VAERS ID: 1332241

AGE: 17| SEX: M|STATE: CA

Description

minor client arrived for a second dose of Moderna, he had erroneously (underage) received the first dose of Moderna from Health Clinic. Site Lead RN escalated to Clinical Operations Coordinator to confirm that per CDC guidelines we would proceed and complete the COVID vaccination series for this minor 17yo. Client and his mother confirmed no medical illnesses or allergies and no adverse reactions from the first dose. Client also had no adverse reactions to the second dose during his 15min observation period. Client and his mother were educated on the CDC's recommendations not to vaccinate minors under 18yo with Moderna, but the CDCs approval to proceed and complete the series.

Symptoms

Product administered to patient of inappropriate age

Vaccines

VAX DATE: 05-19-2021| ONSET DATE: 05-19-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 2 COVID19 MODERNA 021C21A IM LA

RECVDATE:05-19-2021
RPT_DATE:
CAGE_YR:17
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:U
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:none
V_ADMINBY:OTH
OTHER_MEDS:none
CUR_ILL:none
HISTORY:none
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:05-19-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:NKA
V_FUNDBY:

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