Report #2869402

Received Oct 29, 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: 67 yrs
State: OH
Recovered: Unknown
Vaccinated: Oct 22, 2025
Onset: Oct 1, 2025
Days to onset: —
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	3	3053253	IM / LA
FLU3	INFLUENZA (SEASONAL) (FLULAVAL)	GLAXOSMITHKLINE BIOLOGICALS	UNK	4D255	IM / LA

Symptoms (1)

Underdose

Symptom narrative

Patient given pediatric dosage of Covid-19 immunization, 0.25 mL, instead of adult dosage, 0.5 mL

Other medications

None

Allergies

NKDA