Your Health. Your Family. Your Choice.
|History of Changes from the VAERS Wayback Machine|
|Vaccination / Manufacturer||Lot / Dose||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA||038C21A / 1||LA / IM|
Administered by: Work Purchased by: ??
Symptoms: Interchange of vaccine products
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Other Medications: N/A
Diagnostic Lab Data: None
CDC 'Split Type':
Write-up: Participant received J&J COVID-19 vaccine on 4/11/21 and should not have received Moderna COVID vaccine. participant answered ''no'' to ever receiving a COVID-19 vaccine in the past on the prescreening questionnaire.
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