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This is VAERS ID 1328064

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1328064
VAERS Form:2
Age:11.0
Sex:Female
Location:Washington
Vaccinated:2021-05-18
Onset:2021-05-18
Submitted:0000-00-00
Entered:2021-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0187 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Product administered to patient of inappropriate age

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: MOTHER STATED PATIENT WAS 12 YEARS OLD AND ELIGIBLE FOR VACCINATION. PATIENT IS ONLY 11 YEARS OLD AND NOT ELIGIBLE FOR VACCINATION

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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1328064&WAYBACKHISTORY=ON


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