Received Oct 17, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (MODERNA)) | MODERNA | UNK | — | SYR / LA |
This request is intended to report a COVID vaccine administration error by (withheld name) Pharmacy in (city, state withheld). The patient receiving the vaccine had submitted an online appointment request to Pharmacy where he specifically requested the non-mRNA vaccine (ie novavax) prior to the appointment. Upon arrival, no paperwork or confirmation was provided by Pharmacy as to what vaccine was going to be administered. The patient was then injected and thus left the Pharmacy location assuming he had received the non-mRNA version that he had specifically requested online prior to the appointment. Later that night, around 9pm, the patient?s arm started feeling sore (more sore than it had when he previously received the non-mRNA version a year before). The next morning, the patient started feeling very sick/ill (something he had not experienced previously with the non-mRNA version). After checking his online records at Pharmacy, he then learned that The vaccine the Pharmacy administered was not the non-mRNA version. Pharmacy had mistakenly administered the MRNA Spikevax, (Pharmacy incorrectly administered the Moderna SPIKEVAX mRNA instead of the requested non-mRNA version).
N/A
Multivitamin, fish oil
N/a - this report is intended to report COVID vaccine administration error (although patient has flu like symptoms and arm pain, he is managing those symptoms independently)