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This is VAERS ID 1365931

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1365931
VAERS Form:2
Age:43.0
Sex:Female
Location:Texas
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 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0217 / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Underdose, Syringe issue

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: unknown
Current Illness: unknown
Preexisting Conditions: none listed
Allergies: no allergies
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: We had a patient get their second dose of Pfizer today but due to issues with the syringe, I believe the patient did not get the full dose. The syringe used was one provided in the ancillary supply kit. I added the 23G x 1 needle provided in the ancillary supply kit. I ensured the needle was twisted tightly so that it was secure. I drew up the dose of 0.3ml. However, the plunger in the syringe slid easily inside the syringe and the rubber stopper did not hold the dose in place very tightly. When I went to administer the dose, liquid fell down her arm as I injected the dose into her arm. I do not believe she received the full dose. I have administered another dose for the patient as recommended by Pfizer in the CDC guidance, which said to give in the opposite arm immediately with no interval.

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