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VAERS ID: 1793853

AGE: 11| SEX: M|State: KY

Description

Patient was intended to receive a Flu shot and was administered a Covid Pfizer vaccine. Patients mom made aware and wanted patient to receive this vaccine but he does not turn 12 for a few weeks. Right on the edge of the approved guidelines. No adverse reactions at this time. will follow up tomorrow

Symptoms

Interchange of vaccine products, Product administered to patient of inappropriate age

Vaccines

VAX DATE: 15 October 2021 | ONSET DATE: 15 October 2021 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 1
  • IM
  • RA
  • 32030bd

RECVDATE:15 October 2021
CAGE_YR:11
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:U
LAB_DATA:
V_ADMINBY:PHM
OTHER_MEDS:none
CUR_ILL:none
HISTORY:none
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:15 October 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:none
V_FUNDBY:
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