and was discharged on 7/8/05. As per the reporter, the patient''s recovery status is unknown.


Changed on 6/14/2014

VAERS ID: 241509 Before After
VAERS Form:
Age:18.0
Sex:Male
Location:Pennsylvania
Vaccinated:2005-06-10
Onset:2005-06-25
Submitted:2005-07-18
Entered:2005-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1494AB / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Dysarthria, Guillain-Barre syndrome, Muscular weakness

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tubersol
Current Illness:
Preexisting Conditions: The patient has no significant past medical history and did not have any illnesses at the time of vaccination.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501360

Write-up: Initial report received from a health care professional on 7/14/05. An 18 year old male patient received an IM left deltoid injection of Menactra, lot number U1494AB, and an ID right forearm injection of Tubersol 5 TU., lot number C2116AA, on 6/10/05. 15 days later he experienced intermittent tingling in his feet. He was seen by a physician on 6/26/05 and was admitted to the hospital to rule out Guillain-Barre Syndrome. He was released from the hospital on 6/29/05, but was re-admitted on 7/1/05 with facial weakness and slurred speech. He was diagnosed with Guillain-Barre Syndrome. The patient received treatment with plasmaphoresis and was discharged on 7/8/05. As per the reporter, the patient''s recovery status is unknown.


Changed on 3/14/2015

VAERS ID: 241509 Before After
VAERS Form:
Age:18.0
Sex:Male
Location:Pennsylvania
Vaccinated:2005-06-10
Onset:2005-06-25
Submitted:2005-07-18
Entered:2005-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1494AB / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Dysarthria, Guillain-Barre syndrome, Muscular weakness

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tubersol
Current Illness:
Preexisting Conditions: The patient has no significant past medical history and did not have any illnesses at the time of vaccination.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501360

Write-up: Initial report received from a health care professional on 7/14/05. An 18 year old male patient received an IM left deltoid injection of Menactra, lot number U1494AB, and an ID right forearm injection of Tubersol 5 TU., lot number C2116AA, on 6/10/05. 15 days later he experienced intermittent tingling in his feet. He was seen by a physician on 6/26/05 and was admitted to the hospital to rule out Guillain-Barre Syndrome. He was released from the hospital on 6/29/05, but was re-admitted on 7/1/05 with facial weakness and slurred speech. He was diagnosed with Guillain-Barre Syndrome. The patient received treatment with plasmaphoresis and was discharged on 7/8/05. As per the reporter, the patient''s recovery status is unknown.


Changed on 9/14/2017

VAERS ID: 241509 Before After
VAERS Form:(blank) 1
Age:18.0
Sex:Male
Location:Pennsylvania
Vaccinated:2005-06-10
Onset:2005-06-25
Submitted:2005-07-18
Entered:2005-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1494AB / 0 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Dysarthria, Guillain-Barre syndrome, Muscular weakness

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tubersol
Current Illness:
Preexisting Conditions: The patient has no significant past medical history and did not have any illnesses at the time of vaccination.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501360

Write-up: Initial report received from a health care professional on 7/14/05. An 18 year old male patient received an IM left deltoid injection of Menactra, lot number U1494AB, and an ID right forearm injection of Tubersol 5 TU., lot number C2116AA, on 6/10/05. 15 days later he experienced intermittent tingling in his feet. He was seen by a physician on 6/26/05 and was admitted to the hospital to rule out Guillain-Barre Syndrome. He was released from the hospital on 6/29/05, but was re-admitted on 7/1/05 with facial weakness and slurred speech. He was diagnosed with Guillain-Barre Syndrome. The patient received treatment with plasmaphoresis and was discharged on 7/8/05. As per the reporter, the patient''s recovery status is unknown.


Changed on 2/14/2018

VAERS ID: 241509 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Pennsylvania
Vaccinated:2005-06-10
Onset:2005-06-25
Submitted:2005-07-18
Entered:2005-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1494AB / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Dysarthria, Guillain-Barre syndrome, Muscular weakness

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tubersol
Current Illness:
Preexisting Conditions: The patient has no significant past medical history and did not have any illnesses at the time of vaccination.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501360

Write-up: Initial report received from a health care professional on 7/14/05. An 18 year old male patient received an IM left deltoid injection of Menactra, lot number U1494AB, and an ID right forearm injection of Tubersol 5 TU., lot number C2116AA, on 6/10/05. 15 days later he experienced intermittent tingling in his feet. He was seen by a physician on 6/26/05 and was admitted to the hospital to rule out Guillain-Barre Syndrome. He was released from the hospital on 6/29/05, but was re-admitted on 7/1/05 with facial weakness and slurred speech. He was diagnosed with Guillain-Barre Syndrome. The patient received treatment with plasmaphoresis and was discharged on 7/8/05. As per the reporter, the patient''s recovery status is unknown.


