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This is VAERS ID 236858

(NOTE: This result is from the 12/30/2006 version of the VAERS database)

Case Details

VAERS ID: 236858 (history)  
Form: Version .0  
Age: 19.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2005-04-11
Onset:2005-04-12
   Days after vaccination:1
Submitted: 2005-04-25
   Days after onset:13
Entered: 2005-05-02
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, U1526AC / - LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: ASTHENIA, CHILLS, FEVER, HEADACHE, MALAISE
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: HA, weakness, malaise, fatigue, fever, and chills per pt.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20061230&IDNUMBER=236858


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