Report #2875556

Received Dec 1, 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: 73 yrs
State: NM
Recovered: Unknown
Vaccinated: Oct 8, 2022
Onset: Oct 8, 2022
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (PFIZER-BIONTECH))	PFIZER\BIONTECH	4	FP4554	IM / LA

Symptoms (2)

No adverse eventWrong product administered

Symptom narrative

Reported Symptoms: 10029436:NO ADVERSE EFFECT; 10063978:WRONG VACCINE ADMINISTERED; Narrative: 96 patients were seen in the pharmacy drive through vaccination clinic on 10/08/2022 to receive the bivalent Pfizer booster +/- the influenza vaccine; and were inadvertently given the primary series formulation instead as a booster dose. No adverse effects experienced. The primary series lot used was FP4554 exp 10/31/2022. Other Relevant HX: NA Other: primary series formulation given instead of bivalent for COVID Booster; no adverse effects experienced