VAERS ID: 1881303

AGE: 12| SEX: F|STATE: CA (United States)

Description

Patient was given a pediatric dose of Pfizer instead of a 12+ dose of Pfizer. Patient turned 12 years old 1 month before vaccination.

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(If this is a foreign report without a description you will be able to read the description in the Wayback Machine on Medalerts if the report became public for the first time before November 18, 2022.)

Symptoms

Incorrect dose administered

Vaccines

VAX DATE: 11-18-2021| ONSET DATE: 11-18-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH FK5127 IM LA

RECVDATE:11-18-2021
RPT_DATE:
CAGE_YR:12
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:
V_ADMINBY:PUB
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:11-18-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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