Report #2875412

Received Nov 28, 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: 11 yrs
State: MN
Recovered: Recovered
Vaccinated: Nov 28, 2025
Onset: Nov 28, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

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

Symptoms (2)

Extra dose administeredWrong product administered

Symptom narrative

Gave 2 doses of Moderna COVID19 spikevax 0.25 mL IM. Pt mother requested flu and covid vaccinations, gave 2 doses of COVID and 0 of flu vaccines.

Current illness

None

Other medications

None

Allergies

None

Lab data

N/A