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This is VAERS ID 1329858

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1329858
VAERS Form:2
Age:17.0
Sex:Female
Location:New Jersey
Vaccinated:2021-05-18
Onset:2021-05-18
Submitted:0000-00-00
Entered:2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 022C21A / 2 LA / IM

Administered by: Pharmacy      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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Error: Patient Too Young for Vaccine Administered

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1329858&WAYBACKHISTORY=ON


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