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This is VAERS ID 276152

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

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

Administered by: Other      Purchased by: Unknown
Symptoms: Medication error, Wrong drug administered

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':

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 medica"tion error. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 276152 Before After
Age:64.0
Gender:Male
Location:Florida
Vaccinated:2007-03-06
Onset:2007-03-06
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Medication error, Wrong drug administered

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': (blank) 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 medica"tion medication error. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 276152 Before After
Age:64.0
Gender:Male
Location:Florida
Vaccinated:2007-03-06
Onset:2007-03-06
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Wrong drug administered

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.


Changed on 5/14/2017

VAERS ID: 276152 Before After
Age:64.0
Gender:Male
Location:Florida
Vaccinated:2007-03-06
Onset:2007-03-06
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Wrong drug administered

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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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276152&WAYBACKHISTORY=ON


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