Report #2874593

Received Nov 24, 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: 80 yrs
State: NH
Recovered: Unknown
Vaccinated: Nov 24, 2025
Onset: Nov 24, 2025
Days to onset: 0
Hospital days: —

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA MNEXSPIKE))	MODERNA	N/A	305 3824	IM / RA
FLU3	INFLUENZA (SEASONAL) (FLUZONE)	SANOFI PASTEUR	UNK	8862 AA	—

Symptoms (1)

Refusal of vaccination

Symptom narrative

Resident did not have consent for Covid vaccine. Flu vaccine was the only vaccine that consent was given for. Pharmacy technician administered Covid vaccine in error at today's vaccine clinic.

Current illness

N/A

Medical history

Parkinsons, HTN, BPH, dysphagia, Dementia

Other medications

N/A

Allergies

NKA