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This is VAERS ID 276238

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276238
VAERS Form:
Age:0.3
Gender:Male
Location:North Carolina
Vaccinated:2007-03-02
Onset:0000-00-00
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 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:
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 single dose by mistake. Concomitant therapy included Dtap (unspecified), IPV, OPV (unspecified). The mother and fa"ther 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 rep


Changed on 12/8/2009

276238 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:North Carolina
Vaccinated:2007-03-02
Onset:0000-00-00
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTOX: DIPHTHERIA TOXOIDS (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

Administered by: Other      Purchased by: Unknown Other
Symptoms: Diarrhoea, Inappropriate schedule of drug administration, 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:
Current Illness: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0703USA01783

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 single dose by mistake. Concomitant therapy included Dtap (unspecified), IPV, OPV (unspecified). The mother and fa"ther father of the child reported that their son should have received the HIB vaccine (not specified) /"but "but instead (was) given Gardasil. On 20-MAR-2007, the mother of the infant reported that the child had been experiencing /"diarrhea "diarrhea for over a week,/" week," and rep reported that oral electrolyte maintenance (PEDIALYTE) has been ordered. She added that on 16-MAR-2007, the haemophilus influenza type B 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 # 0703USA01289). Additional information has been requested.


Changed on 4/7/2010

276238 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:North Carolina
Vaccinated:2007-03-02
Onset:0000-00-00
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
DTOX: DIPHTHERIA TOXOIDS (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

Administered by: Other      Purchased by: Other
Symptoms: Diarrhoea, Inappropriate schedule of drug administration, 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:
Current Illness: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01783

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 single dose by mistake. Concomitant therapy included Dtap (unspecified), IPV, OPV (unspecified). 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 oral electrolyte maintenance (PEDIALYTE) has been ordered. She added that on 16-MAR-2007, the haemophilus influenza type B 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 # 0703USA01289). Additional information has been requested.


Changed on 10/13/2013

276238 Before After
VAERS Form:
Age:0.3
Gender:Male
Location:North Carolina
Vaccinated:2007-03-02
Onset:0000-00-00
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

Administered by: Other      Purchased by: Other
Symptoms: Diarrhoea, Inappropriate schedule of drug administration, 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:
Current Illness: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01783

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 single dose by mistake. Concomitant therapy included Dtap (unspecified), IPV, OPV (unspecified). 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 oral electrolyte maintenance (PEDIALYTE) has been ordered. She added that on 16-MAR-2007, the haemophilus influenza type B 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 # 0703USA01289). Additional information has been requested.


Changed on 2/14/2017

276238 Before After
VAERS Form:
Age:0.3 0.33
Gender:Male
Location:North Carolina
Vaccinated:2007-03-02
Onset:0000-00-00
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

Administered by: Other      Purchased by: Other
Symptoms: Diarrhoea, Inappropriate schedule of drug administration, 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:
Current Illness: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01783

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 single dose by mistake. Concomitant therapy included Dtap (unspecified), IPV, OPV (unspecified). 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 oral electrolyte maintenance (PEDIALYTE) has been ordered. She added that on 16-MAR-2007, the haemophilus influenza type B 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 # 0703USA01289). Additional information has been requested.


Changed on 9/14/2017

276238 Before After
VAERS Form:(blank) 1
Age:0.33
Gender:Male
Location:North Carolina
Vaccinated:2007-03-02
Onset:0000-00-00
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

Administered by: Other      Purchased by: Other
Symptoms: Diarrhoea, Inappropriate schedule of drug administration, 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:
Current Illness: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01783

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 single dose by mistake. Concomitant therapy included Dtap (unspecified), IPV, OPV (unspecified). 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 oral electrolyte maintenance (PEDIALYTE) has been ordered. She added that on 16-MAR-2007, the haemophilus influenza type B 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 # 0703USA01289). Additional information has been requested.


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