Report #2872971

Received Nov 16, 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: 31 yrs
State: CT
Recovered: Recovered
Vaccinated: Nov 1, 2025
Onset: Nov 1, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	3052668	IM / RA

Symptoms (1)

Underdose

Symptom narrative

State VFC vaccine administered incorrectly to adult patient.

Medical history

ADHD; Albuminuria; Anxiety; Autism Spectrum Disorder; Bilateral Vesicoureteral Reflux; Chronic Bilateral Otitis Media:; Developmental Delay; Diabetes Mellitus; Hearing loss; Mixed conductive & sensorineural hearing loss; Seizures

Other medications

Levetiracetam 500mg; levocarnitine 330mg; Losartan 50mg; Meloxicam 15mg; Metformin 100mg; Calcium Gluconate 500mg; Vitamin D 1000u; Vitamin B12 1000u; Hydrocortisone-acetic acid; Probiotic

Allergies

Lamotrigine; Latex; Milk; Gluten: Sulfa Drugs

Lab data

None