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This is VAERS ID 276227

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276227
VAERS Form:
Age:0.3
Gender:Male
Location:North Carolina
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC - / - UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: hib conj vaccine (unspecified)
Current Illness: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from two consumers, the mother and father of a 4 month old male infant, who on 02-MAR-2007 was vaccinated with a single dose Gardasil by mistake. Concomitant therapy included Dtap (unspecified), IPV (unspecified), OPV (unspec"ified) and Prevnar. The mother and father of the child reported that their son should have received the /"HIB/" vaccine (not specified) /"but instead (was) given (Gardasil)./" On 20-MAR-2007, the mother of the infant reported that the child had been exper


Changed on 12/8/2009

276227 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:North Carolina
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC - / - UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: hib conj vaccine (unspecified)
Current Illness: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0703USA01289

Write-up:Information has been received from two consumers, the mother and father of a 4 month old male infant, who on 02-MAR-2007 was vaccinated with a single dose Gardasil by mistake. Concomitant therapy included Dtap (unspecified), IPV (unspecified), OPV (unspec"ified) (unspecified) and Prevnar. The mother and father of the child reported that their son should have received the /"HIB/" "HIB" vaccine (not specified) /"but "but instead (was) given (Gardasil)./" (Gardasil)." On 20-MAR-2007, the mother of the infant reported that the child had been exper experiencing "diarrhea for over a week," and reported that Pedialyte had been ordered. She added that on 16-MAR-2007, the HIB vaccine was administered. The mother stated that her child did "not appear dehydrated," and continued to have "wet diapers." The patient''s twin brother also experienced the events as described above after vaccination with Gardasil (WAES # 0703USA01783). Additional information has been requested.


Changed on 3/2/2010

276227 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:North Carolina
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC - / - UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: hib conj vaccine (unspecified)
Current Illness: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01289

Write-up:Information has been received from two consumers, the mother and father of a 4 month old male infant, who on 02-MAR-2007 was vaccinated with a single dose Gardasil by mistake. Concomitant therapy included Dtap (unspecified), IPV (unspecified), OPV (unspecified) and Prevnar. The mother and father of the child reported that their son should have received the "HIB" vaccine (not specified) "but instead (was) given (Gardasil)." On 20-MAR-2007, the mother of the infant reported that the child had been experiencing "diarrhea for over a week," and reported that Pedialyte had been ordered. She added that on 16-MAR-2007, the HIB vaccine was administered. The mother stated that her child did "not appear dehydrated," and continued to have "wet diapers." The patient''s twin brother also experienced the events as described above after vaccination with Gardasil (WAES # 0703USA01783). Additional information has been requested.


Changed on 4/7/2010

276227 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:North Carolina
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 UN / UN
DTAPHEPBIP: DTAP + HEPB + IPV (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC - / - UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: hib conj vaccine (unspecified)
Current Illness: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01289

Write-up:Information has been received from two consumers, the mother and father of a 4 month old male infant, who on 02-MAR-2007 was vaccinated with a single dose Gardasil by mistake. Concomitant therapy included Dtap (unspecified), IPV (unspecified), OPV (unspecified) and Prevnar. The mother and father of the child reported that their son should have received the "HIB" vaccine (not specified) "but instead (was) given (Gardasil)." On 20-MAR-2007, the mother of the infant reported that the child had been experiencing "diarrhea for over a week," and reported that Pedialyte had been ordered. She added that on 16-MAR-2007, the HIB vaccine was administered. The mother stated that her child did "not appear dehydrated," and continued to have "wet diapers." The patient''s twin brother also experienced the events as described above after vaccination with Gardasil (WAES # 0703USA01783). Additional information has been requested.


Changed on 8/31/2010

276227 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:North Carolina
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH - / - UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: hib conj vaccine (unspecified)
Current Illness: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01289

Write-up:Information has been received from two consumers, the mother and father of a 4 month old male infant, who on 02-MAR-2007 was vaccinated with a single dose Gardasil by mistake. Concomitant therapy included Dtap (unspecified), IPV (unspecified), OPV (unspecified) and Prevnar. The mother and father of the child reported that their son should have received the "HIB" vaccine (not specified) "but instead (was) given (Gardasil)." On 20-MAR-2007, the mother of the infant reported that the child had been experiencing "diarrhea for over a week," and reported that Pedialyte had been ordered. She added that on 16-MAR-2007, the HIB vaccine was administered. The mother stated that her child did "not appear dehydrated," and continued to have "wet diapers." The patient''s twin brother also experienced the events as described above after vaccination with Gardasil (WAES # 0703USA01783). Additional information has been requested.


