Received Mar 7, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (MODERNA)) | MODERNA | 1 | 3044210 | IM / RL |
| IPV | POLIO VIRUS, INACT. (IPOL) | SANOFI PASTEUR | 2 | W1C831M | SC / RL |
| MMRV | MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) | MERCK & CO. INC. | 2 | Y013583 | SC / LL |
| COVID19 | COVID19 (COVID19 (MODERNA)) | MODERNA | UNK | 3044210 | OT |
| IPV | POLIO VIRUS, INACT. (IPOL) | SANOFI PASTEUR | UNK | W1C831M | OT |
| MMRV | MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) | MERCK & CO. INC. | UNK | — | — |
| UNK | VACCINE NOT SPECIFIED (NO BRAND NAME) | UNKNOWN MANUFACTURER | 2 | Y013583 | OT / LL |
No additional adverse event was reported; Improper storage of product in use; This spontaneous report was received from a nurse and refers to a 6-year-old female patient. The patient's medical history was not reported. The patient's concurrent conditions were not reported. Concomitant therapies were not reported. On 09-Jan-2025, the patient started therapy with Measles, Mumps, Rubella and Varicella (Oka-Merck) Virus Vaccine Live (PROQUAD), (lot #Y013583, expiration date: 03-Feb-2026), dose number 2, administered by Subcutaneous route in Left Thigh for prophylaxis. On 09-Jan-2025, the patient started therapy with sterile diluent (MERCK STERILE DILUENT), for prophylaxis (lot # and expiration date were not reported). On 09-Jan-2025, the patient started therapy with Moderna COVID-19 vaccine (Elasomeran) (lot #3044210) (Dose 1, right thigh), administered by Intramuscular route for prophylaxis (expiration date was not reported). On 09-Jan-2025, the patient started therapy with Ipol (Polio vaccine inact 3v (Vero)) (lot #W1C831M) (Dose 2, right thigh), administered by Subcutaneous route for prophylaxis (expiration date was not reported). Those product were stored in inappropriate temperature (Product storage error). No additional adverse event was reported.; Sender's Comments: Priority : 5 , Is case serious : No , Index user : , Index date : 2025-02-26 , MNSC number : , CLIC number : , ESTAR number : , IRMS number : 11/14/2018 , Central date : 2025-02-20 , Classification : DMC, Attachment description : Post Marketing Basic , Safety case number :