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This is VAERS ID 233765

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 233765
VAERS Form:
Age:15.0
Sex:Male
Location:Massachusetts
Vaccinated:2004-09-07
Onset:2004-10-15
Submitted:2005-02-08
Entered:2005-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / AVENTIS PASTEUR, 307AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: VOMIT, PAIN ABDO, DIARRHEA, ILEITIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data: CT scan/Colonoscopy consistent with Crohn''''s diagnosis.
CDC 'Split Type':

Write-up: Patient developed Crohn''''s Disease about 10/15/04. Started with diarrhea, vomiting, and abdominal pain. Treatment has been Imovan, Prednisone, and Flagyl.


Changed on 12/8/2009

VAERS ID: 233765 Before After
VAERS Form:
Age:15.0
Sex:Male
Location:Massachusetts
Vaccinated:2004-09-07
Onset:2004-10-15
Submitted:2005-02-08
Entered:2005-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / AVENTIS PASTEUR, AVENTIS PASTEUR 307AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Abdominal pain, Crohn's disease, Diarrhoea, Vomiting, VOMIT, PAIN ABDO, DIARRHEA, ILEITIS

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data: CT scan/Colonoscopy consistent with Crohn''''s Crohn''s diagnosis.
CDC 'Split Type':

Write-up: Patient developed Crohn''''s Crohn''s Disease about 10/15/04. Started with diarrhea, vomiting, and abdominal pain. Treatment has been Imovan, Prednisone, and Flagyl.


Changed on 2/14/2017

VAERS ID: 233765 Before After
VAERS Form:
Age:15.0
Sex:Male
Location:Massachusetts
Vaccinated:2004-09-07
Onset:2004-10-15
Submitted:2005-02-08
Entered:2005-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / AVENTIS PASTEUR SANOFI PASTEUR 307AA / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Crohn's disease, Diarrhoea, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data: CT scan/Colonoscopy consistent with Crohn''s diagnosis.
CDC 'Split Type':

Write-up: Patient developed Crohn''s Disease about 10/15/04. Started with diarrhea, vomiting, and abdominal pain. Treatment has been Imovan, Prednisone, and Flagyl.


Changed on 9/14/2017

VAERS ID: 233765 Before After
VAERS Form:(blank) 1
Age:15.0
Sex:Male
Location:Massachusetts
Vaccinated:2004-09-07
Onset:2004-10-15
Submitted:2005-02-08
Entered:2005-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / SANOFI PASTEUR 307AA / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Crohn's disease, Diarrhoea, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data: CT scan/Colonoscopy consistent with Crohn''s diagnosis.
CDC 'Split Type':

Write-up: Patient developed Crohn''s Disease about 10/15/04. Started with diarrhea, vomiting, and abdominal pain. Treatment has been Imovan, Prednisone, and Flagyl.


Changed on 2/14/2018

VAERS ID: 233765 Before After
VAERS Form:1
Age:15.0
Sex:Male
Location:Massachusetts
Vaccinated:2004-09-07
Onset:2004-10-15
Submitted:2005-02-08
Entered:2005-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / SANOFI PASTEUR 307AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Crohn's disease, Diarrhoea, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data: CT scan/Colonoscopy consistent with Crohn''s diagnosis.
CDC 'Split Type':

Write-up: Patient developed Crohn''s Disease about 10/15/04. Started with diarrhea, vomiting, and abdominal pain. Treatment has been Imovan, Prednisone, and Flagyl.


Changed on 6/14/2018

VAERS ID: 233765 Before After
VAERS Form:1
Age:15.0
Sex:Male
Location:Massachusetts
Vaccinated:2004-09-07
Onset:2004-10-15
Submitted:2005-02-08
Entered:2005-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / SANOFI PASTEUR 307AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Crohn's disease, Diarrhoea, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data: CT scan/Colonoscopy consistent with Crohn''s diagnosis.
CDC 'Split Type':

Write-up: Patient developed Crohn''s Disease about 10/15/04. Started with diarrhea, vomiting, and abdominal pain. Treatment has been Imovan, Prednisone, and Flagyl.


