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This is VAERS ID 290709

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 290709 (history)  
Form: Version 1.0  
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 CONJUGATE (MENACTRA) / SANOFI PASTEUR U2408AA / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Wrong drug administered
SMQs:, Medication errors (narrow)

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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http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170914&IDNUMBER=290709


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