National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1424107

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1424107
VAERS Form:2
Age:17.0
Sex:Male
Location:Ohio
Vaccinated:2021-06-04
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 043B21A / 2 LA / IM

Administered by: Work      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? 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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: None
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 17 year old patient received 1st dose of the Moderna vaccine at a previous clinic on 5/7/2021 despite the vaccine only being approved for use in patients 18 years and older. Based on CDC guidance and information from the manufacturer it was recommended to vaccinate patient with a second dose of the Moderna vaccine and follow the vaccine dosing schedule. No adverse effects were reported from the patient.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1424107&WAYBACKHISTORY=ON


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