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VAERS ID: 1656814

AGE: 14| SEX: F|State: NV

Description

Off-label use administered to a 14yo Moderna is 18yo No adverse effects per patient and grandmother

Symptoms

No adverse event, Off label use, Product administered to patient of inappropriate age

Vaccines

VAX DATE: 26 August 2021 | ONSET DATE: 26 August 2021 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • MODERNA
  • COVID19 (COVID19 (MODERNA))
  • 1
  • IM
  • LA
  • 003B21A

RECVDATE:29 August 2021
CAGE_YR:14
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:Y
LAB_DATA:NONE
V_ADMINBY:PVT
OTHER_MEDS:None
CUR_ILL:None
HISTORY:None
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:29 August 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:None
V_FUNDBY:
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