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This is VAERS ID 272274

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

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

Administered by: Private      Purchased by: Unknown
Symptoms: Inappropriate schedule of drug administration, Pyrexia, Wrong drug administered

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

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 c


Changed on 12/8/2009

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

Administered by: Private      Purchased by: Unknown Private
Symptoms: Inappropriate schedule of drug administration, Pyrexia, Wrong drug administered

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


Changed on 7/7/2013

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

Administered by: Private      Purchased by: Private
Symptoms: Inappropriate schedule of drug administration, Pyrexia, Wrong drug administered

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
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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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=272274&WAYBACKHISTORY=ON


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