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This is VAERS ID 241611

Case Details

VAERS ID: 241611 (history)  
Form: Version 1.0  
Age: 18.0  
Sex: Female  
Location: Indiana  
Vaccinated:2005-07-19
Onset:2005-07-19
   Days after vaccination:0
Submitted: 2005-07-21
   Days after onset:2
Entered: 2005-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1659AA / 1 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Patient received Menactra and PPD on 7/19/05. Patient reports itching began evening of 7/19/05, around waist line with progression to rash and hives on neck, stomach and groin the following morning. No respiratory difficulties reported. Hives and itching increased in severity during the day. She saw the nurse practitioner at approximately 3 p.m. and received Decadron 8 mg IM, a Medrol dose pack and Zyrtec p.r.n. The client''s mother reports this morning that the itching and hives are improving but not totally resolved. Patient also received tuberculosis skin test at the same time.


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