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Report #2827204

Received Feb 19, 2025

A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex
Male
Age
12 yrs
State
ND
Recovered
Unknown
Vaccinated
Jan 8, 2025
Onset
Jan 8, 2025
Days to onset
0
Hospital days
—

Vaccines (8)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA1B0002IM / LA
FLU4INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS172RF2IM / LA
HEPHEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS195BJ9IM / RA
HEPAHEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS2T5727IM / LA
HPV9HPV (GARDASIL 9)MERCK & CO. INC.1X024650IM / RA
IPVPOLIO VIRUS, INACT. (IPOL)SANOFI PASTEUR3W1C831MSC / RA
MMRVMEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.2Y013579SC / LA
TDAPTDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS4X449YIM / RA

Symptoms (1)

Product storage error

Symptom narrative

On October 1, 2024, clinic received a shipment of COVID vaccine that needed to be stored in the freezer. There was no room in the freezer to accomodate the shipment. The following document was found on the FDA website Unaware that there were two ProQuad products licensed by the FDA, It was assumed that the ProQuad we received could be refrigerated and both State and Private ProQuad were moved to the refrigerators where they remained within normal refrigerated temperature range (36 to 46 degrees Fahrenheit) until administration. The dose of MMRV admin to this client arrived to our facility on 11/13/24 and was refrigerated until admin on 1/8/25.