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This is VAERS ID 276152

Case Details

VAERS ID: 276152 (history)  
Age: 64.0  
Gender: Male  
Location: Florida  
Vaccinated:2007-03-06
Onset:2007-03-06
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:30
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other       Purchased by: Other
Symptoms: Wrong drug administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA00883

Write-up: Information has been received from a physician concerning a 64 year old male who on 06-MAR-2007 was vaccinated intramuscularly with a 0.5 ml dose of Gardasil instead of Zostavax. It was reported that there was no product confusion and that is was a medication error. Additional information has been requested.


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