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This is VAERS ID 1450069

History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1450069
VAERS Form:2
Age:15.0
Sex:Male
Location:Oklahoma
Vaccinated:2021-06-01
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: 15 y/o inadvertently given Moderna.

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1450069&WAYBACKHISTORY=ON


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