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Report #2870385

Received Nov 3, 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
82 yrs
State
AZ
Recovered
Unknown
Vaccinated
Nov 3, 2025
Onset
Nov 3, 2025
Days to onset
0
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNAUNK3052579IM / OT

Symptoms (1)

Underdose

Symptom narrative

PATIENT WAS GIVEN A PEDIATRIC DOSE OF SPIKEVAX (NDC: 80777-0113-80). I REPORTED THE INCIDENT TO MODERNA. FOLLOWING CDC GUIDANCE ON MANAGEMENT OF ADMINISTRATION ERROS, PTWAS GIVEN ANOTHER DOSE OF PEDIATRIC DOSE OF SPIKEVAX ON THE SAME CLINIC DAY TO MAKE IT 1 FULL DOSE FOR AN ADULT. FIRST DOSE WAS GIVEN ON HIS LEFT ARM AND THE SECOND DOSE WAS GIVEN ON HIS RIGHT ARM PER PT REQUEST.

Medical history

DIABETES

Other medications

CALCITRIOL 0.25 MCG, GABAPENTIN 400 MG, ATORVASTATIN 40 MG, TRULICITY 4.5 MG, HUMALOG KWIKPEN 200 UNIT/ML, LANTUS SOLOSTAR 100 UNIT/ML, FARXIGA 10 MG, FUROSEMIDE 20 MG

Allergies

NONE