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This is VAERS ID 1328736

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1328736
VAERS Form:2
Age:27.0
Sex:Female
Location:Oregon
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 (JANSSEN)) / JANSSEN 1816022 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Underdose

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: NKDA
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: Administration Error - Patient received 1mL of Janssen CoVid-19 dose instead of the intended 0.5mL G1P0, 16wk5d, EDD 10/28/21, 109lb

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1328736&WAYBACKHISTORY=ON


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