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VAERS ID: 2315275

AGE: 17| SEX: F|State: OH

Description

patient was only 17, no side effects recorded

Symptoms

No adverse event, Product administered to patient of inappropriate age

Vaccines

VAX DATE: 08 June 2022 | ONSET DATE: 08 June 2022 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • MODERNA
  • COVID19 (COVID19 (MODERNA))
  • 1
  • IM
  • LA
  • 058a222a

RECVDATE:
09 June 2022
CAGE_YR:
17
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:
LAB_DATA:
V_ADMINBY:
PHM
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
2
TODAYS_DATE:
09 June 2022
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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