Report #2872347

Received Nov 12, 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: 53 yrs
State: UT
Recovered: Unknown
Vaccinated: Nov 11, 2025
Onset: Nov 11, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	N/A	3052784	IM / RA
TDAP	TDAP (BOOSTRIX)	GLAXOSMITHKLINE BIOLOGICALS	UNK	H4K3S	IM / LA

Symptoms (1)

Wrong product administered

Symptom narrative

Tdap given in error when influenza was requested. Patient notified and will follow up if any adverse affects from the error and will seek influenza dose

Current illness

UNKNOWN

Medical history

UNKNOWN

Other medications

UNKNOWN

Allergies

NKA