Report #2874116

Received Nov 21, 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: 10 yrs
State: MI
Recovered: Unknown
Vaccinated: Nov 12, 2025
Onset: Nov 12, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	1	3052741	IM / LA

Symptoms (1)

Unevaluable event

Symptom narrative

n/a

Current illness

n/a

Medical history

n/a

Other medications

none

Allergies

none