Report #2864020

Received Oct 7, 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: 12 yrs
State: MA
Recovered: Unknown
Vaccinated: Oct 6, 2025
Onset: Oct 6, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	UNK	3052579	IM / LA
FLU3	INFLUENZA (SEASONAL) (AFLURIA)	SEQIRUS, INC.	UNK	ax4142a	IM / LA

Symptoms (2)

Incorrect dose administeredNo adverse event

Symptom narrative

no adverse event had. gave pediatric moderna, as when patient registered for clini they were 11 years old. Paper said 11, so pediatric vaccine was given. However, pt DOB was the day before clinic, but registration was made prior to this. At th time of vaccination, pt was 12 years old (1 day of 12 years old) Technically should have received Regular adult formuation