Report #2862094

Received Sep 29, 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: 17 yrs
State: MI
Recovered: Recovered
Vaccinated: Sep 24, 2025
Onset: Sep 24, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	N/A	3052553	IM / RA

Symptoms (1)

Underdose

Symptom narrative

Patient was administered pediatric Moderna dose for patients 6 months to 11 years old. Patient was supposed to receive the adult Moderna covid vaccine dose for patients 12 years and older.

Current illness

n/a

Medical history

n/a

Other medications

Fluoxetine, methylphenidate ER

Allergies

amoxicillin, cephalosporins

Lab data

n/a