Report #2839467

Received May 5, 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: 15 yrs
State: CO
Recovered: Unknown
Vaccinated: May 1, 2025
Onset: May 1, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
DTAPHEPBIP	DTAP + HEPB + IPV (PEDIARIX)	GLAXOSMITHKLINE BIOLOGICALS	1	D252F	IM / LL
PNC20	PNEUMO (PREVNAR20)	PFIZER\WYETH	1	LG5574	IM / RL

Symptoms (1)

Product preparation issue

Symptom narrative

Pt was receiving 2mth old vaccines including HIB. Verified vaccines and given to MA to administer. When MA returned from room, noted that HIB lyophilized antigen component vial was not reconstituted with Sterile Diluent. MA stated only administered syringe containing diluent but did not reconstitute. Upon verifying, syringe did not have any diluent and vial still noted with white powder. Dr. and DON made aware. Dr. advised can repeat HIB this visit. Parents decided to wait and return for a nurse visit for HIB vaccine since at this time pt had already received vaccines and was sleeping. HIB vaccines documented in chart as deferred and wasted. PM made aware

Current illness

UNKNOWN

Medical history

UNKNOWN

Other medications

UNKNOWN

Allergies

NONE

Lab data

N/A