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From the 11/19/2021 release of VAERS data:

Found 1,103 cases where Age is 5-or-more-and-under-12 and Location is U.S., Territories, or Unknown and Vaccine is COVID19 and Vaccination Date from '2021-11-01' to '2021-12-31'

Government Disclaimer on use of this data

Table

   
AgeCountPercent
3-6 Years1109.97%
6-9 Years44640.44%
9-12 Years54749.59%
TOTAL1,103100%



Case Details

This is page 1 out of 111

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VAERS ID: 1833382 (history)  
Form: Version 2.0  
Age: 11.0  
Sex: Male  
Location: California  
Vaccinated:2021-11-01
Onset:2021-11-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH F00809 / 1 RA / IM
FLU4: INFLUENZA (SEASONAL) (FLULAVAL QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS 499ZC / 5 RA / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS F22EZ / 3 RA / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS 2K57N / 1 LA / IM
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. U007652 / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U7190AA / 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS XK524 / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. U015684 / 1 LA / SC

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? 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: Patient was only eleven years old and received Pfizer vaccine approved for ages 12 and older.


VAERS ID: 1840366 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Incorrect dose administered, No adverse event
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: Realized when documenting in the state vaccine database that I had given adult dose covid vaccine to pediatric patient. Spoke with infectious disease doctor about what to look for. Child is not currently having any side effects but may expect to have more pronounced fever, chills, etc, according to the doctor I spoke with.


VAERS ID: 1840376 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0177 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Incorrect dose administered, No adverse event
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: Realized when entering information in state database that had given adult vaccine dose to pediatric patient. informed attending. spoke with infectious disease doctor. called mother. no adverse events at this time.


VAERS ID: 1840529 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2593 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered
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: NO Prescription or OTC medications aware of
Current Illness: NO known illnesses
Preexisting Conditions: NO known chronic or long standing health conditions
Allergies: NO known allergies
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient was given Pfizer Adult. 0.2 ml of the adult formulation.


VAERS ID: 1842363 (history)  
Form: Version 2.0  
Age: 7.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: No
Preexisting Conditions: Asthma
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: She started vomiting around 11pm same day of vaccine. Projectile vomiting twice on the wall, bed, floor. Complained of headache 3 hours after vaccine. No fever.


VAERS ID: 1842555 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FG3527 / 1 LA / 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: Error: Patient too young for vaccine administered.


VAERS ID: 1842855 (history)  
Form: Version 2.0  
Age: 6.0  
Sex: Female  
Location: Indiana  
Vaccinated:2021-11-03
Onset:2021-11-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Headache
SMQs:

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: Zyrtec and daily chewable multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Mild headache on back left side of head near ear


VAERS ID: 1842912 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-11-04
Onset:2021-11-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Headache
SMQs:

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: Mother reported headache as reported by patient approximately 10 minutes after receiving vaccination. Patient alert and talkative. He had not eaten or had any liquids recently. Mother advised to give patient water and planned to retrieve a snack for him from the snack machine. Patient has a history of headaches in similar location and mother reported he tends to be very nervous with vaccines. Patient advised to monitor, may take pain reliever PRN and notify provider of any worsening or new symptoms. Mother in agreement.


VAERS ID: 1843071 (history)  
Form: Version 2.0  
Age: 10.0  
Sex: Male  
Location: D.C.  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FE3590 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Incorrect dose administered
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: On 11/3/2021, Medical assistant administered incorrect vaccine type-dose. Patient received incorrect vaccine type-dose for his age. Patient was to receive Covid-19 Pfizer Pediatric dose (0.2ml) and instead received the wrong dose of Covid-19 Pfizer dose for 12 years old and up. RN followed up with parents and they voiced understanding of the error during vaccine administration and reported patient was doing well. They agreed to monitor child for any side effect and call us to report concern.


VAERS ID: 1843077 (history)  
Form: Version 2.0  
Age: 9.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-11-03
Onset:2021-11-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-11-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FK5127 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Chest pain, Chills, Heart rate increased
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Dehydration (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Chills, pain in chest, pain in stomach, elevated heart rate Still some pain this morning, but seems to be subsiding.


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