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This is VAERS ID 26802

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 26802
VAERS Form:
Age:28.3
Sex:Female
Location:Delaware
Vaccinated:1990-10-24
Onset:1990-10-25
Submitted:1990-11-19
Entered:1990-12-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENOMUNE A/C/Y/W / CONNAUGHT LABS - / - LA / -

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, NEUROPATHY, PAIN, ASTHENIA, PARESTHESIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PCN, Codeine allergies
Allergies:
Diagnostic Lab Data: Post vaccine Peripheral Polyneuropathy
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/Tetanus developed paresthesia of hands & feet w/numbness, fatigue, weakness, aches, fever 99.9.


Changed on 12/8/2009

VAERS ID: 26802 Before After
VAERS Form:
Age:28.3
Sex:Female
Location:Delaware
Vaccinated:1990-10-24
Onset:1990-10-25
Submitted:1990-11-19
Entered:1990-12-03 1990-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENOMUNE A/C/Y/W MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABS CONNAUGHT LABORATORIES - / - LA / -

Administered by: Private      Purchased by: Unknown Other
Symptoms: Asthenia, Neuropathy, Pain, Paraesthesia, Pyrexia, FEVER, NEUROPATHY, PAIN, ASTHENIA, PARESTHESIA

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PCN, Codeine allergies
Allergies:
Diagnostic Lab Data: Post vaccine Peripheral Polyneuropathy
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/Tetanus developed paresthesia of hands & feet w/numbness, fatigue, weakness, aches, fever 99.9.


Changed on 2/14/2017

VAERS ID: 26802 Before After
VAERS Form:
Age:28.3 28.0
Sex:Female
Location:Delaware
Vaccinated:1990-10-24
Onset:1990-10-25
Submitted:1990-11-19
Entered:1990-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES - / - LA / -

Administered by: Private      Purchased by: Other
Symptoms: Asthenia, Neuropathy, Pain, Paraesthesia, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PCN, Codeine allergies
Allergies:
Diagnostic Lab Data: Post vaccine Peripheral Polyneuropathy
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/Tetanus developed paresthesia of hands & feet w/numbness, fatigue, weakness, aches, fever 99.9.


Changed on 5/14/2017

VAERS ID: 26802 Before After
VAERS Form:
Age:28.0
Sex:Female
Location:Delaware
Vaccinated:1990-10-24
Onset:1990-10-25
Submitted:1990-11-19
Entered:1990-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES - / - LA / -

Administered by: Private      Purchased by: Other
Symptoms: Asthenia, Neuropathy, Pain, Paraesthesia, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: PCN, Codeine allergies
Allergies:
Diagnostic Lab Data: Post vaccine Peripheral Polyneuropathy
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/Tetanus developed paresthesia of hands & feet w/numbness, fatigue, weakness, aches, fever 99.9.


Changed on 9/14/2017

VAERS ID: 26802 Before After
VAERS Form:(blank) 1
Age:28.0
Sex:Female
Location:Delaware
Vaccinated:1990-10-24
Onset:1990-10-25
Submitted:1990-11-19
Entered:1990-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES - / - UNK LA / -

Administered by: Private      Purchased by: Other
Symptoms: Asthenia, Neuropathy, Pain, Paraesthesia, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: PCN, Codeine allergies
Allergies:
Diagnostic Lab Data: Post vaccine Peripheral Polyneuropathy
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/Tetanus developed paresthesia of hands & feet w/numbness, fatigue, weakness, aches, fever 99.9.


Changed on 2/14/2018

VAERS ID: 26802 Before After
VAERS Form:1
Age:28.0
Sex:Female
Location:Delaware
Vaccinated:1990-10-24
Onset:1990-10-25
Submitted:1990-11-19
Entered:1990-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES - / UNK LA / -

Administered by: Private      Purchased by: Other
Symptoms: Asthenia, Neuropathy, Pain, Paraesthesia, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: PCN, Codeine allergies
Allergies:
Diagnostic Lab Data: Post vaccine Peripheral Polyneuropathy
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/Tetanus developed paresthesia of hands & feet w/numbness, fatigue, weakness, aches, fever 99.9.


Changed on 6/14/2018

VAERS ID: 26802 Before After
VAERS Form:1
Age:28.0
Sex:Female
Location:Delaware
Vaccinated:1990-10-24
Onset:1990-10-25
Submitted:1990-11-19
Entered:1990-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES - / UNK LA / -

Administered by: Private      Purchased by: Other
Symptoms: Asthenia, Neuropathy, Pain, Paraesthesia, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: PCN, Codeine allergies
Allergies:
Diagnostic Lab Data: Post vaccine Peripheral Polyneuropathy
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/Tetanus developed paresthesia of hands & feet w/numbness, fatigue, weakness, aches, fever 99.9.


Changed on 8/14/2018

VAERS ID: 26802 Before After
VAERS Form:1
Age:28.0
Sex:Female
Location:Delaware
Vaccinated:1990-10-24
Onset:1990-10-25
Submitted:1990-11-19
Entered:1990-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES - / UNK LA / -

Administered by: Private      Purchased by: Other
Symptoms: Asthenia, Neuropathy, Pain, Paraesthesia, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: PCN, Codeine allergies
Allergies:
Diagnostic Lab Data: Post vaccine Peripheral Polyneuropathy
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/Tetanus developed paresthesia of hands & feet w/numbness, fatigue, weakness, aches, fever 99.9.


Changed on 9/14/2018

VAERS ID: 26802 Before After
VAERS Form:1
Age:28.0
Sex:Female
Location:Delaware
Vaccinated:1990-10-24
Onset:1990-10-25
Submitted:1990-11-19
Entered:1990-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES - / UNK LA / -

Administered by: Private      Purchased by: Other
Symptoms: Asthenia, Neuropathy, Pain, Paraesthesia, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: PCN, Codeine allergies
Allergies:
Diagnostic Lab Data: Post vaccine Peripheral Polyneuropathy
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/Tetanus developed paresthesia of hands & feet w/numbness, fatigue, weakness, aches, fever 99.9.


Changed on 10/14/2018

VAERS ID: 26802 Before After
VAERS Form:1
Age:28.0
Sex:Female
Location:Delaware
Vaccinated:1990-10-24
Onset:1990-10-25
Submitted:1990-11-19
Entered:1990-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES - / UNK LA / -

Administered by: Private      Purchased by: Other
Symptoms: Asthenia, Neuropathy, Pain, Paraesthesia, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: PCN, Codeine allergies
Allergies:
Diagnostic Lab Data: Post vaccine Peripheral Polyneuropathy
CDC 'Split Type':

Write-up: Pt vaccinated with MMR/Tetanus developed paresthesia of hands & feet w/numbness, fatigue, weakness, aches, fever 99.9.

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