VAERS ID: 1864519

AGE: 8| SEX: M|STATE: NC (United States)

Description

Patient was given undiluted dose of pediatric Pfizer Covid-19 vaccine. This was caught by the pharmacist on site after administration. Patient did well through observation period in clinic and did not have any immediate reaction. Patient's mother was notified and advised patient may have more impressive immune response due to this increased dose of vaccine.

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Symptoms

Product preparation issue

Vaccines

VAX DATE: 11-11-2021| ONSET DATE: 11-11-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH FK5127 IM LA

RECVDATE:11-12-2021
RPT_DATE:
CAGE_YR:8
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:Focalin, Focalin XR, Intuniv, EpiPen prn
CUR_ILL:None noted.
HISTORY:ADHD
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:11-12-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:Peanuts and tree nuts
V_FUNDBY:

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