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This is VAERS ID 1827151

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History of Changes from the VAERS Wayback Machine

First Appeared on 11/12/2021

VAERS ID: 1827151
VAERS Form:2
Age:
Sex:Male
Location:New York
Vaccinated:2021-07-07
Onset:2021-07-07
Submitted:0000-00-00
Entered:2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS 49TM3 / 1 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Inappropriate schedule of product administration, 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: Administration to a 76 year old patient; 1st dose on 7 july 2021 and 2nd dose on 21 sep 2021; Administration to a 76 year old patient; This case was reported by a pharmacist via call center representative and described the occurrence of inappropriate age at vaccine administration in a 76-year-old male 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, DTPa (Infanrix) (batch number 49tm3, expiry date 28th May 2022) for prophylaxis and dtpa vaccine pre-filled syringe device (Infanrix Pre-Filled Syringe Device) injection syringe for prophylaxis. On 21st September 2021, the patient received the 2nd dose of Infanrix and Infanrix Pre-Filled Syringe Device. On 7th July 2021, the patient received the 1st dose of Infanrix and Infanrix Pre-Filled Syringe Device. On 7th July 2021, not applicable after receiving Infanrix and Infanrix Pre-Filled Syringe Device and unknown after receiving Infanrix and Infanrix Pre-Filled Syringe Device, the patient experienced inappropriate age at vaccine administration. On 21st September 2021, the patient experienced inappropriate age at vaccine administration and drug dose administration interval too short. On an unknown date, the outcome of the inappropriate age at vaccine administration, inappropriate age at vaccine administration and drug dose administration interval too short were unknown. 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 76 year old male patient received 1st and 2nd dose of Infanrix, which led to inappropriate age at vaccine administration. The patient received 2nd dose later than the recommended time interval, which led to shortening of vaccination schedule. No further events were reported. The reporter consented to follow up.

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