This is VAERS ID 275023
| Days after vaccination:||0
| Days after onset:||35
| Days after submission:||2
|Vaccination / Manufacturer
||Lot / Dose
||Site / Route|
|HPV4: HPV (GARDASIL) / MERCK & CO. INC.
||1208F / UNK
||UN / -
|VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC.
||1476F / UNK
||- / IM
Administered by: Other Purchased by: Other
Symptoms: Incorrect dose administered,
Incorrect drug dosage form administered
SMQs:, Medication errors (narrow)
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Other Medications: (therapy unspecified)
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0702USA00873
Write-up: Information has been received from a health professional concerning a 77 year old male with no known allergies who on 06-FEB-2007 was vaccinated IM in the right arm with a 1 ml dose of Zostavax (lot # 656412/1476F). The Zostavax was reconstituted with Gardasil (lot # 654741/1208F) and the combined product was administered to the patient. It was reported that the patient was on an unspecified concomitant medication. No symptoms have been reported. Unspecified medical attention was sought. There was no product quality complaint involved. Additional information has been requested.
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