VAERS ID: 1545242

AGE: 17| SEX: M|STATE: FL

Description

A 17 YEAR OLD CAME TO GET MODERNA VACCINE. PHARMACIST DID NOT REALIZE PATIENT WAS NOT OF AGE FOR MODERNA VACCINE. PATIENT AND HIS FATHER WERE CONTACTED. NO SIDE EFFECTS AS OF NOW HAVE BEEN REPORTED BY PATIENT OR FATHER. PATIENT WOULD LIKE TO STILL RECEIVE 2ND DOSE .

Symptoms

Product administered to patient of inappropriate age

Vaccines

VAX DATE: 08-10-2021| ONSET DATE: 08-10-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 1 COVID19 MODERNA 045C21A IM LA

RECVDATE:08-11-2021
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:
V_ADMINBY:PHM
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:08-11-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

Questions? Comments? Bugs?
[email protected]
Due to the high volume of inquiries, please be patient with response times.

AND PLEASE read the FAQ first.

OpenVAERS is a private organization that posts publicly available CDC/FDA data of injuries reported post-vaccination. Reports are not proof of causality.