Changed on 6/14/2018

VAERS ID: 241509 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Pennsylvania
Vaccinated:2005-06-10
Onset:2005-06-25
Submitted:2005-07-18
Entered:2005-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1494AB / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Dysarthria, Guillain-Barre syndrome, Muscular weakness

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tubersol
Current Illness:
Preexisting Conditions: The patient has no significant past medical history and did not have any illnesses at the time of vaccination.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501360

Write-up: Initial report received from a health care professional on 7/14/05. An 18 year old male patient received an IM left deltoid injection of Menactra, lot number U1494AB, and an ID right forearm injection of Tubersol 5 TU., lot number C2116AA, on 6/10/05. 15 days later he experienced intermittent tingling in his feet. He was seen by a physician on 6/26/05 and was admitted to the hospital to rule out Guillain-Barre Syndrome. He was released from the hospital on 6/29/05, but was re-admitted on 7/1/05 with facial weakness and slurred speech. He was diagnosed with Guillain-Barre Syndrome. The patient received treatment with plasmaphoresis and was discharged on 7/8/05. As per the reporter, the patient''s recovery status is unknown.


Changed on 8/14/2018

VAERS ID: 241509 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Pennsylvania
Vaccinated:2005-06-10
Onset:2005-06-25
Submitted:2005-07-18
Entered:2005-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1494AB / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Dysarthria, Guillain-Barre syndrome, Muscular weakness

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tubersol
Current Illness:
Preexisting Conditions: The patient has no significant past medical history and did not have any illnesses at the time of vaccination.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501360

Write-up: Initial report received from a health care professional on 7/14/05. An 18 year old male patient received an IM left deltoid injection of Menactra, lot number U1494AB, and an ID right forearm injection of Tubersol 5 TU., lot number C2116AA, on 6/10/05. 15 days later he experienced intermittent tingling in his feet. He was seen by a physician on 6/26/05 and was admitted to the hospital to rule out Guillain-Barre Syndrome. He was released from the hospital on 6/29/05, but was re-admitted on 7/1/05 with facial weakness and slurred speech. He was diagnosed with Guillain-Barre Syndrome. The patient received treatment with plasmaphoresis and was discharged on 7/8/05. As per the reporter, the patient''s recovery status is unknown.


Changed on 9/14/2018

VAERS ID: 241509 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Pennsylvania
Vaccinated:2005-06-10
Onset:2005-06-25
Submitted:2005-07-18
Entered:2005-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1494AB / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Dysarthria, Guillain-Barre syndrome, Muscular weakness

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tubersol
Current Illness:
Preexisting Conditions: The patient has no significant past medical history and did not have any illnesses at the time of vaccination.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501360

Write-up: Initial report received from a health care professional on 7/14/05. An 18 year old male patient received an IM left deltoid injection of Menactra, lot number U1494AB, and an ID right forearm injection of Tubersol 5 TU., lot number C2116AA, on 6/10/05. 15 days later he experienced intermittent tingling in his feet. He was seen by a physician on 6/26/05 and was admitted to the hospital to rule out Guillain-Barre Syndrome. He was released from the hospital on 6/29/05, but was re-admitted on 7/1/05 with facial weakness and slurred speech. He was diagnosed with Guillain-Barre Syndrome. The patient received treatment with plasmaphoresis and was discharged on 7/8/05. As per the reporter, the patient''s recovery status is unknown.


Changed on 10/14/2018

VAERS ID: 241509 Before After
VAERS Form:1
Age:18.0
Sex:Male
Location:Pennsylvania
Vaccinated:2005-06-10
Onset:2005-06-25
Submitted:2005-07-18
Entered:2005-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1494AB / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Dysarthria, Guillain-Barre syndrome, Muscular weakness

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tubersol
Current Illness:
Preexisting Conditions: The patient has no significant past medical history and did not have any illnesses at the time of vaccination.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200501360

Write-up: Initial report received from a health care professional on 7/14/05. An 18 year old male patient received an IM left deltoid injection of Menactra, lot number U1494AB, and an ID right forearm injection of Tubersol 5 TU., lot number C2116AA, on 6/10/05. 15 days later he experienced intermittent tingling in his feet. He was seen by a physician on 6/26/05 and was admitted to the hospital to rule out Guillain-Barre Syndrome. He was released from the hospital on 6/29/05, but was re-admitted on 7/1/05 with facial weakness and slurred speech. He was diagnosed with Guillain-Barre Syndrome. The patient received treatment with plasmaphoresis and was discharged on 7/8/05. As per the reporter, the patient''s recovery status is unknown.

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