Report #2868548

Received Oct 27, 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: 4 yrs
State: WI
Recovered: Unknown
Vaccinated: Oct 22, 2025
Onset: Oct 23, 2025
Days to onset: 1
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	4	3052581	IM / LL

Symptoms (1)

Product administered to patient of inappropriate age

Symptom narrative

On 10/22/25 patient seen for a WCE with provider and received a covid high dose vaccine. This was order by accident and not a vaccine that we were going to carry. We discovered this the next day. Provider called parent to let them know and to answer any questions they may have. Provider gave information on what they should watch for as a adverse reaction. Patient is so far tolerating well.

Current illness

None

Medical history

None

Other medications

None

Allergies

No known allergies

Lab data

None