VAERS ID: 1849694

AGE: 9| SEX: M|STATE: NV (United States)

Description

I informed the mother that I gave her 9 year old her dose which is the adult Pfizer covid of 0.3ml. I spoke with the mother this morning and she said that her son is fine.

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Symptoms

Extra dose administered, No adverse event, Wrong product administered

Vaccines

VAX DATE: 11-06-2021| ONSET DATE: 11-06-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH ff2590 IM LA

RECVDATE:11-07-2021
RPT_DATE:
CAGE_YR:9
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:
V_ADMINBY:PHM
OTHER_MEDS:
CUR_ILL:Was in hospital on ventilation
HISTORY:unknown
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:11-07-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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