Report #2874186

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: 15 yrs
State: RI
Recovered: Recovered
Vaccinated: Nov 15, 2025
Onset: Nov 21, 2025
Days to onset: 6
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	N/A	3052860	IM / LA

Symptoms (1)

Underdose

Symptom narrative

Patient is 15 years old and received COVID vaccine dose meant for patients 6 months- 11 years. Spoke to State Vaccine Unit. No concerns. Advised getting 12+ dose in 8 weeks from 11/15/25.

Current illness

NONE

Medical history

GERD

Other medications

NONE

Allergies

NONE