National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1331205

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1331205
VAERS Form:2
Age:16.0
Sex:Male
Location:Idaho
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 003B21A / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: No adverse event

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: Moderna COVID-19 Vaccine
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient is under the age of 18. Currently, the Moderna COVID-19 vaccine has been indicated for those of 18 years of age and older. There has not been any adverse effects with the patient other than being under the age clinically indicated. The patient is 16 years old so is recommended to finish the 2-dose series in 4 weeks.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1331205&WAYBACKHISTORY=ON


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