National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

This is VAERS ID 946915

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 946915
VAERS Form:2
Age:17.0
Sex:Female
Location:New York
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 AR / IM

Administered by: Other      Purchased by: ??
Symptoms: No adverse event, 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: no adverse events reported post vaccination but was notified that a 17 year old was inadvertently administered a Moderna COVID dose #1
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: There was no adverse event from the vaccination itself but we were advised to file a report in VAERS by the vaccine manufacturer because we were notified that a 17 year old received a first dose of the Moderna vaccine before it was realized that she was under age. She and her family reported no adverse reactions from the vaccine.


Changed on 5/7/2021

VAERS ID: 946915 Before After
VAERS Form:2
Age:17.0
Sex:Female
Location:New York
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 AR / IM

Administered by: Other      Purchased by: ??
Symptoms: No adverse event, 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: no adverse events reported post vaccination but was notified that a 17 year old was inadvertently administered a Moderna COVID dose #1
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: There was no adverse event from the vaccination itself but we were advised to file a report in VAERS by the vaccine manufacturer because we were notified that a 17 year old received a first dose of the Moderna vaccine before it was realized that she was under age. She and her family reported no adverse reactions from the vaccine.


Changed on 5/21/2021

VAERS ID: 946915 Before After
VAERS Form:2
Age:17.0
Sex:Female
Location:New York
Vaccinated:2020-12-29
Onset:2020-12-29
Submitted:0000-00-00
Entered:2021-01-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 AR / IM

Administered by: Other      Purchased by: ??
Symptoms: No adverse event, 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: no adverse events reported post vaccination but was notified that a 17 year old was inadvertently administered a Moderna COVID dose #1
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: There was no adverse event from the vaccination itself but we were advised to file a report in VAERS by the vaccine manufacturer because we were notified that a 17 year old received a first dose of the Moderna vaccine before it was realized that she was under age. She and her family reported no adverse reactions from the vaccine.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=946915&WAYBACKHISTORY=ON


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166