Changed on 8/14/2018

VAERS ID: 233765 Before After
VAERS Form:1
Age:15.0
Sex:Male
Location:Massachusetts
Vaccinated:2004-09-07
Onset:2004-10-15
Submitted:2005-02-08
Entered:2005-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / SANOFI PASTEUR 307AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Crohn's disease, Diarrhoea, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data: CT scan/Colonoscopy consistent with Crohn''s diagnosis.
CDC 'Split Type':

Write-up: Patient developed Crohn''s Disease about 10/15/04. Started with diarrhea, vomiting, and abdominal pain. Treatment has been Imovan, Prednisone, and Flagyl.


Changed on 9/14/2018

VAERS ID: 233765 Before After
VAERS Form:1
Age:15.0
Sex:Male
Location:Massachusetts
Vaccinated:2004-09-07
Onset:2004-10-15
Submitted:2005-02-08
Entered:2005-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / SANOFI PASTEUR 307AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Crohn's disease, Diarrhoea, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data: CT scan/Colonoscopy consistent with Crohn''s diagnosis.
CDC 'Split Type':

Write-up: Patient developed Crohn''s Disease about 10/15/04. Started with diarrhea, vomiting, and abdominal pain. Treatment has been Imovan, Prednisone, and Flagyl.


Changed on 10/14/2018

VAERS ID: 233765 Before After
VAERS Form:1
Age:15.0
Sex:Male
Location:Massachusetts
Vaccinated:2004-09-07
Onset:2004-10-15
Submitted:2005-02-08
Entered:2005-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / SANOFI PASTEUR 307AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Crohn's disease, Diarrhoea, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data: CT scan/Colonoscopy consistent with Crohn''s diagnosis.
CDC 'Split Type':

Write-up: Patient developed Crohn''s Disease about 10/15/04. Started with diarrhea, vomiting, and abdominal pain. Treatment has been Imovan, Prednisone, and Flagyl.


Changed on 12/24/2020

VAERS ID: 233765 Before After
VAERS Form:1
Age:15.0
Sex:Male
Location:Massachusetts
Vaccinated:2004-09-07
Onset:2004-10-15
Submitted:2005-02-08
Entered:2005-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / SANOFI PASTEUR 307AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Crohn's disease, Diarrhoea, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data: CT scan/Colonoscopy consistent with Crohn''s diagnosis.
CDC 'Split Type':

Write-up: Patient developed Crohn''s Disease about 10/15/04. Started with diarrhea, vomiting, and abdominal pain. Treatment has been Imovan, Prednisone, and Flagyl.


Changed on 12/30/2020

VAERS ID: 233765 Before After
VAERS Form:1
Age:15.0
Sex:Male
Location:Massachusetts
Vaccinated:2004-09-07
Onset:2004-10-15
Submitted:2005-02-08
Entered:2005-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / SANOFI PASTEUR 307AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Crohn's disease, Diarrhoea, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data: CT scan/Colonoscopy consistent with Crohn''s diagnosis.
CDC 'Split Type':

Write-up: Patient developed Crohn''s Disease about 10/15/04. Started with diarrhea, vomiting, and abdominal pain. Treatment has been Imovan, Prednisone, and Flagyl.


Changed on 5/7/2021

VAERS ID: 233765 Before After
VAERS Form:1
Age:15.0
Sex:Male
Location:Massachusetts
Vaccinated:2004-09-07
Onset:2004-10-15
Submitted:2005-02-08
Entered:2005-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / SANOFI PASTEUR 307AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Crohn's disease, Diarrhoea, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data: CT scan/Colonoscopy consistent with Crohn''s diagnosis.
CDC 'Split Type':

Write-up: Patient developed Crohn''s Disease about 10/15/04. Started with diarrhea, vomiting, and abdominal pain. Treatment has been Imovan, Prednisone, and Flagyl.


Changed on 5/14/2021

VAERS ID: 233765 Before After
VAERS Form:1
Age:15.0
Sex:Male
Location:Massachusetts
Vaccinated:2004-09-07
Onset:2004-10-15
Submitted:2005-02-08
Entered:2005-02-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MEN: MENINGOCOCCAL (MENOMUNE) / SANOFI PASTEUR 307AA / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Crohn's disease, Diarrhoea, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: Depression
Allergies:
Diagnostic Lab Data: CT scan/Colonoscopy consistent with Crohn''s diagnosis.
CDC 'Split Type':

Write-up: Patient developed Crohn''s Disease about 10/15/04. Started with diarrhea, vomiting, and abdominal pain. Treatment has been Imovan, Prednisone, and Flagyl.

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