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This is VAERS ID 263024

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

263024
VAERS Form:
Age:1.5
Gender:Male
Location:North Carolina
Vaccinated:2006-09-11
Onset:0000-00-00
Submitted:2006-09-11
Entered:2006-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / AVENTIS PASTEUR, INC. U1751AB / 3 RL / IM
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / - - / -
PNC: PNEUMO, 7-VALENT (PREVNAR) / LEDERLE LABORATORIES B08682H / 2 LL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Medication error

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? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Wrong vaccine was given Gardasil was given instead of Hep A by mistake.


Changed on 12/8/2009

263024 Before After
VAERS Form:
Age:1.5
Gender:Male
Location:North Carolina
Vaccinated:2006-09-11
Onset:0000-00-00
Submitted:2006-09-11
Entered:2006-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / AVENTIS PASTEUR, INC. SANOFI PASTEUR U1751AB / 3 RL / IM
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. - / - - UN / - UN
PNC: PNEUMO, 7-VALENT (PREVNAR) PNEUMO (PREVNAR) / LEDERLE LABORATORIES WYETH PHARMACEUTICALS, INC B08682H / 2 LL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Medication error, Wrong drug administered

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? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Wrong vaccine was given Gardasil was given instead of Hep A by mistake.


Changed on 3/2/2010

263024 Before After
VAERS Form:
Age:1.5
Gender:Male
Location:North Carolina
Vaccinated:2006-09-11
Onset:0000-00-00
Submitted:2006-09-11
Entered:2006-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U1751AB / 3 RL / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC B08682H / 2 LL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Wrong drug administered

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? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Wrong vaccine was given Gardasil was given instead of Hep A by mistake.


Changed on 4/7/2010

263024 Before After
VAERS Form:
Age:1.5
Gender:Male
Location:North Carolina
Vaccinated:2006-09-11
Onset:0000-00-00
Submitted:2006-09-11
Entered:2006-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U1751AB / 3 RL / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B08682H / 2 LL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Wrong drug administered

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? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Wrong vaccine was given Gardasil was given instead of Hep A by mistake.


Changed on 8/31/2010

263024 Before After
VAERS Form:
Age:1.5
Gender:Male
Location:North Carolina
Vaccinated:2006-09-11
Onset:0000-00-00
Submitted:2006-09-11
Entered:2006-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U1751AB / 3 RL / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH B08682H / 2 LL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Wrong drug administered

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? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Wrong vaccine was given Gardasil was given instead of Hep A by mistake.


Changed on 1/4/2011

263024 Before After
VAERS Form:
Age:1.5
Gender:Male
Location:North Carolina
Vaccinated:2006-09-11
Onset:0000-00-00
Submitted:2006-09-11
Entered:2006-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U1751AB / 3 RL / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08682H / 2 LL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Wrong drug administered

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? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Wrong vaccine was given Gardasil was given instead of Hep A by mistake.


Changed on 4/13/2011

263024 Before After
VAERS Form:
Age:1.5
Gender:Male
Location:North Carolina
Vaccinated:2006-09-11
Onset:0000-00-00
Submitted:2006-09-11
Entered:2006-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U1751AB / 3 RL / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08682H / 2 LL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Wrong drug administered

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? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Wrong vaccine was given Gardasil was given instead of Hep A by mistake.


Changed on 5/13/2011

263024 Before After
VAERS Form:
Age:1.5
Gender:Male
Location:North Carolina
Vaccinated:2006-09-11
Onset:0000-00-00
Submitted:2006-09-11
Entered:2006-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U1751AB / 3 RL / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08682H / 2 LL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Wrong drug administered

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? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Wrong vaccine was given Gardasil was given instead of Hep A by mistake.


Changed on 6/11/2011

263024 Before After
VAERS Form:
Age:1.5
Gender:Male
Location:North Carolina
Vaccinated:2006-09-11
Onset:0000-00-00
Submitted:2006-09-11
Entered:2006-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U1751AB / 3 RL / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08682H / 2 LL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Wrong drug administered

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? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Wrong vaccine was given Gardasil was given instead of Hep A by mistake.


Changed on 2/14/2017

263024 Before After
VAERS Form:
Age:1.5 1.51
Gender:Male
Location:North Carolina
Vaccinated:2006-09-11
Onset:0000-00-00
Submitted:2006-09-11
Entered:2006-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U1751AB / 3 RL / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08682H / 2 LL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Wrong drug administered

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? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Wrong vaccine was given Gardasil was given instead of Hep A by mistake.


Changed on 9/14/2017

263024 Before After
VAERS Form:(blank) 1
Age:1.51
Gender:Male
Location:North Carolina
Vaccinated:2006-09-11
Onset:0000-00-00
Submitted:2006-09-11
Entered:2006-09-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U1751AB / 3 4 RL / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08682H / 2 3 LL / IM

Administered by: Private      Purchased by: Unknown
Symptoms:

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? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Wrong vaccine was given Gardasil was given instead of Hep A by mistake.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=263024&WAYBACKHISTORY=ON


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