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This is VAERS ID 945898

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 945898
VAERS Form:2
Age:17.0
Sex:Unknown
Location:New York
Vaccinated:2021-01-01
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Product administered to patient of inappropriate age

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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: Person who first dose of Moderna vaccine...was a 17 year old; 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 01 Jan 2021 prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 for prophylaxis of COVID-19 infection. On 01 JAN 2021, 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 on 01 Jan 2021.; Reporter''s Comments: This case concerns a 17 year old patient. The patient''s medical history is not provided. The event occurred on 01 Jan 2021 during administration of the first dose of the mRNA-1273. This report refers to a case of medication error where mRNA-1273 has been administered to the patient of inappropriate age. There were no reported adverse reaction associated with this case.


Changed on 5/7/2021

VAERS ID: 945898 Before After
VAERS Form:2
Age:17.0
Sex:Unknown
Location:New York
Vaccinated:2021-01-01
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Product administered to patient of inappropriate age

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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: Person who first dose of Moderna vaccine...was a 17 year old; 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 01 Jan 2021 prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 for prophylaxis of COVID-19 infection. On 01 JAN 2021, 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 on 01 Jan 2021.; Reporter''s Comments: This case concerns a 17 year old patient. The patient''s medical history is not provided. The event occurred on 01 Jan 2021 during administration of the first dose of the mRNA-1273. This report refers to a case of medication error where mRNA-1273 has been administered to the patient of inappropriate age. There were no reported adverse reaction associated with this case.


Changed on 5/21/2021

VAERS ID: 945898 Before After
VAERS Form:2
Age:17.0
Sex:Unknown
Location:New York
Vaccinated:2021-01-01
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 1 - / OT

Administered by: Unknown      Purchased by: ??
Symptoms: Product administered to patient of inappropriate age

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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: Person who first dose of Moderna vaccine...was a 17 year old; 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 01 Jan 2021 prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 for prophylaxis of COVID-19 infection. On 01 JAN 2021, 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 on 01 Jan 2021.; Reporter''s Comments: This case concerns a 17 year old patient. The patient''s medical history is not provided. The event occurred on 01 Jan 2021 during administration of the first dose of the mRNA-1273. This report refers to a case of medication error where mRNA-1273 has been administered to the patient of inappropriate age. There were no reported adverse reaction associated with this case.

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