VAERS ID: 1925261

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

Description

Inadvertently administered 0.3 cc of Pfizer adult formulation instead of pediatric fizer

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Symptoms

Incorrect dose administered

Vaccines

VAX DATE: 12-06-2021| ONSET DATE: 12-06-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH FH8028 IM LA

RECVDATE:12-06-2021
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:PUB
OTHER_MEDS:
CUR_ILL:URI 2 weeks ago
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-06-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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