Received Dec 17, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| FLU3 | INFLUENZA (SEASONAL) (FLUZONE) | SANOFI PASTEUR | 1 | U8881DA | IM / LL |
| HEPA | HEP A (HAVRIX) | GLAXOSMITHKLINE BIOLOGICALS | 1 | 3255P | IM / LL |
| HIBV | HIB (HIBERIX) | GLAXOSMITHKLINE BIOLOGICALS | 4 | CJ9YX | IM / LL |
| MMR | MEASLES + MUMPS + RUBELLA (MMR II) | MERCK & CO. INC. | 1 | Z004961 | SC / RL |
| PNC20 | PNEUMO (PREVNAR20) | PFIZER\WYETH | 4 | MA2484 | IM / RL |
| VARCEL | VARICELLA (VARIVAX) | MERCK & CO. INC. | 1 | Z008194 | SC / RL |
On 12/17/25, RMA observed another staff with vaccines, watched that the HIB needed to be mixed with the diluent. RMA realized that she did not mix the HIB vaccine in with the diluent and gave only the diluent on this vaccine only. RMA immediately reported this to the Vaccine Coordinator. Patient's mother was notified (as patient is underage) and understanding and rescheduled for 12/18/25. There were no adverse reactions with diluent that was given. Provider notified of event. Incident report completed in clinic. Director of Quality and Risk, COO, and Interim Medical Director notified. VAERS being reported on day of observed vaccine not given.
None
None
No other medications
No known drug allergies
No other medical or laboratory test/results were needed for this event.