National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1330909

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1330909
VAERS Form:2
Age:16.0
Sex:Male
Location:Michigan
Vaccinated:2021-05-19
Onset:2021-05-19
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

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: 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.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1330909&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166