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This is VAERS ID 241611

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 241611
VAERS Form:
Age:18.0
Sex:Female
Location:Indiana
Vaccinated:2005-07-19
Onset:2005-07-19
Submitted:2005-07-21
Entered:2005-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1659AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: RASH, URTICARIA, PRURITUS

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: 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 itchi"ng 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 no


Changed on 12/8/2009

VAERS ID: 241611 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Indiana
Vaccinated:2005-07-19
Onset:2005-07-19
Submitted:2005-07-21
Entered:2005-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, AVENTIS PASTEUR U1659AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pruritus, Rash, Urticaria, RASH, URTICARIA, PRURITUS

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: 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 itchi"ng 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 client''s mother reports this morning that the itching and hives are improving but no not totally resolved. Patient also received tuberculosis skin test at the same time.


Changed on 4/7/2010

VAERS ID: 241611 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Indiana
Vaccinated:2005-07-19
Onset:2005-07-19
Submitted:2005-07-21
Entered:2005-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1659AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pruritus, 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: 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.


Changed on 5/14/2017

VAERS ID: 241611 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Indiana
Vaccinated:2005-07-19
Onset:2005-07-19
Submitted:2005-07-21
Entered:2005-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1659AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pruritus, 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: 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.


Changed on 9/14/2017

VAERS ID: 241611 Before After
VAERS Form:(blank) 1
Age:18.0
Sex:Female
Location:Indiana
Vaccinated:2005-07-19
Onset:2005-07-19
Submitted:2005-07-21
Entered:2005-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1659AA / 0 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pruritus, 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: 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.


Changed on 2/14/2018

VAERS ID: 241611 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Indiana
Vaccinated:2005-07-19
Onset:2005-07-19
Submitted:2005-07-21
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

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: 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.


Changed on 6/14/2018

VAERS ID: 241611 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Indiana
Vaccinated:2005-07-19
Onset:2005-07-19
Submitted:2005-07-21
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

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: 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.


Changed on 8/14/2018

VAERS ID: 241611 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Indiana
Vaccinated:2005-07-19
Onset:2005-07-19
Submitted:2005-07-21
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

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: 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.


Changed on 9/14/2018

VAERS ID: 241611 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Indiana
Vaccinated:2005-07-19
Onset:2005-07-19
Submitted:2005-07-21
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

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: 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.


Changed on 10/14/2018

VAERS ID: 241611 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Indiana
Vaccinated:2005-07-19
Onset:2005-07-19
Submitted:2005-07-21
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

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: 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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