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This is VAERS ID 271273

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

271273
VAERS Form:
Age:13.0
Gender:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / -
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: No adverse effect, 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a health professional and a pharmacist concerning a 13 year old patient who on an unspecified date was vaccinated with a dose of Zostavax. Unspecified medical attention was sought. The patient was not experiencing any kn"ow symptoms. it was reported that the error was not a result of product confusion. The patient''''s vaccination history reported to include a first dose of varicella virus vaccine live on an unspecified date, but not a second dose of varicella virus vaccine


Changed on 12/8/2009

271273 Before After
VAERS Form:
Age:13.0
Gender:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / -
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: No adverse effect, 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0612USA04046

Write-up:Information has been received from a health professional and a pharmacist concerning a 13 year old patient who on an unspecified date was vaccinated with a dose of Zostavax. Unspecified medical attention was sought. The patient was not experiencing any kn"ow know symptoms. it was reported that the error was not a result of product confusion. The patient''''s patient''s vaccination history reported to include a first dose of varicella virus vaccine live on an unspecified date, but not a second dose of varicella virus vaccine live. There was no product quality complaint involved. No further information was available. Additional information has been requested.


Changed on 6/2/2010

271273 Before After
VAERS Form:
Age:13.0
Gender:Unknown Female
Location:Unknown Ohio
Vaccinated:0000-00-00 2006-12-26
Onset:0000-00-00 2006-12-26
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / - UN
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / - UN

Administered by: Other      Purchased by: Other
Symptoms: No adverse effect, Wrong drug administered

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0612USA04046

Write-up:Information has been received from a health professional and a pharmacist concerning a 13 year old patient who on an unspecified date was vaccinated with a dose of Zostavax. Unspecified medical attention was sought. The patient was not experiencing any know symptoms. it was reported that the error was not a result of product confusion. The patient''s vaccination history reported to include a first dose of varicella virus vaccine live on an unspecified date, but not a second dose of varicella virus vaccine live. There was no product quality complaint involved. No further information was available. Additional information has been requested. This is in follow-up to report(s) previously submitted on 1/16/2007. Information has beenreceived from a health professional, a pharmacist and a physician concerning a 13 year old female who on 26-DEC-2006 was vaccinated with a dose of ZOSTAVAX (Merck) (reported to be an overdose) instead of GARDASIL. The treating physician reported that the patient was vaccinated with a dose of ZOSTAVAX (Merck) instead of a dose of VARIVAX (Merck). Medical attention was sought. One week after vaccination, on 02-JAN-2007, the patient developed what the physician described as a zoster rash, which was also reported to be a "raging case of chicken pox" by the office manager. It was reported that the zoster rash did not cause itching, but the patient experiecned general fatigue and pain in the muscles and joints of the knees, hips and shoulders. The patient was started on an unspecified antiviral therapy. It was reported that the physician would try to swab the lesion but the patient had already left the office. On an unspecified date the rash cleared but as of 24-JAN-2007 the muscle and joint pain continued. The patient was scheduled to have a follow up appointment on 29-JAN-2007. The patient''s vaccination history was reorted to include a first dose of VARIVAX (Merck)on an unspecified date, but not a second dose of VARIVAX (Merck). It was reported that the administering employee did not follow the 5


Changed on 1/4/2011

271273 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Ohio
Vaccinated:2006-12-26
Onset:2006-12-26
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: No adverse effect, 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0612USA04046

Write-up:Information has been received from a health professional and a pharmacist concerning a 13 year old patient who on an unspecified date was vaccinated with a dose of Zostavax. Unspecified medical attention was sought. The patient was not experiencing any know symptoms. it was reported that the error was not a result of product confusion. The patient''s vaccination history reported to include a first dose of varicella virus vaccine live on an unspecified date, but not a second dose of varicella virus vaccine live. There was no product quality complaint involved. No further information was available. Additional information has been requested. This is in follow-up to report(s) previously submitted on 1/16/2007. Information has beenreceived from a health professional, a pharmacist and a physician concerning a 13 year old female who on 26-DEC-2006 was vaccinated with a dose of ZOSTAVAX (Merck) (reported to be an overdose) instead of GARDASIL. The treating physician reported that the patient was vaccinated with a dose of ZOSTAVAX (Merck) instead of a dose of VARIVAX (Merck). Medical attention was sought. One week after vaccination, on 02-JAN-2007, the patient developed what the physician described as a zoster rash, which was also reported to be a "raging case of chicken pox" by the office manager. It was reported that the zoster rash did not cause itching, but the patient experiecned general fatigue and pain in the muscles and joints of the knees, hips and shoulders. The patient was started on an unspecified antiviral therapy. It was reported that the physician would try to swab the lesion but the patient had already left the office. On an unspecified date the rash cleared but as of 24-JAN-2007 the muscle and joint pain continued. The patient was scheduled to have a follow up appointment on 29-JAN-2007. The patient''s vaccination history was reorted to include a first dose of VARIVAX (Merck)on an unspecified date, but not a second dose of VARIVAX (Merck). It was reported that the administering employee did not follow the 5 R''s, did not ask for assistance from another health care professional and "did not know what she was doing." It was confirmed that this was not a case of product confusion. There was no product quality complaint involved. No further information was available. Additional information has been requested.


