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Report #2902807

Received Jul 7, 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
Male
Age
65 yrs
State
WI
Recovered
Unknown
Vaccinated
Jul 7, 2026
Onset
Jul 7, 2026
Days to onset
0
Hospital days

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
COVID19COVID19 (COVID19 (MODERNA))MODERNAN/A3053855IM / RA

Symptoms (1)

Underdose

Symptom narrative

patient received pediatric vaccine, instead of adult

Allergies

Sulfa