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From the 1/14/2022 release of VAERS data:

This is VAERS ID 925282

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Case Details

VAERS ID: 925282 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-01-06
Onset:2021-01-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026L2A / 1 LA / -

Administered by: Private       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
SMQs:, Medication errors (narrow)

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: Proair Flovent
Current Illness: N/A
Preexisting Conditions: Asthma
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: No adverse reaction noted. Pt was just noted to be < 18 after vaccine administration.


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