Report #2833463

Received Mar 27, 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: 33 yrs
State: IN
Recovered: Unknown
Vaccinated: Mar 22, 2025
Onset: Mar 22, 2025
Days to onset: 0
Hospital days: —

Vaccines (9)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	8081260	IM / RA
FLU3	INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)	SANOFI PASTEUR	1	u8524ca	IM / RA
HEP	HEP B (HEPLISAV-B)	DYNAVAX TECHNOLOGIES CORPORATION	1	944920	IM / LA
HEPA	HEP A (HAVRIX)	GLAXOSMITHKLINE BIOLOGICALS	1	4t93r	IM / LA
HPV9	HPV (GARDASIL 9)	MERCK & CO. INC.	1	y010466	IM / LA
IPV	POLIO VIRUS, INACT. (IPOL)	SANOFI PASTEUR	1	x1c891m	SC / RA
TDAP	TDAP (BOOSTRIX)	GLAXOSMITHKLINE BIOLOGICALS	1	333sk	IM / RA
UNK	VACCINE NOT SPECIFIED (NO BRAND NAME)	UNKNOWN MANUFACTURER	1	x027903	SC / LA
VARCEL	VARICELLA (VARIVAX)	MERCK & CO. INC.	1	y011018	SC / RA

Symptoms (1)

Product administered to patient of inappropriate age

Symptom narrative

High-Dose Flu administered to an out of age range patient

Current illness

N/A

Other medications

N/a

Allergies

N/A