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From the 7/23/2021 release of VAERS data:

This is VAERS ID 1330909



Case Details

VAERS ID: 1330909 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-19
Onset:2021-05-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-05-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048B21A / 1 RA / IM

Administered by: Unknown       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: n/a
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: bee sting
Diagnostic Lab Data:
CDC Split Type:

Write-up: Client received Moderna over at on 4/3/21. Father brought son over to for his son second dose of Moderna. Nurse RN explained to the father that his son should have not received the Moderna due to his age, Pfizer is only given to 16yrs of age at that time of injection. So nurse called Dr. no response then called Nursing Supervisor for concerns. In the mean time Pharmacy was present and stated that he can receive the Moderna vaccine since he already received the 1st dose per Moderna guidelines so client received his 2nd dose of Moderna at Rec Center on 5/19/21 at 11;30am. Note: Nurse is educated on CDC guidelines and CDC states must be age appropriate. Will follow up tomorrow to assess condition.


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