Report #2839131

Received May 1, 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: Female
Age: 4 yrs
State: NY
Recovered: Unknown
Vaccinated: Apr 29, 2025
Onset: Apr 29, 2025
Days to onset: 0
Hospital days: —

Vaccines (7)

Type	Name	Manufacturer	Dose	Lot	Route / Site
DTAP	DTAP (DAPTACEL)	SANOFI PASTEUR	UNK	3CA25C1	IM / LA
HEP	HEP B (ENGERIX-B)	GLAXOSMITHKLINE BIOLOGICALS	UNK	7NX57	IM / LA
HIBV	HIB (ACTHIB)	SANOFI PASTEUR	UNK	UK175AA	IM / LA
IPV	POLIO VIRUS, INACT. (IPOL)	SANOFI PASTEUR	UNK	X1D141M	IM / RA
MMR	MEASLES + MUMPS + RUBELLA (MMR II)	MERCK & CO. INC.	UNK	X027902	SC / RA
PNC20	PNEUMO (PREVNAR20)	PFIZER\WYETH	UNK	HN5980	IM / RA
VARCEL	VARICELLA (VARIVAX)	MERCK & CO. INC.	UNK	Y020586	SC / RA

Symptoms (1)

Product preparation error

Symptom narrative

A Hib vaccine was administered to a patient using sterile water as a diluent instead of the manufacturer -supplied - Hib specific diluent. The parent of the child will be contacted and advised to return to the clinic for proper revaccination. No adverse events were observed or reported at the time of submission.

Current illness

ONLY SCREENED FOR CURRENT ILLNESS MORE SERIOUS THAN A COLD- ANSWERED NO

Medical history

NOT SCREENED (ONLY SCREENED FOR CONDITIONS RELEVANT TO VACCINE CONTRAINDICATIONS)

Other medications

UNKNOWN

Allergies

NONE REPORTED

Lab data

N/A