VAERS ID: 1857819

AGE: 7| SEX: F|STATE: FL (United States)

Description

The patient is 9 years old and received the adult dose instead of the pediatric dose. Patient was monitored for 30 minutes in store with no adverse events. Patient was followed up with 24 hours after vaccine was given and still no adverse events occurred. The patient's pediatrician was also contacted and made aware of the situation.

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Symptoms

Incorrect dose administered, No adverse event

Vaccines

VAX DATE: 11-08-2021| ONSET DATE: 11-08-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH FF8839 IM LA

RECVDATE:11-10-2021
RPT_DATE:
CAGE_YR:7
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:none
V_ADMINBY:PHM
OTHER_MEDS:unknown
CUR_ILL:none
HISTORY:none
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:11-10-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:nkda
V_FUNDBY:

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