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From the 10/8/2021 release of VAERS data:

Found 32,014 cases where Age is 12-or-more-and-under-20 and Vaccine targets COVID-19 (COVID19)



Case Details

This is page 6 out of 3,202

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VAERS ID: 915873 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Texas  
Vaccinated:2020-12-30
Onset:2020-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received the Moderna vaccine and is only 16 years old. Patient arrived with mother to the clinic, patient''s mother argued that the website stated the vaccine is for ages 16 and up. The nurse told the parent the Pfizer vaccine is for 16 and up; however, the Moderna is for 18 and up. Parent demanded and nurse went ahead and administered the vaccine at the parent & patient''s request.


VAERS ID: 915958 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2020-12-30
Onset:2020-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness:
Preexisting Conditions: asthma (reported by mother- denied by child)
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: During Covid Clinic, 17 year old was given Moderna vaccine approved for age 18 and older, Screening In system does not alert to age. Age not noted during screening. No adverse reation noted following Injection. Telephone call to mother on 12/31/20 twice with no response. Voice mail left to check status of child and request return call..


VAERS ID: 916074 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Illinois  
Vaccinated:2020-12-30
Onset:2020-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 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? Yes
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: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: MODERNA COVID-19 VACCINE EUA: Individual presented to COVID-19 vaccination clinic sponsored by Health Department being held for Healthcare Providers. Individual marked on Vaccination Consent form that she was a Medical Assistant at her father''s medical practice. After administration of vaccine it was discovered that she is 17 years old. This vaccine is not for individuals < 18 years old. Call made to CDC who advised us to call Moderna. Called Moderna and awaiting guidance/advice from Moderna Medical Information division.


VAERS ID: 916248 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Illinois  
Vaccinated:2020-12-29
Onset:2020-12-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L20A / 1 AR / IM

Administered by: Private       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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: NO ADVERSE EVENT OCCURRED A 17 year old EMS worker who was coming through out COVID-19 vaccination clinic received the vaccine. At the time, no one realized he was only 17 years old. Since the vaccine is only indicated for 18 years or older adults, I thought it best to report it here since it was technically an error. I spoke with the patient on 12/31/2020 to notify him of the error and he felt fine. He had no adverse reaction to the vaccine


VAERS ID: 916428 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Texas  
Vaccinated:2020-12-30
Onset:2020-12-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2020-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: migraines
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: hives and itching face after receiving the vaccination


VAERS ID: 916466 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Female  
Location: Montana  
Vaccinated:2020-12-28
Onset:2020-12-31
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2020-12-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 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? 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: Patient is below the minimum recommended age of 18. The patient is 17 years of age. The immunizing pharmacist neglected to catch that the patient was 17 before giving the vaccine. No adverse reactions have been reported - patient has been checked in and is fine with no symptoms or side effects. Simply reporting the dosing of an underage individual.


VAERS ID: 916610 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Female  
Location: Virginia  
Vaccinated:2020-12-29
Onset:2020-12-30
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-01-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies: jackfruit
Diagnostic Lab Data:
CDC Split Type:

Write-up: hives and rash all over body that has not gone away in 2 days since it began


VAERS ID: 917040 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2020-12-28
Onset:2020-12-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / UN

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Fatigue, Pain in extremity, Rash
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Yasmine birth control, tretinoin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Arm hurt badly about 10 hours after shot. Felt super weak and tired too the whole day and the next day. A rash started on my neck and traveled down to my collar bone area by day 4


VAERS ID: 917046 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Utah  
Vaccinated:2020-12-31
Onset:2020-12-31
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Chills, Dizziness, Fatigue, Headache
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (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: Multivitamins
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I got the vaccine sometime in the afternoon and felt fine for the 15 minutes after the time of injection. I returned to work afterwards, and later that evening I started to feel chills, but it wasn''t severe to the point where I went home. When I returned home from work, the chills remained but I also felt extremely exhausted which was unusual for me. I also had a bit of a headache/felt lightheaded. I took Tylenol which somewhat helped the symptoms. I felt fine after going to bed.


VAERS ID: 917378 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-01-02
Onset:2021-01-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Sexual dysfunction (broad)

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

Write-up: The patient sat down for 15 minutes to be observed for any reactions and told us that she had numbness on the right side of her face and right arm as well. She then told us that the numbness was spreading to her neck and right leg as well. EMS was called and took her to the hospital.


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