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This is VAERS ID 1487308

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1487308
VAERS Form:2
Age:14.0
Sex:Male
Location:Utah
Vaccinated:2021-07-08
Onset:2021-07-08
Submitted:0000-00-00
Entered:2021-07-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 048C21A / 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? 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: No adverse medical reaction. The patient is 14 years old, too young for the Moderna vaccine We have contacted the health department and moderna

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1487308&WAYBACKHISTORY=ON


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