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VAERS ID: 1925261

AGE: 10| SEX: M|State: GA

Description

Inadvertently administered 0.3 cc of Pfizer adult formulation instead of pediatric fizer

Symptoms

Incorrect dose administered

Vaccines

VAX DATE: 05 December 2021 | ONSET DATE: 05 December 2021 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 2
  • IM
  • LA
  • FH8028

RECVDATE:05 December 2021
CAGE_YR:10
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:U
LAB_DATA:none
V_ADMINBY:PUB
OTHER_MEDS:None
CUR_ILL:URI 2 weeks ago
HISTORY:None
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:05 December 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:None
V_FUNDBY:
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