VAERS ID: 1858521

AGE: 10| SEX: M|STATE: CA (United States)

Description

After patient left it was discovered the he was given 0.2cc of adult Pfizer vacccine. He should have been given covid 19 mRNA 5-11 yr old. Patient waited the 15 min protocol for all patients without a reaction noted. I notified my director who notified doctor. Members weight is 76# >120days noted in chart. Age 10yrs.

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Symptoms

Incorrect dose administered, No adverse event

Vaccines

VAX DATE: 11-09-2021| ONSET DATE: 11-09-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH 32030bd IM LA

RECVDATE:11-10-2021
RPT_DATE:
CAGE_YR:10
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:none
V_ADMINBY:PVT
OTHER_MEDS:Zithromax, Malarone
CUR_ILL:none noted in chart
HISTORY:none noted in chart
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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