Changed on 6/14/2014

271273 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Ohio
Vaccinated:2006-12-26
Onset:2006-12-26
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: No adverse effect, 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0612USA04046

Write-up:Information has been received from a health professional and a pharmacist concerning a 13 year old patient who on an unspecified date was vaccinated with a dose of Zostavax. Unspecified medical attention was sought. The patient was not experiencing any know symptoms. it was reported that the error was not a result of product confusion. The patient''s vaccination history reported to include a first dose of varicella virus vaccine live on an unspecified date, but not a second dose of varicella virus vaccine live. There was no product quality complaint involved. No further information was available. Additional information has been requested. This is in follow-up to report(s) previously submitted on 1/16/2007. Information has beenreceived from a health professional, a pharmacist and a physician concerning a 13 year old female who on 26-DEC-2006 was vaccinated with a dose of ZOSTAVAX (Merck) (reported to be an overdose) instead of GARDASIL. The treating physician reported that the patient was vaccinated with a dose of ZOSTAVAX (Merck) instead of a dose of VARIVAX (Merck). Medical attention was sought. One week after vaccination, on 02-JAN-2007, the patient developed what the physician described as a zoster rash, which was also reported to be a "raging case of chicken pox" by the office manager. It was reported that the zoster rash did not cause itching, but the patient experiecned general fatigue and pain in the muscles and joints of the knees, hips and shoulders. The patient was started on an unspecified antiviral therapy. It was reported that the physician would try to swab the lesion but the patient had already left the office. On an unspecified date the rash cleared but as of 24-JAN-2007 the muscle and joint pain continued. The patient was scheduled to have a follow up appointment on 29-JAN-2007. The patient''s vaccination history was reorted to include a first dose of VARIVAX (Merck)on an unspecified date, but not a second dose of VARIVAX (Merck). It was reported that the administering employee did not follow the 5 R''s, did not ask for assistance from another health care professional and "did not know what she was doing." It was confirmed that this was not a case of product confusion. There was no product quality complaint involved. No further information was available. Additional information has been requested.


Changed on 5/14/2017

271273 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Ohio
Vaccinated:2006-12-26
Onset:2006-12-26
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: No adverse effect, 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0612USA04046

Write-up:Information has been received from a health professional and a pharmacist concerning a 13 year old patient who on an unspecified date was vaccinated with a dose of Zostavax. Unspecified medical attention was sought. The patient was not experiencing any know symptoms. it was reported that the error was not a result of product confusion. The patient''s vaccination history reported to include a first dose of varicella virus vaccine live on an unspecified date, but not a second dose of varicella virus vaccine live. There was no product quality complaint involved. No further information was available. Additional information has been requested. This is in follow-up to report(s) previously submitted on 1/16/2007. Information has beenreceived from a health professional, a pharmacist and a physician concerning a 13 year old female who on 26-DEC-2006 was vaccinated with a dose of ZOSTAVAX (Merck) (reported to be an overdose) instead of GARDASIL. The treating physician reported that the patient was vaccinated with a dose of ZOSTAVAX (Merck) instead of a dose of VARIVAX (Merck). Medical attention was sought. One week after vaccination, on 02-JAN-2007, the patient developed what the physician described as a zoster rash, which was also reported to be a "raging case of chicken pox" by the office manager. It was reported that the zoster rash did not cause itching, but the patient experiecned general fatigue and pain in the muscles and joints of the knees, hips and shoulders. The patient was started on an unspecified antiviral therapy. It was reported that the physician would try to swab the lesion but the patient had already left the office. On an unspecified date the rash cleared but as of 24-JAN-2007 the muscle and joint pain continued. The patient was scheduled to have a follow up appointment on 29-JAN-2007. The patient''s vaccination history was reorted to include a first dose of VARIVAX (Merck)on an unspecified date, but not a second dose of VARIVAX (Merck). It was reported that the administering employee did not follow the 5 R''s, did not ask for assistance from another health care professional and "did not know what she was doing." It was confirmed that this was not a case of product confusion. There was no product quality complaint involved. No further information was available. Additional information has been requested.


Changed on 9/14/2017

271273 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Ohio
Vaccinated:2006-12-26
Onset:2006-12-26
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: No adverse effect, 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0612USA04046

Write-up:Information has been received from a health professional and a pharmacist concerning a 13 year old patient who on an unspecified date was vaccinated with a dose of Zostavax. Unspecified medical attention was sought. The patient was not experiencing any know symptoms. it was reported that the error was not a result of product confusion. The patient''s vaccination history reported to include a first dose of varicella virus vaccine live on an unspecified date, but not a second dose of varicella virus vaccine live. There was no product quality complaint involved. No further information was available. Additional information has been requested. This is in follow-up to report(s) previously submitted on 1/16/2007. Information has beenreceived from a health professional, a pharmacist and a physician concerning a 13 year old female who on 26-DEC-2006 was vaccinated with a dose of ZOSTAVAX (Merck) (reported to be an overdose) instead of GARDASIL. The treating physician reported that the patient was vaccinated with a dose of ZOSTAVAX (Merck) instead of a dose of VARIVAX (Merck). Medical attention was sought. One week after vaccination, on 02-JAN-2007, the patient developed what the physician described as a zoster rash, which was also reported to be a "raging case of chicken pox" by the office manager. It was reported that the zoster rash did not cause itching, but the patient experiecned general fatigue and pain in the muscles and joints of the knees, hips and shoulders. The patient was started on an unspecified antiviral therapy. It was reported that the physician would try to swab the lesion but the patient had already left the office. On an unspecified date the rash cleared but as of 24-JAN-2007 the muscle and joint pain continued. The patient was scheduled to have a follow up appointment on 29-JAN-2007. The patient''s vaccination history was reorted to include a first dose of VARIVAX (Merck)on an unspecified date, but not a second dose of VARIVAX (Merck). It was reported that the administering employee did not follow the 5 R''s, did not ask for assistance from another health care professional and "did not know what she was doing." It was confirmed that this was not a case of product confusion. There was no product quality complaint involved. No further information was available. Additional information has been requested.


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