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VAERS ID: 2038522

AGE: 12| SEX: F|State: CA

Description

0.2CC OF COVID-19 PEDATRIC DOSE OF PFIZER FOR 5 YRS OLD -11 YRS OLD WAS INJECTED TO A 12 YR OLD PATIENT

Symptoms

Incorrect dose administered

Vaccines

VAX DATE: 15 January 2022 | ONSET DATE: 15 January 2022 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 1
  • IM
  • LA
  • FL8095

RECVDATE:15 January 2022
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:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:15 January 2022
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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