VAERS 851368
SANOFI PASTEUR · MENINGOCOCCAL CONJUGATE (MENACTRA) · Charge U6565AB
- Staat
- CA
- Alter
- 17,0
- Geschlecht
- M
- Eingang
- 05.01.2021
- Impfdatum
- 02.12.2019
- Beginn
- 03.12.2019
- Tage bis Beginn
- 1,0
- Dosis
- UNK
- Route/Site
- - / RA
Symptomtext
symptoms more likely related to elevated immune response secondary multiple Innervation Zones (IZ); Information has been received from FDA (VAERS ID 851368) on 20-NOV-2020. This spontaneous report as received from a Registered Nurse refers to a 17 year old male patient. The patient had no illness at time of vaccination; his medical history, concurrent conditions and concomitant therapies were not reported. On 02-DEC-2019 at 14:00, the patient was vaccinated with hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) (first dose on the left deltoid, lot # 1621926 has been verified to be valid, expiration date not reported, but upon internal validation established as 28-NOV-2021; dosage information not provided) for prophylaxis.Other vaccines received for prophylaxis on the same date included hepatitis a vaccine, inactivated (VAQTA) (first dose on the right deltoid, lot # S010727 has been verified to be valid, expiration date not reported, but upon internal validation established as 26-JUL-2020; dosage information not provided), measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live Albumin status rHA (recombinant Human albumin) (M-M-R II) (second dose on the left arm, lot # S006051 has been verified to be valid, expiration date not reported, but upon internal validation established as 27-FEB-2021; dosage information not provided), varicella virus vaccine live (oka/merck) (VARIVAX) (first dose on the right arm, lot # S021321 has been verified to be valid, expiration date not reported, but upon internal validation established as 09-JUL-2021; dosage information not provided), influenza virus vaccine (unspecified) (trade name not reported but reported as manufactured by GSK) (first dose on the left deltoid, lot # 36633; expiration date and dosage information not provided), poliovirus vaccine inactivated (unspecified)(trade name not reported but reported as manufactured by Sanofi) (third dose on the left arm, lot # PIF491M; expiration date and dosage information not provided), meningococcal b vaccine (unspecified) (trade name not reported but reported as manufactured by GSK) (first dose on the left deltoid, lot # ABXA12BA; expiration date and dosage information not provided), meningococcal acyw conj vaccine (dip toxoid) (MENACTRA) (third dose on the left arm, lot # U6565AB; expiration date and dosage information not provided) and diphtheria toxoid, pertussis acellular vaccine (unspecified), tetanus toxoid (trade name not reported but reported as manufactured by Sanofi) (first dose on the right deltoid, lot # U63079A; expiration date and dosage information not provided). On 03-DEC-2019, the patient woke up a 2 AM with body aches, frontal headache, photophobia, some chest pain, throat pain and initially tachycardia. The patient was hospitalized, and the reporting nurse assessed the symptoms were more likely related to an elevated immune response secondary to multiple innervation zones (IZ) (immune system disorder). The patient's white blood cell count was 16.6 (units not provided), a lateral neck x ray showed normal soft tissue and all other tests (unspecified were normal). The patient was hospitalized for one day and on an unspecified date in December 2019, the patient recovered from the immune system disorder. The causality assessment between the event and the suspect therapies was not provided. Follow-up information has been received on 29-DEC-2020. As of 29-DEC-2020, all telephone attempts trying to obtain additional information have been unsuccessful. The nurse who filled out the VAERS form and typically handled all these questions just retired. The reporter unable to locate any patient information that was over a year old.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Chest pain
- Hospital-Tage
- 1,0
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- VAQTA SYRINGE (DEVICE); GARDASIL 9 SYRINGE (DEVICE);
- Allergien
- -
- Vorherige Impfungen
- -