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From the 1/14/2022 release of VAERS data:

Found 36,769 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 24 out of 3,677

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VAERS ID: 958248 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-07
Onset:2021-01-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Work       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: No adverse event, just submitting because someone called and said the MIIC let them know that pt was under 18. She is staff at the facility we serve and her underage status was not noticed at the time. However, since she is so close, and patient age with regard to this vaccine can be thought to be arbitrary (even if pt age <18 wasn''t studied), common sense indicates pt has no increased danger of adverse effects, and further, should receive the 2nd dose on schedule even if before 18 years of age.


VAERS ID: 958535 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Florida  
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 039K20E / 1 - / 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: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: No adverse event, Continue: [UNK], Comment: No reported medical history
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Vaccine administered to a 17 year old; A spontaneous report was received from a health care professional concerning a 17-year-old, female, patient who received Moderna''s COVID-19 vaccine (mRNA-1273) resulting in the event, vaccine administered to a 17-year-old. The patient''s medical history was not provided. No relevant concomitant medications were reported. On 06 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: 039K20E) intramuscularly in the arm for prophylaxis of COVID-19 infection. On 06 Jan 2021, the 17-year-old patient was vaccinated. The patient was 10 days away from turning 18. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, vaccine administered to a 17-year-old, was considered resolved on 06 Jan 2021.; Reporter''s Comments: This case concerns a 17 year old femaile subject with who experienced a non serious unexpected event inappropriate age at vaccine administration. There were no reported AEs associated with this event of inappropriate age at vaccine administration.


VAERS ID: 958554 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Unknown  
Location: California  
Vaccinated:2021-01-04
Onset:2021-01-04
   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: Poor quality product administered, 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 history)
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20210

Write-up: Immunized at age 12; Administered vials that were exposed to room temperature for more than 12 hours; A spontaneous report was received from a physician concerning an 12-year-old patient who received Moderna''s COVID-19 vaccine (mRNA-1273) and experienced the events, immunized at age 12 and administered vials that were exposed to room temperature for more than 12 hours. The patient''s medical history was not provided. Concomitant product use was not provided by the reporter. On 04 Jan 2021, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On 04 Jan 2021, the patient received a vaccine dose of mRNA-1273 that had been left at room temperature more than 12 hours. It was originally thought that the freezer which stored the mRNA-1273 vaccine died on 04 Jan 2021 at 2am, so vaccine administration occurred up until 2pm. After checking freezer temperature logs, it was discovered the freezer had died at 1:11am. Treatment for the events was not provided. Action taken with mRNA-1273 in response to the events was not provided. The events, immunized at age 12 and administered vials that were exposed to room temperature for more than 12 hours, were considered resolved on 04 Jan 2021.; Reporter''s Comments: Company comment: This report refers to a case of 12- year-old patient who was administered vaccine outside the lower age limit for Moderna''s mRNA-1273 vaccine, and received a vaccine dose that had been left at room temperature more than 12 hours (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 and vaccine dose of mRNA-1273 that had been left at room temperature more than 12 hours.


VAERS ID: 958627 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: California  
Vaccinated:2021-01-14
Onset:2021-01-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: 12/2020: abnormal urine findings/urgency/infective urethritis, LBP
Preexisting Conditions: Acne vulgaris (Primary Dx); Medication monitoring encounter; Hypercholesterolemia; Asteatotic eczema
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: A 17yo was scheduled for vaccination via invite link shared with his parent''s dental office. His parents signed consent for him to receive the vaccine and the patient was able to slip in through the system unnoticed. Pt has not reported any side effects or adverse outcomes to us.


VAERS ID: 958693 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New Mexico  
Vaccinated:2021-01-15
Onset:2021-01-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 029L20A / 1 LA / 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: ON 01/15/2021, WAS PLACED ON THE COVID VACCINE SCHEDULE. WE HAD ?NO SHOWS? DURING THE CLINIC WHICH WARRANTED ADDITIONAL PATIENTS/ EMPLOYEES BEING PLACED ON THE SCHEDULE THE SAME DAY. WAS CHECKED IN BY THE PSR. I INSTRUCTED HIM TO BE SEATED IN THE WAITING ROOM WHERE HE WAS TO RECEIVE HIS VACCINE. I ASKED PATIENT TO VERIFY HIS NAME AND DATE OF BIRTH FOR THE PURPOSES OF ?DOUBLE IDENTIFICATION?. UNFORTUNATELY, I DID NOT RECOGNIZE THAT HE WAS UNDER THE AGE OF 18, AS I WAS WORKING UNDER THE UNDERSTANDING THAT ONLY ADULTS WERE BEING PLACED ON THE SCHEDULE FOR COVID VACCINE. DURING THE VACCINE CLINIC I AM NOT ACCESSING PATIENT CHARTS IN ECW, WHERE THE AGE OF THE PATIENT IS CLEARLY VISIBLE IN THE CHART. I DISCOVERED THIS MISTAKE ON 01/18/2021 WHILE WORKING FROM HOME. I HAPPENED TO BE REVIEWING THE SCHEDULE FROM 01/15/2021 AND DISCOVERED THE PATIENTS AGE. I IMMEDIATELY REACHED OUT TO MY SUPERVISOR.


VAERS ID: 958895 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Michigan  
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 027L20A / 1 RA / IM

Administered by: Pharmacy       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:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was under the age allowed to vaccinate


VAERS ID: 959059 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-01-08
Onset:2021-01-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 RA / IM

Administered by: Pharmacy       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: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: No adverse reactions. The patient is underage and was not supposed to receive the shot until turning 18. We were advised to give the second dose after the patient turns 18 per the CDC.


VAERS ID: 959217 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Nebraska  
Vaccinated:2021-01-08
Onset:2021-01-01
Submitted: 0000-00-00
Entered: 2021-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025J202A / 1 LA / IM

Administered by: Pharmacy       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:
Diagnostic Lab Data:
CDC Split Type:

Write-up: No adverse events. The vaccine was administered in an error to the patient who is 16 year old.


VAERS ID: 959455 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Texas  
Vaccinated:2021-01-07
Onset:2021-01-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 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: none
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Client is 17 years old


VAERS ID: 959623 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Indiana  
Vaccinated:2021-01-05
Onset:2021-01-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 025L20A / 1 LA / IM

Administered by: Senior Living       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: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies: UNKNOWN
Diagnostic Lab Data: No tests were needed/done.
CDC Split Type:

Write-up: Vaccine was administered outside the FDA approved age range. There were no adverse events/reactions.


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