Received Mar 7, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| HEP | HEP B (ENGERIX-B) | GLAXOSMITHKLINE BIOLOGICALS | 3 | 95BJ9 | IM / RA |
| IPV | POLIO VIRUS, INACT. (IPOL) | SANOFI PASTEUR | 4 | Y1A201M | SC / RA |
| MMRV | MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) | MERCK & CO. INC. | 1 | Y017208 | SC / RA |
| MNQ | MENINGOCOCCAL CONJUGATE (MENVEO) | NOVARTIS VACCINES AND DIAGNOSTICS | 1 | LN75D | IM / LA |
| TDAP | TDAP (BOOSTRIX) | GLAXOSMITHKLINE BIOLOGICALS | 4 | CX4HL | IM / LA |
| UNK | VACCINE NOT SPECIFIED (NO BRAND NAME) | UNKNOWN MANUFACTURER | UNK | Y017208 | OT / RA |
No adverse effects reported. No additional AE; State and Private ProQuad were moved to the refrigirators where they remained within normal refrigerated temperature range until adminsitration.; This spontaneous report was received from nurse, regarding a 12-year-old male patient. The patient's medical history and concurrent conditions were not reported. Historical vaccines included diphtheria vaccine toxoid (+) Pertussis vaccine acellular 3-component (+) Tetanus vaccine toxoid (BOOSTRIX). Concomitant medications included sterile diluent (BAXTER STERILE DILUENT), Polio vaccine inact 3v (Vero) (IPOL), Meningococcal vaccine A/C/Y/W conj (CRM197) (MENVEO), and hepatitis b vaccine rHBsAg (yeast) (ENGERIX B) . On 13-Jan-2025, the pharmacy received a shipment of Measles, Mumps, Rubella and Varicella (Oka-Merck) Virus Vaccine Live (PROQUAD). There was no room in the freezer to accommodate the shipment and it was assumed they could be stored in both freezer and refrigerator, they were moved to the refrigerators where they remained within normal refrigerated temperature range util administration. Then on 06-Feb-2025, the patient was vaccinated with one of this improperly storage doses, as first dose, of Measles, Mumps, Rubella and Varicella (Oka-Merck) Virus Vaccine Live (PROQUAD), in combination with the sterile diluent (BAXTER STERILE DILUENT), subcutaneously in the right arm as prophylaxis (lot number: Y017208, which was determined to be valid, with an expiration date on 13-Apr-2026) (product storage error). No additional adverse events were reported.
Sterile Diluent; Inactivated Polio Virus (IPOL); Meningococcal Conjugate (Menveo); Hep B (Engerix-B)