VAERS ID: 1569998

AGE: 17| SEX: M|STATE: GA

Description

Dosing error (pediatric use); A spontaneous report was received from a healthcare professional concerning a 17 year old patient who received first dose of Moderna's COVID-19 Vaccine (mRNA-1273) and experienced Product administered to patient of inappropriate age. The patient's medical history, was not provided. Concomitant product use was not provided by the reporter. On an unknown date, the patient received the first of two planned doses of mRNA-1273 (Batch number: 023M20A) intramuscularly for prophylaxis of COVID-19 infection. On an unknown date, the patient experienced the event Product administered to patient of inappropriate age. No treatment information was provided. Action taken with mRNA-1273 in response to the events was unknown. The outcome of the event, Product administered to patient of inappropriate age, was considered resolved.; Sender's Comments: This report refers to a case of Product Administered to Patient of Inappropriate Age for mRNA-1273 (Lot number: 023M20A) with no associated AEs.

Symptoms

Product administered to patient of inappropriate age

Vaccines

VAX DATE: | ONSET DATE: | DAYS TO ONSET:
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 1 COVID19 MODERNA 023M20A OT Unknown

RECVDATE:08-15-2021
RPT_DATE:
CAGE_YR:
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:
OTHER_MEDS:
CUR_ILL:
HISTORY:Medical History/Concurrent Conditions: No adverse event (No adverse event reported.)
PRIOR_VAX:
SPLTTYPE:USMODERNATX, INC.MOD20210
FORM_VERS:2
TODAYS_DATE:08-12-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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