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This is VAERS ID 49911

Case Details

VAERS ID: 49911 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Georgia  
Vaccinated:1993-02-01
Onset:1993-02-01
   Days after vaccination:0
Submitted: 1993-02-10
   Days after onset:9
Entered: 1993-02-16
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / CONNAUGHT LABORATORIES - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Dyspepsia, Rash
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific dysfunction (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Donnatal & Maalox
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO4663

Write-up: rash; erythematous rash on arms to tips of fingers, then on neck & face 1 hr p/vax; also had GI upset about 1/2 hr p/inject;


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