National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 11/26/2021 release of VAERS data:

This is VAERS ID 1771142

Government Disclaimer on use of this data

Case Details

VAERS ID: 1771142 (history)  
Form: Version 2.0  
Age: 13.0  
Sex: Male  
Location: Texas  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Work       Purchased by: ?
Symptoms: Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Site: Pain at Injection Site-Mild, Systemic: Sore Arm for 1 day as per mom and pt has taken ibuprofen for 24 hours.-Mild, Error: Patient Too Young for Vaccine Administered-, Additional Details: Sore Arm for 1 day as per mom and pt has taken ibuprofen for 24 hours. Pharmacist has requested the immunization team to contact the patients family regarding any further notice. patient has been waiting for the call from pharmacy in order to hear anything in details. The error could have been prevented if laptops were present during the clinic and woking. we could not type a prescription as system was automatically rejecting due to age limit.

New Search

Link To This Search Result:

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