Received May 12, 2026
Reports are unverified and do not show that a vaccine caused an event. Full disclaimer
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| FLU3 | INFLUENZA (SEASONAL) (FLUZONE) | SANOFI PASTEUR | UNK | — | — |
S - Situation Wrong Vaccine Administration: A patient scheduled for the Southern Hemisphere Influenza vaccine erroneously received the Standard (Northern Hemisphere) Influenza vaccine. B - Background The clinic was experiencing high patient volume with only one organic staff member present. A medical group staff member arrived to assist and prepared the Southern Hemisphere Flu and Typhoid vaccines with the patient's shot record. A second support staff member then arrived to take over vaccinations. During this high-tempo transition and "warm handoff," the Standard Influenza vaccine was administered instead of the prepared Southern Hemisphere dose. A - Assessment The error was caused by a failure in the handoff protocol. Specifically, there was a lack of verbal verification (read-back) and a failure to cross-check the physical vaccine vial against the patient's printed immunization record and lot number during the staff transition. R - Recommendation Immediate: Patient was notified of the error, educated on standard adverse reaction protocols, and advised to seek emergency care if symptoms arise. Follow-up: Implement a mandatory "Verbal Handoff/Double-Check" protocol during staff transitions and ensure all vaccines are kept in clearly segregated, labeled containers during high-volume surges to prevent cross-contamination of similar products.
patient denies
patient denies
unknown
nkda
n/a