Adverse Event Reporting

VAERS ID 2556617
Gender Female
Age 9
StateCode FR
Pharmaceutical Company MODERNA
Lot Number 057A22A
Number of vaccinations 1
Vaccinated 2022-12-30
Onset 2022-12-30
Condition
Symptoms
  • No adverse event
  • Wrong product administered

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

Write-up

No adverse event; They incorrectly received a 0.
5 mL dose from the adult Moderna COVID-19 vaccine vial; This spontaneous case was reported by an other health care professional and describes the occurrence of WRONG PRODUCT ADMINISTERED (They incorrectly received a 0.
5 mL dose from the adult Moderna COVID-19 vaccine vial) and NO ADVERSE EVENT (No adverse event) in a 9-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no.
057A22A) for COVID-19 prophylaxis.
No Medical History information was reported.
On 30-Dec-2022, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .
5 milliliter.
On 30-Dec-2022, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced WRONG PRODUCT ADMINISTERED (They incorrectly received a 0.
5 mL dose from the adult Moderna COVID-19 vaccine vial).
On an unknown date, the patient experienced NO ADVERSE EVENT (No adverse event).
At the time of the report, WRONG PRODUCT ADMINISTERED (They incorrectly received a 0.
5 mL dose from the adult Moderna COVID-19 vaccine vial) and NO ADVERSE EVENT (No adverse event) outcome was unknown.
For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter considered NO ADVERSE EVENT (No adverse event) to be not related.
No further causality assessment was provided for WRONG PRODUCT ADMINISTERED (They incorrectly received a 0.
5 mL dose from the adult Moderna COVID-19 vaccine vial).
No concomitant medications were reported.
HCP states that it was recently discovered that 2 pediatric patients were administered the first dose of the Moderna COVID-19 vaccine from an incorrect vial.
They incorrectly received a 0.
5 mL dose from the adult Moderna COVID-19 vaccine vial as the facility does not carry the pediatric vials.
No adverse reactions have been reported by any patients so far.
No treatment medication was provided.
This case was linked to MODERNATX, INC.
-MOD-2023-694997 (E2B Linked Report).
Sender's Comments: MODERNATX, INC.
-MOD-2023-694997:Same reporter