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This is VAERS ID 1732592

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History of Changes from the VAERS Wayback Machine

First Appeared on 10/1/2021

VAERS ID: 1732592
VAERS Form:2
Age:28.0
Sex:Male
Location:Missouri
Vaccinated:2021-09-06
Onset:2021-09-06
Submitted:0000-00-00
Entered:2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / 2 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Expired product administered

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: APAP
Current Illness: No
Preexisting Conditions: Hepatitis C, Colostomy
Allergies: NKDA
Diagnostic Lab Data: N/A
CDC 'Split Type': MOD21/145959

Write-up: 2nd Dose of Moderna Vaccine administered on 9/6/21 from Lot #011A21A expired 8/16/21. *Site leadership consulted with the Moderna Medical Safety Department and received the below confirmation: * If the dose given in error is the first dose, a second dose should be administered 28 days later. If this dose is the second dose, the series is complete and no additional doses are needed.

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