Received May 19, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| HEPA | HEP A (HAVRIX) | GLAXOSMITHKLINE BIOLOGICALS | 3 | 273H3 | IM / RA |
| HIBV | HIB (ACTHIB) | SANOFI PASTEUR | 5 | UK333AA | IM / LA |
| PNC15 | PNEUMO (VAXNEUVANCE) | MERCK & CO. INC. | 5 | Z006429 | IM / RA |
Patient scheduled for immunizations for 5/13/2026 at 12:40. Patient's documented vaccine in Web was at 6 months of age. Nurse administering vaccines informed mom patient was behind on vaccines and she would be on a catch-up schedule and explained the vaccines she would be on a catch-up schedule and explained the vaccines she would be getting. Mom verbalized understanding. Immunization records were printed off and given to mom to give to school. The nurse from Pre-K called later that afternoon saying all of patient's immunizations were not listed on record, asked if she could fax the record over that she has. Per employee patient's mother had brought in the immunization record that morning and she asked if she could fax the record over that she has. Per clerk, patient's mother brought in the immunization record that morning and she gave it to PHN around lunch. The records were never entered into We. Patient received an unnecessary dose of Hib, PCV15, and Hep A. RN PCM and RN CDNS were notified. RN consulted with RN Program Nurse. Per Dr. since it was two years from last dose there is no increased immune response from doses being too close together. Notify Parent of incident and to watch for normal reactions. Medical facility instructed staff on how to handle shot records brought into clinic and Nurses responsibilities to verify vaccines before administering. A plan of correction, VAERS and form to be completed. Mother was contacted by RN. Mom verbalized understanding. Instructed mom to monitor for any side effects, none reported at this time.
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