Report #2869185

Received Oct 28, 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: 13 yrs
State: UT
Recovered: Not recovered
Vaccinated: Oct 25, 2025
Onset: Oct 25, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	N/A	3052995	IM / RA
FLU3	INFLUENZA (SEASONAL) (FLUCELVAX)	SEQIRUS, INC.	N/A	407003	IM

Symptoms (1)

Underdose

Symptom narrative

PEDS COVID-19 0.25 ML GIVEN IN ERROR TO 13 YEAR OLD

Current illness

UNKNOWN

Medical history

UNKNOWN

Other medications

UNKNOWN

Allergies

NKA