Adverse Event Reporting

VAERS ID 2547981
Gender Unknown
Age
StateCode
Pharmaceutical Company MODERNA
Lot Number
Number of vaccinations
Vaccinated 2022-09-22
Onset 2022-12-29
Condition
Symptoms
  • Extra dose administered
  • No adverse event

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

Write-up

administered with a 2nd dose of the COVID-19 Vaccine Bivalent on 29Dec2022.
HCP mentioned the 1st dose of the bivalent was given on 22Sep2022; No adverse event; This spontaneous case was reported by an other health care professional and describes the occurrence of EXTRA DOSE ADMINISTERED (administered with a 2nd dose of the COVID-19 Vaccine Bivalent on 29Dec2022.
HCP mentioned the 1st dose of the bivalent was given on 22Sep2022) and NO ADVERSE EVENT (No adverse event) in an adult patient of an unknown gender who received mRNA-1273 BIVALENT .
222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.
4/BA.
5)) for COVID-19 prophylaxis.
No Medical History information was reported.
On 22-Sep-2022, the patient received dose of mRNA-1273 BIVALENT .
222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.
4/BA.
5)) (unknown route) 1 dosage form.
On 29-Dec-2022, received dose of mRNA-1273 BIVALENT .
222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.
4/BA.
5)) (unknown route) dosage was changed to .
5 milliliter.
On 29-Dec-2022, the patient experienced EXTRA DOSE ADMINISTERED (administered with a 2nd dose of the COVID-19 Vaccine Bivalent on 29Dec2022.
HCP mentioned the 1st dose of the bivalent was given on 22Sep2022) and NO ADVERSE EVENT (No adverse event).
At the time of the report, EXTRA DOSE ADMINISTERED (administered with a 2nd dose of the COVID-19 Vaccine Bivalent on 29Dec2022.
HCP mentioned the 1st dose of the bivalent was given on 22Sep2022) and NO ADVERSE EVENT (No adverse event) outcome was unknown.
For mRNA-1273 BIVALENT .
222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.
4/BA.
5)) (Unknown), the reporter considered NO ADVERSE EVENT (No adverse event) to be not related.
No further causality assessment was provided for EXTRA DOSE ADMINISTERED (administered with a 2nd dose of the COVID-19 Vaccine Bivalent on 29Dec2022.
HCP mentioned the 1st dose of the bivalent was given on 22Sep2022).
Patient was inadvertently administered with a 2nd dose of the COVID-19 Vaccine Bivalent on 29-Dec-2022.
HCP mentioned the 1st dose of the bivalent was given on 22-Sep-2022.
HCP mentioned patient did not reported any adverse event after the vaccine was given.
It was unknown if patient experienced any adverse event after previous doses of the vaccine.
No concomitant medications were reported.
No treatment medications were reported.