VAERS ID: 1840376

AGE: 7| SEX: M|STATE: OH (United States)

Description

Realized when entering information in state database that had given adult vaccine dose to pediatric patient. informed attending. spoke with infectious disease doctor. called mother. no adverse events at this time.

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Symptoms

Incorrect dose administered, No adverse event

Vaccines

VAX DATE: 11-03-2021| ONSET DATE: 11-03-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EW0177 IM LA

RECVDATE:11-03-2021
RPT_DATE:
CAGE_YR:7
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:
V_ADMINBY:PVT
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:11-03-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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