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This is VAERS ID 1331530

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1331530
VAERS Form:2
Age:16.0
Sex:Male
Location:Ohio
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 035C21A / 1 LA / IM

Administered by: Private      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 Known
Current Illness: None Known
Preexisting Conditions: Seasonal allergies
Allergies: None Known
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Administered to unauthorized age group. No known adverse events.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1331530&WAYBACKHISTORY=ON


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