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This is VAERS ID 272911

Case Details

VAERS ID: 272911 (history)  
Form: Version 1.0  
Age: 1.1  
Gender: Female  
Location: New York  
Vaccinated:2007-02-17
Onset:2007-02-17
   Days after vaccination:0
Submitted: 2007-02-22
   Days after onset:5
Entered: 2007-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC14B008AA / 2 RA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 2 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1948AA / 2 RA / -

Administered by: Private       Purchased by: Public
Symptoms: No adverse effect, Wrong drug administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: none-realized Dtap was given instead of Tdap


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