National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

This is VAERS ID 1807363

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 11/12/2021

VAERS ID: 1807363
VAERS Form:2
Age:29.0
Sex:Female
Location:Colorado
Vaccinated:2021-10-12
Onset:2021-10-12
Submitted:0000-00-00
Entered:2021-10-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS 49TM3 / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Exposure during pregnancy, Product administered to patient of inappropriate age

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': USGLAXOSMITHKLINEUS202121

Write-up: pregnant woman received Infanrix; pregnant woman received Infanrix / DOB :04-MAR-1992; received Infanrix instead of Boostrix; This prospective pregnancy case was reported by a other health professional via call center representative and described the occurrence of inappropriate age at vaccine administration in a 29-year-old female patient who received DTPa (Infanrix) (batch number 49TM3, expiry date 28th May 2022) for prophylaxis. Co-suspect products included dtpa vaccine pre-filled syringe device (Infanrix Pre-Filled Syringe Device) injection syringe for prophylaxis. On 12th October 2021, the patient received Infanrix and Infanrix Pre-Filled Syringe Device. The patient''s last menstrual period was on an unknown date and estimated date of delivery was on an unknown date. The patient received Infanrix at an unknown time during the pregnancy. On 12th October 2021, unknown after receiving Infanrix and Infanrix Pre-Filled Syringe Device, the patient experienced inappropriate age at vaccine administration and adult use of a child product. On an unknown date, the patient experienced vaccine exposure during pregnancy. On an unknown date, the outcome of the inappropriate age at vaccine administration, adult use of a child product and vaccine exposure during pregnancy were unknown. The pregnancy was ongoing. This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences. Additional details were provided as follows: The medical assistant reported that a pregnant patient received Infanrix instead of Boostrix, which led to vaccine exposure during pregnancy, inappropriate age at vaccine administration and Adult use of a child product. The reporter consented to follow up by email.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1807363&WAYBACKHISTORY=ON


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166