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From the 1/7/2022 release of VAERS data:

Found 35,754 cases where Age is 6-or-more-and-under-18 and Vaccine is COVID19

Government Disclaimer on use of this data



Case Details

This is page 23 out of 3,576

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VAERS ID: 957009 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: New York  
Vaccinated:2021-01-15
Onset:2021-01-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013L20A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Patient denied "serious or life-threatening allergic reaction, such as hives or difficulty breathing, to any vaccine or shot."
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient''s age (17 years) was noted at data entry following the Point of Dispensing Clinic. The patient presented with family to the POD and all are members of a local fire department. No adverse reactions were noted; the patient has not contacted Department of Health to report any adverse reactions. The patient was contacted to aid in the completion of this report but was not able to be reached by phone.


VAERS ID: 957199 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Washington  
Vaccinated:2021-01-15
Onset:2021-01-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK LA / IM

Administered by: Other       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Buspirone 7.5mg twice daily
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Apparently, the adverse event is that Moderna Covid 19 vaccine is not licensed for use on minors under the age of 18. We received an email from the Police Department inviting the immediate family of first responders age 16+ to sign up and get the vaccine. We did so, and our son was vaccinated with the Moderna Covid vaccine and is only 17. We are now UNABLE to get him fully protected because we are told he can''t have his second dose since he''s not 18. We are unable to opt for the Pfizer vaccine, which is licensed for 16+, because you can''t mix the brands apparently. Because of this sloppy mess, our son will now be without protection from Covid 19 until some time in the future- whenever some scientists decide it is safe for people who got a single dose of Moderna to now get both doses of Pfizer-- or when he is 18 in a year from now, and can take the Moderna vaccine again. This is very frustrating.


VAERS ID: 957206 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Alaska  
Vaccinated:2021-01-19
Onset:2021-01-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030L20A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ProAir, Levocetirizine, Qvar Redihaler
Current Illness: Unknown
Preexisting Conditions: Asthma, atopic dermatitis, allergic rhinitis
Allergies: Food allergies to peanut and tree nuts
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Vaccine administered before pt''s 18th birthday. Pt is 17 years old.


VAERS ID: 957494 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-01-19
Onset:2021-01-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: No adverse event, Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Vaccine was administered to minor who is 15 years of age. Vaccine not licensed for this age group. Patient was monitored for 15 minutes post vaccination. No S/S of complications Client denied any adverse reaction while in clinic. Reviewed with clients parents expected vaccine reactions and encouraged registration of client in the V-Safe Program.


VAERS ID: 957353 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Unknown  
Location: New York  
Vaccinated:2020-12-01
Onset:2020-12-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Product use issue
SMQs:, Medication errors (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (No medical history reported)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: 17 year old administered vaccine; A spontaneous report was received from a pharmacist concerning a 17-year-old consumer who received Moderna''s COVID-19 vaccine and was at an inappropriate age at vaccine administration. The patient''s medical history was not provided. No relevant concomitant medications were reported. On 29 or 30 Dec 2020, the patient received their first of two planned doses of mRNA-1273 for prophylaxis of COVID-19 infection. On 29 or 30 Dec 2020, a 17-year-old patient was given the vaccine and is outside the lower age limit for Moderna''s mRNA-1273 vaccine. No adverse events were reported. No treatment information was provided. Action taken with the second dose of mRNA-1273 in response to the event was not reported. The event, inappropriate age at vaccine administration, was considered resolved.; Reporter''s Comments: This report refers to a case of 17- year-old patient who was administered vaccine outside the lower age limit for Moderna''s mRNA-1273 vaccine, lot # unknown, Exp. unknown. There were no reported AEs associated with this case of vaccine and is outside the lower age limit for Moderna''s mRNA-1273 vaccine.


VAERS ID: 957769 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Idaho  
Vaccinated:2021-01-19
Onset:2021-01-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL0140 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Chills, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: body aches, nausea, vomiting, and chills


VAERS ID: 957906 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-20
Onset:2021-01-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039K20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: unknown
Allergies: Nka
Diagnostic Lab Data: None
CDC Split Type:

Write-up: None. Patient is 17 years old and received Moderna vaccine . Will moniter for reactions.


VAERS ID: 957908 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Alabama  
Vaccinated:2021-01-19
Onset:2021-01-20
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042L20A / 1 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none known
CDC Split Type:

Write-up: pt is a health care provider and desired the vaccine due to her job . 17 years old. When she was called she was told she needed to rtc for second dose after her 18 year birthday. She reported a fever fo 101, sore arm and body aches. Discussed comfort measures today.


VAERS ID: 958092 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2021-01-06
Onset:2021-01-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011J20A / 1 LA / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: No adverse event (No reported medical condition)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Vaccine to someone who was less than 18 years old.; A spontaneous report was received from a healthcare professional (HCP) concerning a 16-year-old, female consumer who received Moderna''s COVID-19 vaccine and experienced product administered to patient of inappropriate age. The patient''s medical history was not provided. No relevant concomitant medications were reported. On 06 Jan 2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (Lot number: 011J20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection and experienced product administered to patient of inappropriate age. No side effects were reported. No treatment information was provided. Action taken with the second dose of mRNA-1273 in response to the event was not reported. The event, vaccine given to a patient less than 18-years-old, was considered resolved on 06 Jan 2021.; Reporter''s Comments: This report refers to a case of product administered to patient of inappropriate age for mRNA-1273, lot # 011J20A. There were no reported AEs associated with this case of product administered to patient of inappropriate age.


VAERS ID: 958207 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-01-18
Onset:2021-01-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 012L20A / 1 AR / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Medication error, Wrong patient
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Error: Wrong Patient (documentation in EMR)


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