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This is VAERS ID 290709

(NOTE: This result is from the 12/31/2007 version of the VAERS database)

Case Details

VAERS ID: 290709 (history)  
Form: Version .0  
Age: 12.0  
Gender: Female  
Location: South Carolina  
Vaccinated:2007-09-06
Onset:0000-00-00
Submitted: 2007-09-10
Entered: 2007-09-17
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2408AA / 0 RA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Wrong drug administered
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: N/A
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Gardasil 0.5 ml lot # 0930U, Exp 11/10 given IM inadvertently instead of Tdap.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=290709


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