National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 277918

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

277918
VAERS Form:
Age:13.0
Gender:Female
Location:West Virginia
Vaccinated:2007-04-20
Onset:0000-00-00
Submitted:2007-04-23
Entered:2007-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U1813BA / 5 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1492F / 1 UN / SC

Administered by: Public      Purchased by: Unknown
Symptoms: No adverse effect, Wrong drug administered, Medical device complication

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Box of DTaP placed with Tdap. Pt given DTaP instead of Tdap. No adverse reactions.


Changed on 12/8/2009

277918 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:West Virginia
Vaccinated:2007-04-20
Onset:0000-00-00
Submitted:2007-04-23
Entered:2007-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U1813BA / 5 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1492F / 1 UN / SC

Administered by: Public      Purchased by: Unknown Public
Symptoms: No adverse effect, Wrong drug administered, Medical device complication

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WV0707

Write-up:Box of DTaP placed with Tdap. Pt given DTaP instead of Tdap. No adverse reactions.


Changed on 9/14/2017

277918 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:West Virginia
Vaccinated:2007-04-20
Onset:0000-00-00
Submitted:2007-04-23
Entered:2007-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR U1813BA / 5 6 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 0 1 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1492F / 1 2 UN / SC

Administered by: Public      Purchased by: Public
Symptoms: No adverse effect, Wrong drug administered, Medical device complication

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WV0707

Write-up:Box of DTaP placed with Tdap. Pt given DTaP instead of Tdap. No adverse reactions.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=277918&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166