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This is VAERS ID 929805

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History of Changes from the VAERS Wayback Machine

First Appeared on 3/19/2021

VAERS ID: 929805
VAERS Form:2
Age:16.0
Sex:Female
Location:Texas
Vaccinated:2021-01-08
Onset:2021-01-08
Submitted:0000-00-00
Entered:2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: 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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown.
Allergies: None reported from patient.
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Patient is asymptomatic, but vaccine was given to a 16 year old, where manufacturer recommends 18 years and above.


Changed on 5/7/2021

VAERS ID: 929805 Before After
VAERS Form:2
Age:16.0
Sex:Female
Location:Texas
Vaccinated:2021-01-08
Onset:2021-01-08
Submitted:0000-00-00
Entered:2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: 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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown.
Allergies: None reported from patient. patient.
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Patient is asymptomatic, but vaccine was given to a 16 year old, where manufacturer recommends 18 years and above.


Changed on 5/21/2021

VAERS ID: 929805 Before After
VAERS Form:2
Age:16.0
Sex:Female
Location:Texas
Vaccinated:2021-01-08
Onset:2021-01-08
Submitted:0000-00-00
Entered:2021-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037K20A / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: 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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown.
Allergies: None reported from patient. patient.
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Patient is asymptomatic, but vaccine was given to a 16 year old, where manufacturer recommends 18 years and above.

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