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This is VAERS ID 270065

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

270065
VAERS Form:
Age:17.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-28
Onset:2006-01-02
Submitted:2007-01-03
Entered:2007-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / - RA / -
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1974AB / - LA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Headache, Hypoaesthesia, Muscle rigidity, Neck pain

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

Write-up:17 year old female received Menactra on 12/28/06. On 1/2/06, patient reported pain in neck and head with non-specific bilateral numbness sensation and pain present in lower extremities (thighs, calves, feet (soles)). Bilateral knee and ankle tendon reflex"es normal. Also bilateral calf tightness reported.


Changed on 12/8/2009

270065 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-28
Onset:2006-01-02 2007-01-02
Submitted:2007-01-03
Entered:2007-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / - RA / -
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1974AB / - LA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Headache, Hypoaesthesia, Muscle rigidity, Neck pain

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

Write-up:17 year old female received Menactra on 12/28/06. On 1/2/06, patient reported pain in neck and head with non-specific bilateral numbness sensation and pain present in lower extremities (thighs, calves, feet (soles)). Bilateral knee and ankle tendon reflex"es reflexes normal. Also bilateral calf tightness reported.


Changed on 4/7/2010

270065 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-28
Onset:2007-01-02
Submitted:2007-01-03
Entered:2007-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / - RA / -
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1974AB / - LA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Headache, Hypoaesthesia, Muscle rigidity, Neck pain

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

Write-up:17 year old female received Menactra on 12/28/06. On 1/2/06, patient reported pain in neck and head with non-specific bilateral numbness sensation and pain present in lower extremities (thighs, calves, feet (soles)). Bilateral knee and ankle tendon reflexes normal. Also bilateral calf tightness reported.


Changed on 9/14/2017

270065 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-28
Onset:2007-01-02
Submitted:2007-01-03
Entered:2007-01-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / - UNK RA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1974AB / - UNK LA / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Headache, Hypoaesthesia, Muscle rigidity, Neck pain

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

Write-up:17 year old female received Menactra on 12/28/06. On 1/2/06, patient reported pain in neck and head with non-specific bilateral numbness sensation and pain present in lower extremities (thighs, calves, feet (soles)). Bilateral knee and ankle tendon reflexes normal. Also bilateral calf tightness reported.


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