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||027C21A / 2||RA / IM|
Administered by: Private 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: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC 'Split Type':
Write-up: Pt received Moderna vaccine on 5/4/21. Then again on 6/1/21. Was inadvertently also vaccinated with Pfizer vaccine on 6/1/21 so had both Moderna and Pfizer vaccines on the same day in different arms
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