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Report #2838882

Received Apr 30, 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
4 yrs
State
HI
Recovered
Unknown
Vaccinated
Apr 17, 2025
Onset
Apr 17, 2025
Days to onset
0
Hospital days
—

Vaccines (5)

TypeNameManufacturerDoseLotRoute / Site
MMRMEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER2Y000225OT / LL
UNKVACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURERUNK3CA20C1OT
UNKVACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURERUNKNIC74IMOT
UNKVACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURERUNKU8442BAOT
VARCELVARICELLA (VARIVAX)MERCK & CO. INC.2Y011019OT / LL

Symptoms (1)

Product storage error

Symptom narrative

No other information provided. No additional AEs/PQC reported.; vaccines administered after temperature excursion; This spontaneous report was received from a medical assistant and refers to a(n) 4-year-old male patient. The patient's pertinent medical history, previous drug reactions or allergies and concomitant medications were not provided. On 17-APR-2025, the patient was vaccinated with vaccines that suffered temperature excursion with a temperature - 9.8 C, for a time frame of 2 hours 3 minutes, with digital data logger: dose number 2Measles, Mumps, and Rubella (Wistar RA 27-3) Virus Vaccine, Live (M-M-R II) solution for injection (lot #Y000225, expiration date: 03-JAN-2026), administered by Subcutaneous route in Left Thigh; dose # 2 of Varicella Virus Vaccine Live (Oka-Merck) (VARIVAX) solution for injection (lot #Y011019, expiration date: 18-JUN-2026), administered by subcutaneous route in Left Thigh, both as prophylaxis (exact doses not reported), reconstituted with sterile diluent. Also received on the same date, Diphtheria vaccine toxoid (+) Pertussis vaccine acellular (+) Tetanus vaccine toxoid (Dtap) (lot #3CA20C1, expiration date: 28-FEB-2026) (Previous doses: 4, administered right thigh), administered by Intramuscular route; Ipv (Polio vaccine inact) (lot #NIC74IM, expiration date: 17-NOV-2025) (Number of previous doses: 3, administered right thigh), administered by Intramuscular route; and Influenza vaccine (Influenza vaccine) (lot #U8442BA, expiration date: 30-JUN-2025) (Number of previous doses: 4, administered Right thigh), administered by Intramuscular route (doses, indications were not reported). No previous temperature excursions were reported. No other information provided. No additional adverse events (AEs)/product quality complaints (PQC) reported.

Other medications

sterile diluent; sterile diluent