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This is VAERS ID 241584

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 241584
VAERS Form:
Age:19.0
Sex:Male
Location:Illinois
Vaccinated:2005-07-16
Onset:2005-07-16
Submitted:2005-07-18
Entered:2005-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1684AA / 0 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: FEVER, RASH, URTICARIA, MALAISE, PHOTOSENSITIVITY

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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up: Dr had called health dept to report that pt had low grade fever (100.9); feeling of malaise, faint rash, urticaria, photosensitivity.


Changed on 12/8/2009

VAERS ID: 241584 Before After
VAERS Form:
Age:19.0
Sex:Male
Location:Illinois
Vaccinated:2005-07-16
Onset:2005-07-16
Submitted:2005-07-18
Entered:2005-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR U1684AA / 0 RA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Malaise, Photosensitivity reaction, Pyrexia, Rash, Urticaria, FEVER, RASH, URTICARIA, MALAISE, PHOTOSENSITIVITY

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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up: Dr had called health dept to report that pt had low grade fever (100.9); feeling of malaise, faint rash, urticaria, photosensitivity.


Changed on 4/7/2010

VAERS ID: 241584 Before After
VAERS Form:
Age:19.0
Sex:Male
Location:Illinois
Vaccinated:2005-07-16
Onset:2005-07-16
Submitted:2005-07-18
Entered:2005-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1684AA / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Malaise, Photosensitivity reaction, Pyrexia, Rash, Urticaria

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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up: Dr had called health dept to report that pt had low grade fever (100.9); feeling of malaise, faint rash, urticaria, photosensitivity.


Changed on 5/14/2017

VAERS ID: 241584 Before After
VAERS Form:
Age:19.0
Sex:Male
Location:Illinois
Vaccinated:2005-07-16
Onset:2005-07-16
Submitted:2005-07-18
Entered:2005-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1684AA / 0 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Malaise, Photosensitivity reaction, Pyrexia, Rash, Urticaria

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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up: Dr had called health dept to report that pt had low grade fever (100.9); feeling of malaise, faint rash, urticaria, photosensitivity.


Changed on 9/14/2017

VAERS ID: 241584 Before After
VAERS Form:(blank) 1
Age:19.0
Sex:Male
Location:Illinois
Vaccinated:2005-07-16
Onset:2005-07-16
Submitted:2005-07-18
Entered:2005-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1684AA / 0 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Malaise, Photosensitivity reaction, Pyrexia, Rash, Urticaria

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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up: Dr had called health dept to report that pt had low grade fever (100.9); feeling of malaise, faint rash, urticaria, photosensitivity.


Changed on 2/14/2018

VAERS ID: 241584 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Illinois
Vaccinated:2005-07-16
Onset:2005-07-16
Submitted:2005-07-18
Entered:2005-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1684AA / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Malaise, Photosensitivity reaction, Pyrexia, Rash, Urticaria

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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up: Dr had called health dept to report that pt had low grade fever (100.9); feeling of malaise, faint rash, urticaria, photosensitivity.


Changed on 6/14/2018

VAERS ID: 241584 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Illinois
Vaccinated:2005-07-16
Onset:2005-07-16
Submitted:2005-07-18
Entered:2005-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1684AA / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Malaise, Photosensitivity reaction, Pyrexia, Rash, Urticaria

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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up: Dr had called health dept to report that pt had low grade fever (100.9); feeling of malaise, faint rash, urticaria, photosensitivity.


Changed on 8/14/2018

VAERS ID: 241584 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Illinois
Vaccinated:2005-07-16
Onset:2005-07-16
Submitted:2005-07-18
Entered:2005-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1684AA / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Malaise, Photosensitivity reaction, Pyrexia, Rash, Urticaria

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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up: Dr had called health dept to report that pt had low grade fever (100.9); feeling of malaise, faint rash, urticaria, photosensitivity.


Changed on 9/14/2018

VAERS ID: 241584 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Illinois
Vaccinated:2005-07-16
Onset:2005-07-16
Submitted:2005-07-18
Entered:2005-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1684AA / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Malaise, Photosensitivity reaction, Pyrexia, Rash, Urticaria

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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up: Dr had called health dept to report that pt had low grade fever (100.9); feeling of malaise, faint rash, urticaria, photosensitivity.


Changed on 10/14/2018

VAERS ID: 241584 Before After
VAERS Form:1
Age:19.0
Sex:Male
Location:Illinois
Vaccinated:2005-07-16
Onset:2005-07-16
Submitted:2005-07-18
Entered:2005-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1684AA / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Malaise, Photosensitivity reaction, Pyrexia, Rash, Urticaria

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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up: Dr had called health dept to report that pt had low grade fever (100.9); feeling of malaise, faint rash, urticaria, photosensitivity.

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