Report #2842318

Received May 22, 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: 63 yrs
State: CA
Recovered: Unknown
Vaccinated: May 21, 2025
Onset: May 21, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	8080469	SYR / RA
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	2	8081561	SYR / RA

Symptoms (2)

No adverse eventVaccination error

Symptom narrative

Dose given in error. Patient is asymptomatic. No c/o SOB, discomfort or pain, no N/V, gait steady, auditory and vision intact. Speech clear, no c/o dizziness

Current illness

NO RECORDS OF ILLNESSES/NO KNOWN ILLNESSES AT THE TIME OF VACCINATION AND UP TO ONE MONTH PRIOR

Medical history

N/A

Other medications

ACETAMINOPHEN 650 MG PRN, AMANTADINE HCL 100 MG, ATORVASTATIN CALCIUM 40 MG, LITHIUM CARBONATE 600 MG, OLANZAPINE 10 MG, SENNOSIDES 2 TAB PRN

Allergies

NO KNOWN ALLERGIES

Lab data

N/A