Report #2824178

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: 77 yrs
State: MT
Recovered: Unknown
Vaccinated: May 8, 2021
Onset: May 8, 2021
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	025B21A	IM / RA

Symptoms (2)

Extra dose administeredWrong product administered

Symptom narrative

Reported Symptoms: 10063978: WRONG VACCINE ADMINISTERED; Narrative: On 04/10/2021 Patient was administered one dose of the Janssen COVID-19 Vaccine. Patient returned on 05/08/2021 requesting his second dose. Moderna COVID-19 vaccine was then administered. The individual administering the vaccine did not review the chart prior to injection. The chart accurately showed the patient received Janssen the month prior, thus a second dose of any COVID-19 vaccine would have been inappropriate. Other Relevant HX: Other: Dose of Moderna COVID-19 vaccine given following a dose of Janssen COVID-19 vaccine