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This is VAERS ID 272274

Case Details

VAERS ID: 272274 (history)  
Form: Version 1.0  
Age: 1.0  
Gender: Female  
Location: North Carolina  
Vaccinated:2006-12-15
Onset:2006-12-15
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:61
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR 427U7AA / 1 - / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / UNK - / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 - / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / 1 - / SC

Administered by: Private       Purchased by: Private
Symptoms: Inappropriate schedule of drug administration, Pyrexia, Wrong drug administered
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Test, Date, Value, Unit, Normal Range, Comment-body temp, 12/17/06, slight fever
CDC Split Type: WAES0612USA02803

Write-up: Initial and follow up information has been received from a physician and an office manager concerning a 12 month old white female patient with no past medical history who on 15-DEC-2006 was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Concomitant vaccinations on the same day included a first dose of measles-mumps-rubella vaccine (MSD) SC into the left leg, Hib conj vaccine (OMPC) (manufacturer unknown) and a first dose of varicella virus vaccine live (MSD) SC into the left leg. Other concomitant vaccinations included a first dose of influenza virus split virion 3v vaccine inactivated (FLUZONE) (lot# 427U7AA) IM into the right leg. It was reported that the patient received HPV rL1 6 11 16 18 VLP vaccine (yeast) by accident. She was supposed to receive a dose of pneumococcal 4 6B 9V 14 18C 23F conj vaccine (CRM197) (PREVNAR). The reporter stated that the products were clearly labeled; there was not a confusion of products. It was "lack of education" of the medical assistant working on the office. The parents reported the patient had slight fever on 16-DEC-2006 (also reported as the 17-DEC-2006). Subsequently, the patient was seen in the office on 18-DEC-2006 and had recovered from slight fever. There were no there reported problems or "any other adverse events." Additional information is not expected.


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