Report #2874869

Received Nov 25, 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: 14 yrs
State: LA
Recovered: Unknown
Vaccinated: Nov 19, 2025
Onset: Nov 19, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	N/A	3053238	IM / RA

Symptoms (2)

No adverse eventProduct administered to patient of inappropriate age

Symptom narrative

No adverse reaction or outcome. Vaccine for 6m to 11 years, patient 14 years old at time of administration

Current illness

none

Medical history

none

Other medications

none

Allergies

nkda

Lab data

none