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VAERS ID: 1975358

AGE: 16| SEX: F|State: TN

Description

No adverse reactions reported. She is under the approved age for Moderna

Symptoms

No adverse event, Product administered to patient of inappropriate age

Vaccines

VAX DATE: 30 November 2021 | ONSET DATE: 30 November 2021 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • MODERNA
  • COVID19 (COVID19 (MODERNA))
  • 1
  • IM
  • RA
  • 027h21b

RECVDATE:22 December 2021
CAGE_YR:16
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:Y
LAB_DATA:None
V_ADMINBY:WRK
OTHER_MEDS:unknown
CUR_ILL:none
HISTORY:none
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:22 December 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:unknown
V_FUNDBY:
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