National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1465986

History of Changes from the VAERS Wayback Machine

First Appeared on 7/16/2021

VAERS ID: 1465986
VAERS Form:2
Age:12.0
Sex:Male
Location:Guam
Vaccinated:2021-07-02
Onset:2021-07-02
Submitted:0000-00-00
Entered:2021-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038B21A / 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
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: NA
CDC 'Split Type':

Write-up: COVID19 Moderna Vaccine given to 12yrs old patient. No adverse reaction/symtoms noted after vaccine given.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1465986&WAYBACKHISTORY=ON


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