Report #2840752

Received May 13, 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: 44 yrs
State: MA
Recovered: Unknown
Vaccinated: Dec 21, 2021
Onset: Dec 21, 2021
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	066H21A	IM / LA

Symptoms (1)

No adverse event

Symptom narrative

Pt was given 0.25ml twice to make 0.5ml (1 dose). Patient did not call us to report any adverse events following administration. We only knew about this event after we received the email from DPH on 12/312024.

Current illness

N/A

Medical history

N/A

Other medications

N/A

Allergies

N/A

Lab data

N/A