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This is VAERS ID 273751

Case Details

VAERS ID: 273751 (history)  
Form: Version 1.0  
Age: 0.33  
Gender: Male  
Location: North Carolina  
Vaccinated:2007-03-02
Onset:2007-03-03
   Days after vaccination:1
Submitted: 2007-03-09
   Days after onset:6
Entered: 2007-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER NA / 1 RL / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NA / 1 RL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Pyrexia, Rash macular, Vomiting, Wrong drug administered
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), 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: n/a
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Wrong Vaccination was give. My son was given the HPV vaccine which is for women 18-26 years old. So far just normal post vaccine responses. Some blotching of skin, fever, and vomiting. Pediatric office contacted me on March 8th to report the wrong vaccination administration


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