Received Sep 15, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (MODERNA)) | MODERNA | 1 | 3052553 | IM / LL |
My 4 year old daughter was brought into office today 09/15/25 for a 4 year old well child check up. The medical Assistant told my wife and mother of our child upon entering patient care room that patient was due for some vaccinations today. My wife asked which vaccines were being offered and medical assistant stated, DTaP-POL (KINRIX), COVID-19, HIB PRP-T, (Fluzone trivalent) (influenza) and PCV13 (PREVNAR13) (Pneumococcal conjugate, 13 valent). My wife at that time verbally declined the COVID-19 vaccine. After the MD saw our daughter for her physical exam the medical assistant came back in the room for vaccine administration. My wife had to help hold my daughter still due to her being scared of getting shots. After the vaccines were administered, the medical assistant stated that she gave four vaccines and admitted to giving COVID-19 vaccine. My wife verbally declined this vaccine and did NOT sign a consent form for this vaccine to be given. The doctor did come in afterward and apologized to my wife that it was "her fault" because she ordered it by mistake. The medical assistant also did not do a final verification with. my wife prior to injecting patient.
minor cold/ congestion
none
none
none
vaccine given today, none as of now