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This is VAERS ID 270291

Case Details

VAERS ID: 270291 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: Unknown  
Vaccinated:2006-12-28
Onset:2007-01-07
   Days after vaccination:10
Submitted: 2007-01-09
   Days after onset:2
Entered: 2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / UNK RL / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1974AB / UNK LL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre 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: not provided
Current Illness: unknown
Preexisting Conditions: not provided
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Reporter states 19 year old female received Menactra on 12/28/06. On Jan. 7, 2007, patient reported tingling sensation from feet to thighs. Returned to school. Will be seen by physician.


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