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This is VAERS ID 1365930

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1365930
VAERS Form:2
Age:62.0
Sex:Female
Location:Hawaii
Vaccinated:2021-06-01
Onset:2021-06-01
Submitted:0000-00-00
Entered:2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1821288 / 1 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: No adverse event, Product storage error

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: Patient was inadvertently given vaccine that was from a vial punctured approximately 6 hours and 30 minutes prior and kept in fridge, while current labelling only recommend using within 6 hours if kept in the fridge. No adverse events reported by patient at this time.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1365930&WAYBACKHISTORY=ON


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