VAERS ID: 1669625

AGE: 18| SEX: F|STATE: MD (United States)

Description

Missed second dose date; 90 days since first dose; This spontaneous case was reported by a physician and describes the occurrence of INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (90 days since first dose) and PRODUCT DOSE OMISSION ISSUE (Missed second dose date) in an 18-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 0UU21A) for COVID-19 vaccination. No Medical History information was reported. On 30-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 30-Apr-2021, the patient experienced INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (90 days since first dose). On an unknown date, the patient experienced PRODUCT DOSE OMISSION ISSUE (Missed second dose date). On 30-Apr-2021, INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION (90 days since first dose) had resolved. At the time of the report, PRODUCT DOSE OMISSION ISSUE (Missed second dose date) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant medications were reported. No Treatment information was reported by the porter. Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 18-Aug-2021: Follow up appended for document attachment contains no new information. On 18-Aug-2021: Follow up information contains event: Missed second dose date.

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Symptoms

Inappropriate schedule of product administration, Product dose omission issue

Vaccines

VAX DATE: 04-30-2021| ONSET DATE: 04-30-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 1 COVID19 MODERNA 0UU21A OT Unknown

RECVDATE:09-03-2021
RPT_DATE:
CAGE_YR:18
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:
V_ADMINBY:
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:USMODERNATX, INC.MOD20212
FORM_VERS:
TODAYS_DATE:09-02-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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