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This is VAERS ID 236926

(NOTE: This result is from the 4/7/2010 version of the VAERS database)

Case Details

VAERS ID: 236926 (history)  
Form: Version .0  
Age: 14.0  
Sex: Male  
Location: Ohio  
Vaccinated:2005-04-25
Onset:2005-04-26
   Days after vaccination:1
Submitted: 2005-04-28
   Days after onset:2
Entered: 2005-05-04
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1493AC / - RA / IM
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / AVENTIS PASTEUR U1221BA / - LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Recurrent hives. Started 04/26/05- seen in office for hives 04/28/05. RX for Claritin and predinisone taper.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20100407&IDNUMBER=236926


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