Report #2882807

Received Jan 22, 2026

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: Female
Age: 11 yrs
State: WI
Recovered: Unknown
Vaccinated: Jan 21, 2026
Onset: Jan 21, 2026
Days to onset: 0
Hospital days: —

Vaccines (3)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (PFIZER-BIONTECH))	PFIZER\BIONTECH	1	NA0739	IM / RA
FLU3	INFLUENZA (SEASONAL) (FLULAVAL)	GLAXOSMITHKLINE BIOLOGICALS	UNK	2T543	IM / RA
HPV9	HPV (GARDASIL 9)	MERCK & CO. INC.	2	Y019459	IM / LA

Symptoms (1)

Product administered to patient of inappropriate age

Symptom narrative

Moderna Spike Vax 6 m - 11 y was ordered. MA prepared Pfizer Combinarty 12+ was administered to PT. Provider was informed and no further action was needed.

Other medications

Cephalexin 250 MG

Allergies

Amoxicillin

Lab data

None