National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1328552

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1328552
VAERS Form:2
Age:12.0
Sex:Female
Location:California
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 EW0168 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Patient did not actually have any Adverse effects, situation is when we tried to bill the patient''s vaccine, we found she already had a profile in our system for the year of 2009, called the pharmacy that gave her the flu shot in September 2020 and they confirmed that consent form marked year of 2009. I then proceed to call the mother and she confirmed at least twice that the daughter was born in 2008 and that she thinks she wrote the year wrong last year for the flu shot. However, in the evening when we tried to bill the insurance it also stated the year of 2008 was invalid DOB.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1328552&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166