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VAERS ID: 1881303

AGE: 12| SEX: F|State: CA

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.

Symptoms

Incorrect dose administered

Vaccines

VAX DATE: 17 November 2021 | ONSET DATE: 17 November 2021 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 1
  • IM
  • LA
  • FK5127

RECVDATE:17 November 2021
CAGE_YR:12
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:Y
LAB_DATA:
V_ADMINBY:PUB
OTHER_MEDS:Unknown
CUR_ILL:Unknown
HISTORY:Unknown
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:17 November 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:Unknown
V_FUNDBY:
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