Adverse Event Reporting

VAERS ID	921207
Gender	Unknown
Age
StateCode	OH
Pharmaceutical Company	MODERNA
Lot Number	039K20A
Number of vaccinations
Vaccinated
Onset	2020-12-30
Condition

Symptoms

• Product preparation issue

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations

Allergies

Laboratory Data

Write-up

RN experienced in COVID-19 vaccinations unable to remove final full 0.
5mL dose from vial - about 0.
1mL short