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This is VAERS ID 1327753

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1327753
VAERS Form:2
Age:17.0
Sex:Male
Location:Washington
Vaccinated:2021-05-18
Onset:2021-05-18
Submitted:0000-00-00
Entered:2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / IM

Administered by: Public      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? No
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: None reported
Current Illness: None reported
Preexisting Conditions: None reported
Allergies: None reported
Diagnostic Lab Data: NA
CDC 'Split Type':

Write-up: Mobile clinic nurses vaccinating at residence of homebound person. Vaccinated family as well and failed to catch that young male family member was not 18 years of age but was 17 years of age. No adverse reaction to vaccine at time of administration but EUA not does not allow for vaccinating under 18 with this vaccine.

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