Changed on 10/13/2013

276227 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:North Carolina
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / - 0 UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: hib conj vaccine (unspecified)
Current Illness: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01289

Write-up:Information has been received from two consumers, the mother and father of a 4 month old male infant, who on 02-MAR-2007 was vaccinated with a single dose Gardasil by mistake. Concomitant therapy included Dtap (unspecified), IPV (unspecified), OPV (unspecified) and Prevnar. The mother and father of the child reported that their son should have received the "HIB" vaccine (not specified) "but instead (was) given (Gardasil)." On 20-MAR-2007, the mother of the infant reported that the child had been experiencing "diarrhea for over a week," and reported that Pedialyte had been ordered. She added that on 16-MAR-2007, the HIB vaccine was administered. The mother stated that her child did "not appear dehydrated," and continued to have "wet diapers." The patient''s twin brother also experienced the events as described above after vaccination with Gardasil (WAES # 0703USA01783). Additional information has been requested.


Changed on 6/14/2014

276227 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:North Carolina
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / 0 UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: hib conj vaccine (unspecified)
Current Illness: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01289

Write-up:Information has been received from two consumers, the mother and father of a 4 month old male infant, who on 02-MAR-2007 was vaccinated with a single dose Gardasil by mistake. Concomitant therapy included Dtap (unspecified), IPV (unspecified), OPV (unspecified) and Prevnar. The mother and father of the child reported that their son should have received the "HIB" vaccine (not specified) "but instead (was) given (Gardasil)." On 20-MAR-2007, the mother of the infant reported that the child had been experiencing "diarrhea for over a week," and reported that Pedialyte had been ordered. She added that on 16-MAR-2007, the HIB vaccine was administered. The mother stated that her child did "not appear dehydrated," and continued to have "wet diapers." The patient''s twin brother also experienced the events as described above after vaccination with Gardasil (WAES # 0703USA01783). Additional information has been requested.


Changed on 3/14/2015

276227 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:North Carolina
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / 0 UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: hib conj vaccine (unspecified)
Current Illness: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01289

Write-up:Information has been received from two consumers, the mother and father of a 4 month old male infant, who on 02-MAR-2007 was vaccinated with a single dose Gardasil by mistake. Concomitant therapy included Dtap (unspecified), IPV (unspecified), OPV (unspecified) and Prevnar. The mother and father of the child reported that their son should have received the "HIB" vaccine (not specified) "but instead (was) given (Gardasil)." On 20-MAR-2007, the mother of the infant reported that the child had been experiencing "diarrhea for over a week," and reported that Pedialyte had been ordered. She added that on 16-MAR-2007, the HIB vaccine was administered. The mother stated that her child did "not appear dehydrated," and continued to have "wet diapers." The patient''s twin brother also experienced the events as described above after vaccination with Gardasil (WAES # 0703USA01783). Additional information has been requested.


Changed on 2/14/2017

276227 Before After
VAERS Form:
Age:0.3 0.33
Gender:Male
Location:North Carolina
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / 0 UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: hib conj vaccine (unspecified)
Current Illness: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01289

Write-up:Information has been received from two consumers, the mother and father of a 4 month old male infant, who on 02-MAR-2007 was vaccinated with a single dose Gardasil by mistake. Concomitant therapy included Dtap (unspecified), IPV (unspecified), OPV (unspecified) and Prevnar. The mother and father of the child reported that their son should have received the "HIB" vaccine (not specified) "but instead (was) given (Gardasil)." On 20-MAR-2007, the mother of the infant reported that the child had been experiencing "diarrhea for over a week," and reported that Pedialyte had been ordered. She added that on 16-MAR-2007, the HIB vaccine was administered. The mother stated that her child did "not appear dehydrated," and continued to have "wet diapers." The patient''s twin brother also experienced the events as described above after vaccination with Gardasil (WAES # 0703USA01783). Additional information has been requested.


Changed on 9/14/2017

276227 Before After
VAERS Form:(blank) 1
Age:0.33
Gender:Male
Location:North Carolina
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 0 1 UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / UN
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 2 UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / 0 1 UN / UN

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: hib conj vaccine (unspecified)
Current Illness: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01289

Write-up:Information has been received from two consumers, the mother and father of a 4 month old male infant, who on 02-MAR-2007 was vaccinated with a single dose Gardasil by mistake. Concomitant therapy included Dtap (unspecified), IPV (unspecified), OPV (unspecified) and Prevnar. The mother and father of the child reported that their son should have received the "HIB" vaccine (not specified) "but instead (was) given (Gardasil)." On 20-MAR-2007, the mother of the infant reported that the child had been experiencing "diarrhea for over a week," and reported that Pedialyte had been ordered. She added that on 16-MAR-2007, the HIB vaccine was administered. The mother stated that her child did "not appear dehydrated," and continued to have "wet diapers." The patient''s twin brother also experienced the events as described above after vaccination with Gardasil (WAES # 0703USA01783). Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276227&WAYBACKHISTORY=ON


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