Report #2877264

Received Dec 10, 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: NH
Recovered: Recovered
Vaccinated: Dec 8, 2025
Onset: Dec 8, 2025
Days to onset: 0
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (MODERNA))	MODERNA	N/A	3052741	IM / RA

Symptoms (2)

Product administered to patient of inappropriate ageWrong product administered

Symptom narrative

Incorrect vaccine given. Patient was given Moderna Spikevax 12+ instead of Moderna Spikevax 6 month to 11 years old. Provider in office notified, patient notified, and state notified.

Current illness

N/A

Medical history

N/A

Other medications

Flonase nasal spray, Zyrtec tablets daily, probiotic and multivitamin

Allergies

Gluten

Lab data

N/A