The following is all the information available on report# VAERS_ID: 726958
Vaccine(s) were received on 11/11/2016
Patient sex : U
Reaction was life threatening?: N
Patient eventually recovered from reaction ?: U
Patient eventually died?: N
No adverse event
Patient sex : U
Reaction was life threatening?: N
Patient eventually recovered from reaction ?: U
Patient eventually died?: N
The following Data for this patients ALLERGIES is available: [ ]
Description of adverse reaction: This spontaneous initial report was received from a nurse referring a 14 year old patient of unknown gender. The patient's medical history, concurrent conditions and concomitant medications were not reported. The Nurse reported that on in 11-NOV-2016 the patient was vaccinated with PROQUAD lot # L032761, expiration date 24-FEB-2017 (strength, dose and route of administration were not reported) for prophylaxis. (Product use issue). The nurse also informed that the sterile diluent (MERCK) (unknown lot number and expiration date) used to reconstitute PROQUAD did not undergo a temperature excursion. No adverse effects were reported.
Vaccine(s) associated with report# 726958
| Type | Name | Manufacturer | Vaccine LOT # | Dose Series | ROUTE | Site |
|---|---|---|---|---|---|---|
| MMRV | MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) | MERCK & CO. INC. | L032761 | 0 |
Symptoms(s) associated with report# 726958
Drug administered to patient of inappropriate ageNo adverse event