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Report #2824156

Received Feb 3, 2025

A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex
Male
Age
71 yrs
State
MT
Recovered
Unknown
Vaccinated
Apr 17, 2021
Onset
Apr 17, 2021
Days to onset
0
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNA3032B21AIM / RA

Symptoms (1)

Extra dose administered

Symptom narrative

Reported Symptoms: 10064366: EXTRA DOSE ADMINISTERED; Narrative: Patient received first dose of COVID-19 Moderna vaccine on 02/26/2021, Patient received second dose of COVID-19 Moderna vaccine on 03/20/2021. Patient returned to clinic on 04/17/2021 to receive what he believed was his second dose of COVID-19 vaccine. A third dose of the two dose series was administered prior to the chart being reviewed for appropriateness. When asked for his vaccination card, Patient produced two cards indicating two doses on two different dates had been given as well. These dates were then confirmed through accurate reporting in the patient's chart. Other Relevant HX: Other: Third dose of two dose series given