Age: 44.0
Sex: U
Vaccine: COVID19-2, COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: It appears the QR code on the original booster box is taking you to the bivalent information; No adverse event; I had been given the original booster instead of the bilavent booster; This spontaneous case was reported by a pharmacist and describes the occurrence of WRONG PRODUCT ADMINISTERED (I had been given the original booster instead of the bilavent booster), CIRCUMSTANCE OR INFORMATION CAPABLE OF LEADING TO MEDICATION ERROR (It appears the QR code on the original booster box is taking you to the bivalent information) and NO ADVERSE EVENT (No adverse event) in a 44-year-old patient of an unknown gender who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. AR5186C) for COVID-19 prophylaxis.     No Medical History information was reported.   On 07-Oct-2022, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Oct-2022, the patient experienced WRONG PRODUCT ADMINISTERED (I had been given the original booster instead of the bilavent booster). On an unknown date, the patient experienced CIRCUMSTANCE OR INFORMATION CAPABLE OF LEADING TO MEDICATION ERROR (It appears the QR code on the original booster box is taking you to the bivalent information) and NO ADVERSE EVENT (No adverse event). At the time of the report, WRONG PRODUCT ADMINISTERED (I had been given the original booster instead of the bilavent booster), CIRCUMSTANCE OR INFORMATION CAPABLE OF LEADING TO MEDICATION ERROR (It appears the QR code on the original booster box is taking you to the bivalent information) and NO ADVERSE EVENT (No adverse event) outcome was unknown.      For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter considered NO ADVERSE EVENT (No adverse event) to be not related. No further causality assessments were provided for WRONG PRODUCT ADMINISTERED (I had been given the original booster instead of the bilavent booster) and CIRCUMSTANCE OR INFORMATION CAPABLE OF LEADING TO MEDICATION ERROR (It appears the QR code on the original booster box is taking you to the bivalent information).    No concomitant medications were reported.  It was reported that the nurse informed that it was bivalent booster in the syringe prior to vaccination. After vaccination nurse filled out patients COVID-19 Vaccination record card where she put November date on the card instead of todays date. When the patient asked about it she said she did not know that she had to put todays date on the card and that she had wrote the expiration date on the card. She then wrote over the November date with todays date. Patient was really surprised that bivalent booster would be expired in next month.  Nurse showed original booster vial of NDC 80777-275-05 and not the bivalent booster vial. Nurse pulled in two other employees and they got the box out and it was the original booster box of NDC 80777-275-99. They had me scan the QR code, the staff had been administering original booster doses to patients instead of bivalent booster dose.  Patient had pulled the NDC number for bivalent booster on mobile, It was different color than what patient was given. The facility left patient in a room and they did not monitor patient nor given patient information on booster.  No treatment medications were reported.   This case was linked to MOD-2022-503142 (Patient Link).