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This is VAERS ID 303464

(NOTE: This result is from the 12/31/2008 version of the VAERS database)

Case Details

VAERS ID: 303464 (history)  
Form: Version .0  
Age: 0.5  
Gender: Unknown  
Location: Michigan  
Vaccinated:2007-10-29
Onset:2007-10-29
   Days after vaccination:0
Submitted: 2008-01-15
   Days after onset:78
Entered: 2008-01-21
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - UN / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC - / - UN / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 3 - / PO
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - UN / UN

Administered by: Other       Purchased by: Unknown
Symptoms: Viral rash, 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:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type:

Write-up: Information has been received from a physician and an office manager concerning a 6 month old patient who on approximately 29-OCT-2007 was vaccinated PO with a fourth dose of Rotateq (no lot number was provided) in place of PREVNAR. Concomitant vaccinati"ons administered on that same day included a dose of Varivax (MSD), MMR II (Enders-Edmonston, Jeryl Lynn, Wistar RA 27/3) (MSD) and a dose of of FLUZONE. Subsequently the patient developed a viral rash which had since resolved. It was unknown whether me


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http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20081231&IDNUMBER=303464


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