Report #2858424

Received Sep 12, 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: 66 yrs
State: PA
Recovered: Recovered
Vaccinated: Sep 9, 2025
Onset: Sep 9, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	UNK	—	IM / LA

Symptoms (4)

Circumstance or information capable of leading to medication errorDevice connection issueSyringe issueUnderdose

Symptom narrative

As the patient was receiving the vaccine, he had jerked his arm back a little and the needle tip became dislodged slightly at the connection point to the syringe. A small amount of vaccine leaked out of the syringe. A new needle was attached and the remainder of the vaccine was givien.

Medical history

None listed

Allergies

None