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This is VAERS ID 1365937

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1365937
VAERS Form:2
Age:12.0
Sex:Female
Location:Connecticut
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 EW0178 / 1 LA / IM

Administered by: Public      Purchased by: ??
Symptoms: 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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NKDA
Diagnostic Lab Data: NA
CDC 'Split Type':

Write-up: Pt received the dose 7 hours from the time the diluent added to vial. According to Pfizer , once diluent added dose must be administered within 6 hours. Pfizer contacted. Per Pfizer stability data , data supports an excursion up to 18 hours in addition to the allowed 6 hrs if doses remain in vial and not syringe.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1365937&WAYBACKHISTORY=ON


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