Report #2866065

Received Oct 15, 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: 4 yrs
State: MI
Recovered: Unknown
Vaccinated: Oct 10, 2025
Onset: Oct 10, 2025
Days to onset: 0
Hospital days: —

Vaccines (5)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (PFIZER-BIONTECH))	PFIZER\BIONTECH	N/A	NA0846	IM
DTAP	DTAP (DAPTACEL)	SANOFI PASTEUR	5	3CA20C1	IM
FLU3	INFLUENZA (SEASONAL) (FLUZONE)	SANOFI PASTEUR	N/A	U8881CA	IM
IPV	POLIO VIRUS, INACT. (IPOL)	SANOFI PASTEUR	4	Y1D49P1	IM
MMRV	MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)	MERCK & CO. INC.	N/A	Z010729	IM

Symptoms (2)

No adverse eventProduct administered to patient of inappropriate age

Symptom narrative

No adverse event or outcome occurred. A VAERS report is being filled out because the patient was 4 years old at the time of receiving the 5-11yr old COVID formulation.

Current illness

None

Medical history

Premature Infant born at 31 weeks

Other medications

None

Allergies

Allergy to cashew nut

Lab data

None