Report #2835836

Received Apr 11, 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: Female
Age: 72 yrs
State: WA
Recovered: Unknown
Vaccinated: Jan 3, 2025
Onset: Jan 3, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	3044079	IM / RA

Symptoms (1)

Underdose

Symptom narrative

PATIENT WAS GIVEN THE PEDIATRIC FORMULATION OF THE COVID VACCINE. PATIENT WAS CONTACTED TO OFFER THE CORRECT FORMULATION BUT PATIENT DENIED THE CORRECT VACCINE AT THIS TIME AND STATES THEY WILL RECEIVE IT NEXT YEAR.

Allergies

JARDIANCE, PENICILLINS