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This is VAERS ID 1367694

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1367694
VAERS Form:2
Age:49.0
Sex:Female
Location:New Jersey
Vaccinated:2021-06-02
Onset:2021-06-02
Submitted:0000-00-00
Entered:2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014M20A / 1 LA / IM

Administered by: Private      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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Employee, Medical assistant took Moderna from freezer and without waiting the 2.5 hours, he drew vaccine and injected into patients arm. I I have spoke with the patient today after she left to make sure she was not feeling any unusual side effects. I am not sure of what the proper protocol is for this error is. I called the Moderna hotline and they really could not assist me in this matter.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1367694&WAYBACKHISTORY=ON


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